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Certified Pediatric Nurse Exam

Subjects : certifications, health-sciences, nursing

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. What is Cystic Fibrosis?
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
dysfunction of the lower esophageal sphincter and delayed gastric emptying time

2. Diagnose Intussusception by
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
Barium enema
Milk - Ice cream - Malts - Grains
Directly related to force - Acceleration-Deceleration= brain striking part of skull - Shearing force= stretching caused by unequal rate of movement of the brain tissue resulting in small tearing of the cerbral vessels

3. What can promote dryness in a child with enuresis?
Airborne and contact
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

4. Contraindications to all vaccines
up to 14 days
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
poor feeding - wt loss - fatigue - develop. delays - edema
Previous history of life threatening reaction - Mod-severe illness w/wo fever

5. What is the rate of growth each year from 3 yrs until puberty?
3 years
measures the largest velocity which occurs during a forced exhale
Equal to
2.5 inches

6. Signs and Symptoms of Hemolytic Disease of the newborn
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
lethargy - irritability - decrease feedings - fever - seizures
Repeated involuntary urination in a child who should already by toilet trained at night
Cool mist therapy - encourage oral intake - s/sx of resp. distress

7. Steatorrhea
Excessive stool fat
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
head
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

8. What interventions prevent urinary tract infections?
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
used for prolonged sz's
inflammation located in the middle ear

9. Treatment of a bleed in hemophilia
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
Adequate O2 adequatte hydration

10. Clinical signs of infection wilth sickle cell disease
Repeated involuntary urination in a child who should already by toilet trained at night
up to 14 days
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Between 6-12 months

11. Hourly maintenance Fluid Requirements
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
20 inches
Directly related to force - Acceleration-Deceleration= brain striking part of skull - Shearing force= stretching caused by unequal rate of movement of the brain tissue resulting in small tearing of the cerbral vessels
< 1

12. Nursing care for a child with Reye's Syndrome
Phototherapy - exchange transfusion
Growth spurt
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

13. Treatment of celiac disease
Mechanical Ventalation - high inhaled o2 concentration
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
glutten free diet - no wheat - rye - barley and oats - may use corn - rice - millet - multivitam - folic acid -iron. Avoid high fiber during periods of bowel inflammation
A mild self limiting condition affecting 50% of newborns because of increin - increase RBC Hemolysis - Decrease in RBC life span - decrease ability to conjugate bilirubrubin - decrease ability to excrete bilirubin in feces

14. Age that birth length doubles
4 years
3 years
A typical lymphocytosis - mono-spot - EBV serology
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)

15. Pathophysiology of Acute Asthma
1-6 months
Airborne and contact
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Swelling of the airways - mucous production - bronchospasms

16. At what age is a length board required?
School age
0-24 months
A narrowing within the Aorta resulting in collateral circulation
high protien and calorie - multivitamins - extra enzymes for high fat food

17. S/Sx of pyloric stenosis
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
9 months
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen

18. Predisposing factors to subacute bacterial endocarditis
Dental procedures - gum disease and urinary tract infections
Erythroblastosis Fetalis
Equal to
hearing loss - scarring - mastoiditis - meningitis

19. Causes of Bronchopulmonary Dysplasia
Mechanical Ventalation - high inhaled o2 concentration
High persistent fever for 5 days - swelling of the conjunctiva w/o drainage - inflammation of the mouth-lips-tongue - swollen red hands & feet - rash - cervical lymphadinopathy
Abdominal ultrasound - Upper GI
# of stools per day - goal=2-3 stools per day

20. Normal Bilirubin
< 1
fecal soiling
Sterile-caused by blockage of thick mucous at the vas deferens
dysfunction of the lower esophageal sphincter and delayed gastric emptying time

21. Males Reproductive issues for CF patients
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
from trunk to extremities
Sterile-caused by blockage of thick mucous at the vas deferens
2.5 inches

22. Characteristics of the RBC's in sickle cell

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23. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Length Chart
glutten free diet - no wheat - rye - barley and oats - may use corn - rice - millet - multivitam - folic acid -iron. Avoid high fiber during periods of bowel inflammation
Directly related to force - Acceleration-Deceleration= brain striking part of skull - Shearing force= stretching caused by unequal rate of movement of the brain tissue resulting in small tearing of the cerbral vessels

24. What level does the bilirubin need to be at in order for jaundice to occur?
5ml/dl
>95%
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
0-24 months

25. Treatment of Kawasaki disease
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
larger
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
Erythroblastosis Fetalis

26. Signs and Symptoms of mononucleosis
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Barium enema

27. treatment of hemolytic disease of the newborn
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
2.5 inches
Phototherapy - exchange transfusion

28. Puberty for boys
A narrowing within the Aorta resulting in collateral circulation
E. Coli
12 years
trunk

29. Pancreatic enzyme therapy for cystic fibrosis is adjusted based on what factors growth and development?
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
decrease in myocardial contractility - cause congestion of the circulatory system. the heart is unable to pump adequate amounts of bld to meet the bodys needs
# of stools per day - goal=2-3 stools per day

30. Part of body that grows the fastest in infancy
head
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Dental procedures - gum disease and urinary tract infections
13 years

31. Treatment for Hirschsprungs
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
larger
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
A mild self limiting condition affecting 50% of newborns because of increin - increase RBC Hemolysis - Decrease in RBC life span - decrease ability to conjugate bilirubrubin - decrease ability to excrete bilirubin in feces

32. At 6-24 months - head circumference is what size in relationship to chest circumference
2 snacks
Equal to
Triple
Regular diet with low sodium an no added salt

33. When does the surgery to correct hypospadias usually occur?
Low fiber - high calorie and protein
Between 6-12 months
10 inches
5ml/dl

34. Neonatal Jaundice
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
2 years
Dental procedures - gum disease and urinary tract infections

35. Hirschsprung's Disease
Successful management is based on early diagnosis and aggressive therapy
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Liver Biopsy
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

36. Signs and Symptoms of Bilirubin Kernicterus (encephalopathy)
Sterile-caused by blockage of thick mucous at the vas deferens
lethargy - irritability - decrease feedings - fever - seizures
used for prolonged sz's
Previous history of life threatening reaction - Mod-severe illness w/wo fever

37. Two important assessment rules related to coarctation of the aorta?
Mechanical Ventalation - high inhaled o2 concentration
Brain damage - hearing loss and learning disabilities
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
glutten free diet - no wheat - rye - barley and oats - may use corn - rice - millet - multivitam - folic acid -iron. Avoid high fiber during periods of bowel inflammation

38. Key nursing intervention for subacute bacterial endocarditis
prevention - po antibiotics should be given before and after an invasive procedure
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
School age
Maternal infection - premature rupture of membranes

39. Asthma inhaler - what can be done to decrease risk of thrush
double birth weight
Length Chart
Directly related to force - Acceleration-Deceleration= brain striking part of skull - Shearing force= stretching caused by unequal rate of movement of the brain tissue resulting in small tearing of the cerbral vessels
Rinse mouth and brush teeth

40. Average rate of growth for the 1st year
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
< 5%
10 inches
Growth spurt

41. Kawasaki Disease
Between 6-12 months
MVA - bike accidents and falls
High persistent fever for 5 days - swelling of the conjunctiva w/o drainage - inflammation of the mouth-lips-tongue - swollen red hands & feet - rash - cervical lymphadinopathy
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

42. Average rate of growth for the 2nd year of lif
poor feeding - wt loss - fatigue - develop. delays - edema
School age
5 inches
Dust - mold - animal dander - viral infections

43. ABG
larger
O2 status of blood - acid-base balance
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death

44. Most cases of Reye's Syndrome follows what type of illness?
Phototherapy - exchange transfusion
Viral---Varicella or influenza
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Bacteria enter the blood stream from a site of localized infection and grows in the heart

45. What is Pyloric stenosis?
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
fever and infection
Triple

46. BMI-@ risk for overweight
drooling
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Epstein Barr Virus - transmitted with intimate contact
85-95%

47. Screening for overweight or underweight child on chart
Successful management is based on early diagnosis and aggressive therapy
from head to toe
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
BMI chart

48. Pathophysiology of hirschsprung's disease
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
Give freedom and choices - save battles for the important things
Penicillin Prophylaxis (BID)
Phototherapy - exchange transfusion

49. Growth spurt for adolescent boys
measures the largest velocity which occurs during a forced exhale
Adequate O2 adequatte hydration
Mid puberty
Liver Biopsy

50. Can Asthma be cured?
13 years
Low fiber - high calorie and protein
No - it can only be controlled
Day 3 of life