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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.
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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. GER (gastroesophageal reflux)
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
36 months
Epstein Barr Virus - transmitted with intimate contact
passage of abdominal contents to the esophagus

2. How is mononucleosis diagnosed
one portion of the intestine 'telescopes' into another leading to lymphatic and venous obstruction which causes ischemia - mucous backflow into the intestine and leaking of blood into the intestine
Salicylates
2 snacks
A typical lymphocytosis - mono-spot - EBV serology

3. Leading cause of acquired heart disease in children
4 years
Less than 120 f.
measures the largest velocity which occurs during a forced exhale
Kawasaki disease - w/o treatment 25% will have permanent heart damage

4. Sequence of resp distress
Time and discription of seizure
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
passage of abdominal contents to the esophagus

5. What is broncho-pulmonary dysplasia?
Bacteria enter the blood stream from a site of localized infection and grows in the heart
one portion of the intestine 'telescopes' into another leading to lymphatic and venous obstruction which causes ischemia - mucous backflow into the intestine and leaking of blood into the intestine
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
crowded living conditions - homeless and low income

6. Kawasaki Disease
parainfluenza - RSV - Influenza A&B - M. pneumonia
Rinse mouth and brush teeth
Dust - mold - animal dander - viral infections
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

7. 3 symptoms of coarctation of the aorta
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
one portion of the intestine 'telescopes' into another leading to lymphatic and venous obstruction which causes ischemia - mucous backflow into the intestine and leaking of blood into the intestine
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

8. What should a child's wt be at 1 yr compared to birth weight?
Triple
maternal nutrition and genetics
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Contact isolation - gown - gloves and handwashing

9. Side effects of benzodiazepines
Barium enema
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
drooling

10. Signs and symptoms of neonatal meningitis
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
< 5%
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

11. Hirschsprung's Disease
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
Brain damage - hearing loss and learning disabilities
from head to toe
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine

12. Characteristics of the RBC's in sickle cell

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13. Head circumference should be assessed until what age
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
3 years
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Between 6-12 months

14. Hourly maintenance Fluid Requirements
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
high protien and calorie - multivitamins - extra enzymes for high fat food

15. Post Op treatment of a VP shunt
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Bacteria enter the blood stream from a site of localized infection and grows in the heart

16. Cephalocaudal
13 years
from head to toe
parainfluenza - RSV - Influenza A&B - M. pneumonia
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

17. Pancreatic enzyme therapy for cystic fibrosis is adjusted based on what factors growth and development?
# of stools per day - goal=2-3 stools per day
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Abdominal ultrasound - Upper GI
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications

18. Diet for CF patients
high protien and calorie - multivitamins - extra enzymes for high fat food
9 months
Small bowel biopsy
Day 3 of life

19. Viral Meningitis
2 years
A typical lymphocytosis - mono-spot - EBV serology
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Bacteria enter the blood stream from a site of localized infection and grows in the heart

20. What confirms a positive TB infection?
head
from trunk to extremities
2 snacks
chest x-ray following a Positive PPD skin test

21. What is physiologic Jaundice?
Triple
Dental procedures - gum disease and urinary tract infections
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
parainfluenza - RSV - Influenza A&B - M. pneumonia

22. What is used to diagnose GER?
Dust - mold - animal dander - viral infections
inflammation and hypersensitivity to triggers
Contact isolation - gown - gloves and handwashing
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor

23. Screening for overweight or underweight child on chart
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Triple
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
BMI chart

24. What foods are prohibited for a person with Celiac Disease?
6 months
< 5%
A narrowing within the Aorta resulting in collateral circulation
Milk - Ice cream - Malts - Grains

25. Signs and Symptoms of Asthma
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
3 years
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

26. Diagnose Reye's Syndrome
Between 6-12 months
Swelling or obstruction of the Larynx
Liver Biopsy
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system

27. Two important assessment rules related to coarctation of the aorta?
O2 status of blood - acid-base balance
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures

28. What level does the bilirubin need to be at in order for jaundice to occur?
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
parainfluenza - RSV - Influenza A&B - M. pneumonia
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
5ml/dl

29. Puberty for boys
MVA - bike accidents and falls
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
They are people - need a balance of limits and independence
12 years

30. Term infant --Bilirubin peaks at what day of life
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Day 3 of life
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
3 years

31. What are the four main causes of viral croup?
An Acute inflamation of the meninges and CSF often caused by Enterovirus
parainfluenza - RSV - Influenza A&B - M. pneumonia
from trunk to extremities
Hepatoxicity - pancreatitis

32. What are development considerations for hemophilia?
Regular diet with low sodium an no added salt
double birth weight
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection

33. What Pharmalogical measures can be used to treat GERD?
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Time and discription of seizure
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks

34. Pertussis?
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
>95%
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
inflammation and hypersensitivity to triggers

35. At birth - head circumference is ____ compared to chest circumference
Bacteria enter the blood stream from a site of localized infection and grows in the heart
larger
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Dental procedures - gum disease and urinary tract infections

36. What is the rate of growth each year from 3 yrs until puberty?
Milk - Ice cream - Malts - Grains
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
Liver Biopsy
2.5 inches

37. 2 key factors to consider when caring for a preschooler
They are people - need a balance of limits and independence
Viral---Varicella or influenza
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
birth-36 months

38. Complications related to varicella
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice

39. Complications of acute otitis media
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
hearing loss - scarring - mastoiditis - meningitis
diazepam - lorazapam

40. Teaching for Mononucleosis
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
GERD is the complications and symptoms that happen because of GER
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
Triple

41. Treatment of Kawasaki disease
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
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

42. Incubation period for TB
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
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
from head to toe
1-6 months

43. Treatment of a bleed in hemophilia
one portion of the intestine 'telescopes' into another leading to lymphatic and venous obstruction which causes ischemia - mucous backflow into the intestine and leaking of blood into the intestine
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
2.5 inches

44. What occurs in a subacute baterial endocarditis?
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Airborne and contact
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Rinse mouth and brush teeth

45. Females reproductive issues for CF patients
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
measures the largest velocity which occurs during a forced exhale

46. Varicella communicable
12-24 days
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
fever - malaise - poor appetite - wt loss -cough - night sweats and chills

47. Signs and symptoms of varicella Prodromal
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
Maternal infection - premature rupture of membranes
from head to toe
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days

48. Two examples of benzodiazepines
diazepam - lorazapam
Previous history of life threatening reaction - Mod-severe illness w/wo fever
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
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages

49. What interventions prevent urinary tract infections?
GERD is the complications and symptoms that happen because of GER
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
maternal nutrition and genetics

50. Another name for Hemolytic Disease of the Newborn
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
Successful management is based on early diagnosis and aggressive therapy
Erythroblastosis Fetalis
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth

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Certified Pediatric Nurse Exam

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