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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 patient with Meningitis
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
1-6 months
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium

2. Average age of menarche
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
13 years
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

3. Define Magical thinking

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4. Viral Meningitis
# of stools per day - goal=2-3 stools per day
Repeated involuntary urination in a child who should already by toilet trained at night
>95%
An Acute inflamation of the meninges and CSF often caused by Enterovirus

5. Asthma inhaler - what can be done to decrease risk of thrush
Mid puberty
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
Rinse mouth and brush teeth
Time and discription of seizure

6. Cephalocaudal
from head to toe
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Between 6-12 months
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption

7. How does pertussis present?
< 5%
trunk - gonads and associative tissue
fever and infection
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months

8. Diet for CF patients
2 years
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
chest x-ray following a Positive PPD skin test
high protien and calorie - multivitamins - extra enzymes for high fat food

9. What can promote dryness in a child with enuresis?
Salicylates
Adequate O2 adequatte hydration
36 months
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void

10. What is an acute otitis media?
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Contact isolation - gown - gloves and handwashing
inflammation located in the middle ear
poor feeding - wt loss - fatigue - develop. delays - edema

11. Nursing care for Kawasaki Disease
complete physical and psychosocial assessment to rule out underlying disorders
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

12. S/Sx of pyloric stenosis
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Viral---Varicella or influenza

13. Pathophysiology of hirschsprung's disease
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
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
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility

14. Temp of home water heater to avoid burns
inflammation located in the middle ear
Contact isolation - gown - gloves and handwashing
Less than 120 f.
>95%

15. What interventions prevent urinary tract infections?
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption

16. Why is early diagnosis important w. Reye's Syndrome?
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Successful management is based on early diagnosis and aggressive therapy
Erythroblastosis Fetalis

17. 2 factors that determine birth weight
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
Barium enema
maternal nutrition and genetics
Mid puberty

18. What should a child's wt be at 1 yr compared to birth weight?
Triple
6 months
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin

19. Teaching for Croup
Cool mist therapy - encourage oral intake - s/sx of resp. distress
0-24 months
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects

20. Post Op treatment of a VP shunt
Sterile-caused by blockage of thick mucous at the vas deferens
Repeated involuntary urination in a child who should already by toilet trained at night
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Urethral opening is positioned below the glans penis

21. What is used to diagnose pyloric stenosis?
Abdominal ultrasound - Upper GI
Equal to
Small bowel biopsy
2 snacks

22. Nursing care for a child with Reye's Syndrome
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

23. Asthma
2.5 inches
2 snacks
Sterile-caused by blockage of thick mucous at the vas deferens
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli

24. At what age is a stadiometer required to measure linear growth?
none
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
36 months
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds

25. Treatment of a bleed in hemophilia
Foreskin is used during the surgical repair
inflammation and hypersensitivity to triggers
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days

26. Incubation period for TB
12-24 days
1-6 months
>95%
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

27. Diastat rectal diazepam gel

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28. Leading cause of bacterial meningitis in Neonates
used for prolonged sz's
Barium enema
Group B Streptococcus
complete physical and psychosocial assessment to rule out underlying disorders

29. Signs of increased ICP
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
1-6 months
Length Chart
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache

30. What is Cystic Fibrosis?
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
20 inches
Mid puberty
3 years

31. Complications related to varicella
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
5 inches
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
Abdominal ultrasound - Upper GI

32. Side effects of dilatin hirsuitism (body hair)
2 years
Mechanical Ventalation - high inhaled o2 concentration
Swelling of the airways - mucous production - bronchospasms
gum hypertrophy

33. Signs and symptoms of varicella Prodromal
BMI chart
No - it can only be controlled
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages

34. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
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
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption

35. What are the S/SX of bleeds in hemophilia?
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Brain damage - hearing loss and learning disabilities
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects

36. Kawasaki Disease
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
5 inches
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

37. Encoperesis
School age
fecal soiling
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
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

38. Varicella communicable
85-95%
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium

39. Focus of adolescent discipline
10 years
9 months
Give freedom and choices - save battles for the important things
Regular diet with low sodium an no added salt

40. Nursing care of the infant with pyloric stenosis
Length Chart
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated

41. At birth - head circumference is ____ compared to chest circumference
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Sterile-caused by blockage of thick mucous at the vas deferens
Less than 120 f.
larger

42. Pathophysiology of celiac disease
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
12-24 days
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy

43. Hirschsprung's Disease
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Kawasaki disease - w/o treatment 25% will have permanent heart damage
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US

44. Risk factors of tuberculosis
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
crowded living conditions - homeless and low income
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
double birth weight

45. Part of the body that grows the fastest in the toddler-preschool age
Foreskin is used during the surgical repair
trunk
Mid puberty
crowded living conditions - homeless and low income

46. Age group the limbs grow the fastest
<25 yrs old
Vaso-occulisive crisis - infection and sepsis
School age
Salicylates

47. What is epiglottitis?
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Kawasaki disease - w/o treatment 25% will have permanent heart damage
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film

48. What is Pyloric stenosis?
fever and infection
Salicylates
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Mid puberty

49. Treatment for Varicella
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Swelling or obstruction of the Larynx
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)

50. Childs weight at 6 months compared to birth weight
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
double birth weight
Brain damage - hearing loss and learning disabilities
Enteropathy caused by an insensitivity to the gluten found in wheat