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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. Normal presentation of cystic fibrosis
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Phototherapy - exchange transfusion
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications

2. Temp of home water heater to avoid burns
Liver Biopsy
85-95%
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Less than 120 f.

3. Precaustions needed for pt's with varicella
>95%
Airborne and contact
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

4. signs and symptoms of meningitis in older children
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
from trunk to extremities
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

5. Age group the limbs grow the fastest
Contact isolation - gown - gloves and handwashing
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
School age
Delayed puberty - viscous cervical secretions - difficulty getting pregnant

6. What is used to diagnose pyloric stenosis?
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Abdominal ultrasound - Upper GI
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
O2 status of blood - acid-base balance

7. Hourly maintenance Fluid Requirements
3 years
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
10 years
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film

8. What is physiologic Jaundice?
Less than 120 f.
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
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
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia

9. Lead screening should begin. at ..
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
20 inches
Rinse mouth and brush teeth
9 months

10. Pathophysiology of intussusception

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11. Sickle Cell Disease
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
fever - malaise - poor appetite - wt loss -cough - night sweats and chills

12. Signs and Symptoms that indicate and adverse reaction to a vaccine
12-24 days
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
5ml/dl

13. What is Hemolytic Disease of the Newborn
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
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
Phototherapy - exchange transfusion
2.5 inches

14. Why is early diagnosis important w. Reye's Syndrome?
Swelling or obstruction of the Larynx
hearing loss - scarring - mastoiditis - meningitis
Successful management is based on early diagnosis and aggressive therapy
used for prolonged sz's

15. How many days after birth do bilirubin levels return to normal limits?
12-24 days
high protien and calorie - multivitamins - extra enzymes for high fat food
School age
Penicillin Prophylaxis (BID)

16. Males Reproductive issues for CF patients
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
trunk - gonads and associative tissue
Sterile-caused by blockage of thick mucous at the vas deferens
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days

17. What occurs in a subacute baterial endocarditis?
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Bacteria enter the blood stream from a site of localized infection and grows in the heart
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening

18. Complications related to varicella
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
<25 yrs old
chest x-ray following a Positive PPD skin test

19. Can Asthma be cured?
No - it can only be controlled
complete physical and psychosocial assessment to rule out underlying disorders
Contact isolation - gown - gloves and handwashing
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated

20. Bilirubin encephalopathy
Mechanical Ventalation - high inhaled o2 concentration
5ml/dl
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain

21. Asthma inhaler - what can be done to decrease risk of thrush
BMI chart
Rinse mouth and brush teeth
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
crowded living conditions - homeless and low income

22. What are the four main causes of viral croup?
Maternal infection - premature rupture of membranes
# of stools per day - goal=2-3 stools per day
parainfluenza - RSV - Influenza A&B - M. pneumonia
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes

23. At 6-24 months - head circumference is what size in relationship to chest circumference
larger
Equal to
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
2 years

24. Treatment for Varicella
Rinse mouth and brush teeth
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
Successful management is based on early diagnosis and aggressive therapy
fever and infection

25. At what age is a length board required?
trunk - gonads and associative tissue
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
2.5 inches
0-24 months

26. Head circumference should be assessed until what age
Swelling of the airways - mucous production - bronchospasms
3 years
Swelling or obstruction of the Larynx
dysfunction of the lower esophageal sphincter and delayed gastric emptying time

27. Term infant --Bilirubin peaks at what day of life
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
BMI chart
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Day 3 of life

28. Bronchiolitis
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
12 years
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function

29. How does pertussis present?
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
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
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months

30. Treatment for sickle cell disease
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

31. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Give freedom and choices - save battles for the important things
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption

32. S/sx of GERD
Less than 120 f.
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics

33. What are development considerations for hemophilia?
Airborne and contact
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Between 6-12 months

34. Prevention of infection in Sickle Cell Disease
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Penicillin Prophylaxis (BID)
Enteropathy caused by an insensitivity to the gluten found in wheat
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening

35. Incubation period for TB
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
< 5%
double birth weight
1-6 months

36. What is heart failure?
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
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
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

37. 3 main causes of Bacterial meningitis in children
poor feeding - wt loss - fatigue - develop. delays - edema
Length board standiometer
Give freedom and choices - save battles for the important things
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides

38. BMI- overweight
Small bowel biopsy
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
>95%
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days

39. Age that birth length doubles
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
85-95%
4 years
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects

40. Characteristics of the RBC's in sickle cell

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41. Treatment for Hirschsprungs
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
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
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Dental procedures - gum disease and urinary tract infections

42. Common Asthma irritants
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
85-95%
used for prolonged sz's
Dust - mold - animal dander - viral infections

43. Pathophysiology of Acute Asthma
# of stools per day - goal=2-3 stools per day
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
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Swelling of the airways - mucous production - bronchospasms

44. What are the side effects of depakote?
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
Hepatoxicity - pancreatitis
GERD is the complications and symptoms that happen because of GER

45. Hirschsprung's Disease
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
2 years
chest x-ray following a Positive PPD skin test
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

46. What are major risk factors for neonatal meningitis?
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
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
Maternal infection - premature rupture of membranes

47. Signs and symptoms of tuberculosis
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
Group B Streptococcus
fever - malaise - poor appetite - wt loss -cough - night sweats and chills

48. Part of body that grows the fastest in infancy
head
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
No - it can only be controlled
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness

49. What is Cystic Fibrosis?
Regular diet with low sodium an no added salt
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Previous history of life threatening reaction - Mod-severe illness w/wo fever

50. Viral Croup
Triple
Rinse mouth and brush teeth
Swelling or obstruction of the Larynx
inflammation and hypersensitivity to triggers