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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. Nursing care of the infant with pyloric stenosis
Dust - mold - animal dander - viral infections
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
MVA - bike accidents and falls
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film

2. Encoperesis
fecal soiling
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
up to 14 days
from head to toe

3. Treatment of Kawasaki disease
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
12 years
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
BMI chart

4. Signs and Symptoms of intussusception
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
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

5. Two examples of benzodiazepines
Airborne and contact
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
diazepam - lorazapam

6. What confirms a positive TB infection?
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
chest x-ray following a Positive PPD skin test
Contact isolation - gown - gloves and handwashing
Cool mist therapy - encourage oral intake - s/sx of resp. distress

7. 2 key factors to consider when caring for a preschooler
2 snacks
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
They are people - need a balance of limits and independence
1-6 months

8. Asthma inhaler - what can be done to decrease risk of thrush
passage of abdominal contents to the esophagus
Sterile-caused by blockage of thick mucous at the vas deferens
inflammation and hypersensitivity to triggers
Rinse mouth and brush teeth

9. Non-pharmalogical measures to treat GER
>95%
inflammation located in the middle ear
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
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

10. Why is early diagnosis important w. Reye's Syndrome?
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
13 years
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
Successful management is based on early diagnosis and aggressive therapy

11. Pathophysiology of Chronic Asthma
Adequate O2 adequatte hydration
3 years
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
inflammation and hypersensitivity to triggers

12. Part of the body that grows the fastest in the toddler-preschool age
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
trunk
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications

13. Side effects of benzodiazepines
Mid puberty
drooling
Regular diet with low sodium an no added salt
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

14. 3 main causes of Bacterial meningitis in children
prevention - po antibiotics should be given before and after an invasive procedure
A narrowing within the Aorta resulting in collateral circulation
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months

15. How is Celiac Disease diagnosed?
Small bowel biopsy
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Contact isolation - gown - gloves and handwashing
Delayed puberty - viscous cervical secretions - difficulty getting pregnant

16. Pathophysiology of cystic fibrosis
Vaso-occulisive crisis - infection and sepsis
trunk
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function

17. Cephalocaudal
double birth weight
Contact isolation - gown - gloves and handwashing
from head to toe
36 months

18. Neonatal Jaundice
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system

19. Nursing care for child with seizure

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20. BMI-@ risk for overweight
85-95%
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects

21. Nursing care of patient with Meningitis
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
A narrowing within the Aorta resulting in collateral circulation
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

22. What are development considerations for hemophilia?
Liver Biopsy
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Equal to
Give freedom and choices - save battles for the important things

23. Signs and symptoms of tuberculosis
inflammation located in the middle ear
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
Mechanical Ventalation - high inhaled o2 concentration
Enteropathy caused by an insensitivity to the gluten found in wheat

24. Nursing interventions for hemophilia
Viral---Varicella or influenza
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Enteropathy caused by an insensitivity to the gluten found in wheat
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds

25. ABG
O2 status of blood - acid-base balance
Excessive stool fat
13 years
Small bowel biopsy

26. Complications of acute otitis media
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
fecal soiling
O2 status of blood - acid-base balance
hearing loss - scarring - mastoiditis - meningitis

27. How many days after birth do bilirubin levels return to normal limits?
passage of abdominal contents to the esophagus
12-24 days
School age
An Acute inflamation of the meninges and CSF often caused by Enterovirus

28. signs and symptoms of meningitis in older children
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Liver Biopsy
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system

29. Two important assessment rules related to coarctation of the aorta?
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Enteropathy caused by an insensitivity to the gluten found in wheat
Mechanical Ventalation - high inhaled o2 concentration
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures

30. Age range that is appropriate to use a length chart
Triple
No - it can only be controlled
birth-36 months
Sterile-caused by blockage of thick mucous at the vas deferens

31. Signs and symptoms of varicella Prodromal
Dental procedures - gum disease and urinary tract infections
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
chest x-ray following a Positive PPD skin test

32. Treatment for Hirschsprungs
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Foreskin is used during the surgical repair
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

33. 3 symptoms of coarctation of the aorta
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Bacteria enter the blood stream from a site of localized infection and grows in the heart
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2

34. Kawasaki Disease
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
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
An Acute inflamation of the meninges and CSF often caused by Enterovirus

35. What should a child's wt be at 1 yr compared to birth weight?
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Triple

36. Pathophysiology of intussusception

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37. Age group affected by mononucleosis
<25 yrs old
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Group B Streptococcus
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

38. Risk factors of tuberculosis
crowded living conditions - homeless and low income
Give freedom and choices - save battles for the important things
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
Contact isolation - gown - gloves and handwashing

39. Signs and Symptoms of Hemolytic Disease of the newborn
Barium enema
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption

40. Diastat rectal diazepam gel

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41. What Pharmalogical measures can be used to treat GERD?
Between 6-12 months
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
10 inches
A narrowing within the Aorta resulting in collateral circulation

42. What is Cystic Fibrosis?
2.5 inches
< 5%
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US

43. Etiology of GERD
Repeated involuntary urination in a child who should already by toilet trained at night
Airborne and contact
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
36 months

44. Average Birth Length
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
Kawasaki disease - w/o treatment 25% will have permanent heart damage
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
20 inches

45. Equipment used to measure a 24 to 36 month old height
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
Length board standiometer
Repeated involuntary urination in a child who should already by toilet trained at night
36 months

46. Rheumatic Fever
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
up to 14 days
Previous history of life threatening reaction - Mod-severe illness w/wo fever

47. Considerations should be taken when treating a child with cystic fibrosis who has a ___________ tx promptly since bacterial colonization increases destruction of lung tissue----prevention is key
fever and infection
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
none

48. What level does the bilirubin need to be at in order for jaundice to occur?
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
5ml/dl
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
Foreskin is used during the surgical repair

49. What are the four main causes of viral croup?
13 years
Previous history of life threatening reaction - Mod-severe illness w/wo fever
School age
parainfluenza - RSV - Influenza A&B - M. pneumonia

50. What is epiglottitis?
inflammation located in the middle ear
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Urethral opening is positioned below the glans penis
Length Chart