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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 for a child with Reye's Syndrome
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
measures the largest velocity which occurs during a forced exhale
diazepam - lorazapam

2. Pathophysiology of cystic fibrosis
Equal to
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
Between 6-12 months
5ml/dl

3. S/sx of GERD
hearing loss - scarring - mastoiditis - meningitis
trunk - gonads and associative tissue
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

4. Head circumference should be assessed until what age
Previous history of life threatening reaction - Mod-severe illness w/wo fever
3 years
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
fever - malaise - poor appetite - wt loss -cough - night sweats and chills

5. Treatment of Kawasaki disease
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening

6. Treatment and nursing care for pertussis
<25 yrs old
Vaso-occulisive crisis - infection and sepsis
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping

7. Rheumatic Fever
Cool mist therapy - encourage oral intake - s/sx of resp. distress
complete physical and psychosocial assessment to rule out underlying disorders
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing

8. Why is early diagnosis important w. Reye's Syndrome?
complete physical and psychosocial assessment to rule out underlying disorders
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
Successful management is based on early diagnosis and aggressive therapy
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support

9. Incubation period for TB
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
1-6 months
up to 14 days

10. Teaching for Mononucleosis
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
Cool mist therapy - encourage oral intake - s/sx of resp. distress
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void

11. Signs and Symptoms of Bilirubin Kernicterus (encephalopathy)
used for prolonged sz's
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
lethargy - irritability - decrease feedings - fever - seizures

12. Why avoid circumcision in a baby with hypospadias?
Foreskin is used during the surgical repair
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
They are people - need a balance of limits and independence
double birth weight

13. What are the four main causes of viral croup?
measures the largest velocity which occurs during a forced exhale
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Epstein Barr Virus - transmitted with intimate contact
parainfluenza - RSV - Influenza A&B - M. pneumonia

14. S/Sx of pyloric stenosis
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
Regular diet with low sodium an no added salt

15. signs and symptoms of meningitis in older children
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Triple
12 years
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash

16. At 6-24 months - head circumference is what size in relationship to chest circumference
Repeated involuntary urination in a child who should already by toilet trained at night
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Equal to
MVA - bike accidents and falls

17. What are the S/SX of bleeds in hemophilia?
older preschool age and young school age-believe that they have caused an event such as a sibling's illness or hospitalization is a form of punishment
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
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
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)

18. Normal Bilirubin
Bacteria enter the blood stream from a site of localized infection and grows in the heart
< 1
0-24 months
Mechanical Ventalation - high inhaled o2 concentration

19. Part of body that grows the fastest in infancy
Dental procedures - gum disease and urinary tract infections
Urethral opening is positioned below the glans penis
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
head

20. Linear growth event happens in Adolescents
Growth spurt
BMI chart
They are people - need a balance of limits and independence
Group B Streptococcus

21. Risk factors of tuberculosis
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
A typical lymphocytosis - mono-spot - EBV serology
crowded living conditions - homeless and low income
Rinse mouth and brush teeth

22. Precaustions needed for pt's with varicella
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
They are people - need a balance of limits and independence
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Airborne and contact

23. Celiac Disease
Dust - mold - animal dander - viral infections
lethargy - irritability - decrease feedings - fever - seizures
poor feeding - wt loss - fatigue - develop. delays - edema
Enteropathy caused by an insensitivity to the gluten found in wheat

24. Treatment for Varicella
prevention - po antibiotics should be given before and after an invasive procedure
up to 14 days
chest x-ray following a Positive PPD skin test
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)

25. Age range that is appropriate to use a length chart
Growth spurt
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
birth-36 months

26. Nursing care for Kawasaki Disease
Rinse mouth and brush teeth
12-24 days
1-6 months
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks

27. Nursing care of patient with Meningitis
chest x-ray following a Positive PPD skin test
Penicillin Prophylaxis (BID)
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Adequate O2 adequatte hydration

28. Bronchiolitis
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Repeated involuntary urination in a child who should already by toilet trained at night
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
36 months

29. Clinical signs of infection wilth sickle cell disease
parainfluenza - RSV - Influenza A&B - M. pneumonia
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Erythroblastosis Fetalis
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death

30. What is an acute otitis media?
inflammation located in the middle ear
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
School age
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US

31. Cause of bronchiolitis
GERD is the complications and symptoms that happen because of GER
4 years
Small bowel biopsy
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus

32. Pathophysiology of intussusception

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33. Nursing care for child with seizure

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34. What is the rate of growth each year from 3 yrs until puberty?
Dust - mold - animal dander - viral infections
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
2.5 inches

35. Characteristics of the RBC's in sickle cell

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36. What interventions prevent urinary tract infections?
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

37. What promotes unsickling of RBC's?
Less than 120 f.
Excessive stool fat
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Adequate O2 adequatte hydration

38. Assessment of a patient with suspected epiglottitis
Swelling of the airways - mucous production - bronchospasms
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
6 months
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film

39. 3 symptoms of coarctation of the aorta
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
6 months
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

40. What confirms a positive TB infection?
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
chest x-ray following a Positive PPD skin test
Family history - EEG - CBC - LP and MRI
maternal nutrition and genetics

41. difference btwn GER and GERD
E. Coli
0-24 months
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
GERD is the complications and symptoms that happen because of GER

42. Part of the body that grows the fastest in the toddler-preschool age
parainfluenza - RSV - Influenza A&B - M. pneumonia
trunk
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Length board standiometer

43. BMI- overweight
chest x-ray following a Positive PPD skin test
>95%
Triple
A narrowing within the Aorta resulting in collateral circulation

44. Sickle Cell Disease
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
lethargy - irritability - decrease feedings - fever - seizures
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Excessive stool fat

45. ABG
O2 status of blood - acid-base balance
2 years
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Viral---Varicella or influenza

46. How does pertussis present?
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
4 years
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml

47. When does the surgery to correct hypospadias usually occur?
2 snacks
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
Between 6-12 months
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness

48. Define Proximodistal
36 months
from trunk to extremities
Triple
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

49. At birth - head circumference is ____ compared to chest circumference
Low fiber - high calorie and protein
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
larger
4 years

50. Hirschsprung's Disease
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Adequate O2 adequatte hydration
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated