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Certified Pediatric Nurse Exam

Subjects : certifications, health-sciences, nursing

Instructions:

Answer 50 questions in 15 minutes.
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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. Pathophysiology of celiac disease
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
No - it can only be controlled
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium

2. What is the cause of mononucleosis and its method of transmission?
Epstein Barr Virus - transmitted with intimate contact
Equal to
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash

3. Nursing care for Cystic Fibrosis
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
Length Chart
provide airway clearance (CPT - postural drainage - coughing & deep breathing) prevent infection - aggressively treat any infection with IV antibiotics - pt family education - adequate nutrition - psychosocial support

4. Signs of increased ICP
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Low fiber - high calorie and protein
Excessive stool fat

5. Males Reproductive issues for CF patients
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Sterile-caused by blockage of thick mucous at the vas deferens
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis

6. Treatment for mononucleosis
Repeated involuntary urination in a child who should already by toilet trained at night
none
Viral---Varicella or influenza
Penicillin Prophylaxis (BID)

7. What is used to diagnose pyloric stenosis?
They are people - need a balance of limits and independence
Abdominal ultrasound - Upper GI
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant

8. What is heart failure?
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
< 1
Salicylates
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

9. signs and symptoms of meningitis in older children
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
parainfluenza - RSV - Influenza A&B - M. pneumonia
5ml/dl

10. Varicella communicable
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
12 years
Barium enema
Dust - mold - animal dander - viral infections

11. Basic defect in coarctation of the aorta
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
A narrowing within the Aorta resulting in collateral circulation
Liver Biopsy

12. What is broncho-pulmonary dysplasia?
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
13 years
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth

13. Treatment and nursing care for pertussis
gum hypertrophy
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
measures the largest velocity which occurs during a forced exhale
< 1

14. Side effects of benzodiazepines
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
drooling
MVA - bike accidents and falls
Erythroblastosis Fetalis

15. Prevention of bronchiolitis spreading
Contact isolation - gown - gloves and handwashing
diazepam - lorazapam
Small bowel biopsy
5ml/dl

16. Asthma
BMI chart
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
parainfluenza - RSV - Influenza A&B - M. pneumonia
Maternal infection - premature rupture of membranes

17. Part of body that grows the fastest in infancy
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
head
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
fever and infection

18. Treatment of a bleed in hemophilia
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
passage of abdominal contents to the esophagus
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
poor feeding - wt loss - fatigue - develop. delays - edema

19. Can Asthma be cured?
poor feeding - wt loss - fatigue - develop. delays - edema
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
No - it can only be controlled
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects

20. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
36 months
prevention - po antibiotics should be given before and after an invasive procedure

21. Clinicla manifestations of sickle cell disease
Bacteria enter the blood stream from a site of localized infection and grows in the heart
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
parainfluenza - RSV - Influenza A&B - M. pneumonia
Vaso-occulisive crisis - infection and sepsis

22. Nursing interventions for hemophilia
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
Sterile-caused by blockage of thick mucous at the vas deferens
Epstein Barr Virus - transmitted with intimate contact

23. Pathophysiology of Acute Asthma
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
Swelling of the airways - mucous production - bronchospasms

24. What promotes unsickling of RBC's?
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Adequate O2 adequatte hydration
Airborne and contact
Repeated involuntary urination in a child who should already by toilet trained at night

25. Age that birth length doubles
3 years
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
4 years
2 years

26. Post Op treatment of a VP shunt
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
poor feeding - wt loss - fatigue - develop. delays - edema
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

27. What is Pyloric stenosis?
10 inches
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
MVA - bike accidents and falls

28. Signs and symptoms of tuberculosis
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
Dust - mold - animal dander - viral infections
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain

29. Pancreatic enzyme therapy for cystic fibrosis is adjusted based on what factors growth and development?
Adequate O2 adequatte hydration
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Vaso-occulisive crisis - infection and sepsis
# of stools per day - goal=2-3 stools per day

30. Treatment for Varicella
Phototherapy - exchange transfusion
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
Urethral opening is positioned below the glans penis
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine

31. Kawasaki Disease
Growth spurt
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
A typical lymphocytosis - mono-spot - EBV serology
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

32. Treatment of celiac disease
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
maternal nutrition and genetics
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain

33. Teaching for RSV
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
Less than 120 f.
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration

34. What is epiglottitis?
E. Coli
2 snacks
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
chest x-ray following a Positive PPD skin test

35. What is an acute otitis media?
poor feeding - wt loss - fatigue - develop. delays - edema
E. Coli
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
inflammation located in the middle ear

36. Hirschsprung's Disease
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
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds

37. Asthma inhaler - what can be done to decrease risk of thrush
1-6 months
Rinse mouth and brush teeth
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
5 inches

38. Cause of bronchiolitis
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)

39. Key nursing intervention for subacute bacterial endocarditis
drooling
GERD is the complications and symptoms that happen because of GER
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
prevention - po antibiotics should be given before and after an invasive procedure

40. What are the four main causes of viral croup?
inflammation and hypersensitivity to triggers
parainfluenza - RSV - Influenza A&B - M. pneumonia
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
School age

41. S/sx of GERD
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
Penicillin Prophylaxis (BID)
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis

42. Treatment for Hirschsprungs
Hepatoxicity - pancreatitis
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
hearing loss - scarring - mastoiditis - meningitis
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

43. Define Magical thinking

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44. Temp of home water heater to avoid burns
Rinse mouth and brush teeth
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Small bowel biopsy
Less than 120 f.

45. Diet for a child with glumerlonephritis
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
Vaso-occulisive crisis - infection and sepsis
Between 6-12 months
Regular diet with low sodium an no added salt

46. Steatorrhea
Excessive stool fat
from trunk to extremities
6 months
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)

47. BMI - underweight
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
MVA - bike accidents and falls
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
< 5%

48. Pathophysiology related to Head Trauma
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
Equal to
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
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure

49. Leading cause of head injury
# of stools per day - goal=2-3 stools per day
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
MVA - bike accidents and falls
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice

50. treatment of intussusception
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Previous history of life threatening reaction - Mod-severe illness w/wo fever

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