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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. Growth spurt for adolescent boys
Mid puberty
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
10 inches

2. ABG
O2 status of blood - acid-base balance
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
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
high protien and calorie - multivitamins - extra enzymes for high fat food

3. Most cases of Reye's Syndrome follows what type of illness?
Erythroblastosis Fetalis
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
Viral---Varicella or influenza
13 years

4. 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
Milk - Ice cream - Malts - Grains
Small bowel biopsy
Abdominal ultrasound - Upper GI

5. Nursing care for Cystic Fibrosis
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
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
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

6. Pathophysiology of hirschsprung's disease
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
5 inches
Time and discription of seizure
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated

7. Kawasaki Disease
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Foreskin is used during the surgical repair
Less than 120 f.
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

8. Age of children at half their adult height
2 years
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Vaso-occulisive crisis - infection and sepsis

9. Signs and Symptoms of Hemolytic Disease of the newborn
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
10 inches
fever and infection

10. Assess the cause of enuresis
complete physical and psychosocial assessment to rule out underlying disorders
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
lethargy - irritability - decrease feedings - fever - seizures
A narrowing within the Aorta resulting in collateral circulation

11. At birth - head circumference is ____ compared to chest circumference
Less than 120 f.
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
larger
Cool mist therapy - encourage oral intake - s/sx of resp. distress

12. Pancreatic enzyme therapy for cystic fibrosis is adjusted based on what factors growth and development?
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Penicillin Prophylaxis (BID)
# of stools per day - goal=2-3 stools per day
2.5 inches

13. Signs and symptoms of Reye's Syndrome
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

14. Asthma
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Barium enema
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
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli

15. What is physiologic Jaundice?
Sterile-caused by blockage of thick mucous at the vas deferens
Epstein Barr Virus - transmitted with intimate contact
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
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

16. What confirms a positive TB infection?
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Viral---Varicella or influenza
chest x-ray following a Positive PPD skin test
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

17. Nursing care of patient with Meningitis
Swelling of the airways - mucous production - bronchospasms
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
BMI chart
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics

18. treatment of intussusception
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin

19. Where does the adolescent experience rapid growth?
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Mechanical Ventalation - high inhaled o2 concentration
trunk - gonads and associative tissue
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

20. Side effects of dilatin hirsuitism (body hair)
>95%
0-24 months
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
gum hypertrophy

21. Age group the limbs grow the fastest
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Barium enema
School age

22. Leading cause of bacterial meningitis in Neonates
drooling
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Group B Streptococcus
6 months

23. Reyes Syndrome
5 inches
Epstein Barr Virus - transmitted with intimate contact
Swelling of the airways - mucous production - bronchospasms
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness

24. At what age is a stadiometer required to measure linear growth?
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
36 months
Dental procedures - gum disease and urinary tract infections
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine

25. What is used to diagnose GER?
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Sterile-caused by blockage of thick mucous at the vas deferens

26. Asthma inhaler - what can be done to decrease risk of thrush
maternal nutrition and genetics
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Rinse mouth and brush teeth
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

27. What are development considerations for hemophilia?
13 years
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
larger

28. What should be used for feeding a child during the post operative period following cleft palate surgery?
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Sterile-caused by blockage of thick mucous at the vas deferens
They are people - need a balance of limits and independence
85-95%

29. Predisposing factors to subacute bacterial endocarditis
Dental procedures - gum disease and urinary tract infections
Regular diet with low sodium an no added salt
inflammation and hypersensitivity to triggers
MVA - bike accidents and falls

30. Two examples of benzodiazepines
diazepam - lorazapam
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Rinse mouth and brush teeth
5 inches

31. Signs of increased ICP
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Day 3 of life
Vaso-occulisive crisis - infection and sepsis
poor feeding - wt loss - fatigue - develop. delays - edema

32. Part of body that grows the fastest in infancy
# of stools per day - goal=2-3 stools per day
head
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Time and discription of seizure

33. signs and symptoms of meningitis in older children
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
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
5ml/dl
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping

34. Diet for Hirschsprung's prior to corrction and treatment
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Epstein Barr Virus - transmitted with intimate contact
Low fiber - high calorie and protein
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium

35. Age group affected by mononucleosis
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
<25 yrs old
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
from trunk to extremities

36. Equipment used to measure a 24 to 36 month old height
passage of abdominal contents to the esophagus
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Length board standiometer
Viral---Varicella or influenza

37. Signs and Symptoms of intussusception
double birth weight
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
Growth spurt

38. At 6-24 months - head circumference is what size in relationship to chest circumference
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
up to 14 days
Liver Biopsy
Equal to

39. What are the four main causes of viral croup?
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
parainfluenza - RSV - Influenza A&B - M. pneumonia
Length Chart
measures the largest velocity which occurs during a forced exhale

40. 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
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Penicillin Prophylaxis (BID)
fever and infection
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

41. Key nursing intervention for subacute bacterial endocarditis
prevention - po antibiotics should be given before and after an invasive procedure
used for prolonged sz's
Abdominal ultrasound - Upper GI
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

42. Contraindications to all vaccines
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia

43. Treatment for Hirschsprungs
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
Steatorrhea - frequent respiratory infections during infancy - failure to thrive

44. What interventions prevent urinary tract infections?
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
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
< 1
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes

45. Treatment of a bleed in hemophilia
parainfluenza - RSV - Influenza A&B - M. pneumonia
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
A narrowing within the Aorta resulting in collateral circulation

46. What Component of Aspirin cause's Reye's Syndrome?
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Salicylates
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
<25 yrs old

47. Sickle Cell Disease
Barium enema
>95%
A narrowing within the Aorta resulting in collateral circulation
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin

48. Varicella communicable
Give freedom and choices - save battles for the important things
Small bowel biopsy
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks

49. Hypospadias
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
gum hypertrophy
Urethral opening is positioned below the glans penis
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing

50. first tooth
2 years
Dental procedures - gum disease and urinary tract infections
6 months
Epstein Barr Virus - transmitted with intimate contact