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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. What promotes unsickling of RBC's?
They are people - need a balance of limits and independence
Swelling or obstruction of the Larynx
Adequate O2 adequatte hydration
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support

2. Test to evaluate a Seizure disorder
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Family history - EEG - CBC - LP and MRI
maternal nutrition and genetics
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

3. Define Magical thinking

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4. Normal Bilirubin
< 1
Mechanical Ventalation - high inhaled o2 concentration
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks

5. Asthma
Dust - mold - animal dander - viral infections
measures the largest velocity which occurs during a forced exhale
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
none

6. Linear growth event happens in Adolescents
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Growth spurt
head
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure

7. Growth spurt for adolescent boys
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Mid puberty
A typical lymphocytosis - mono-spot - EBV serology

8. Normal presentation of cystic fibrosis
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
>95%
up to 14 days
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection

9. Diet for Hirschsprung's prior to corrction and treatment
Hepatoxicity - pancreatitis
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Low fiber - high calorie and protein
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor

10. Lead screening should begin. at ..
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
Viral---Varicella or influenza
Dental procedures - gum disease and urinary tract infections
9 months

11. 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
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth

12. What is the cause of mononucleosis and its method of transmission?
36 months
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Epstein Barr Virus - transmitted with intimate contact
larger

13. Average rate of growth for the 2nd year of lif
>95%
5 inches
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
inflammation located in the middle ear

14. Age group the limbs grow the fastest
Airborne and contact
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
O2 status of blood - acid-base balance
School age

15. Pathophysiology of Acute Asthma
lethargy - irritability - decrease feedings - fever - seizures
Swelling of the airways - mucous production - bronchospasms
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
Triple

16. What is used to diagnose GER?
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
A narrowing within the Aorta resulting in collateral circulation
Maternal infection - premature rupture of membranes
prevention - po antibiotics should be given before and after an invasive procedure

17. Post Op treatment of a VP shunt
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Repeated involuntary urination in a child who should already by toilet trained at night
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

18. What is Cystic Fibrosis?
inflammation and hypersensitivity to triggers
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Abdominal ultrasound - Upper GI
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US

19. Assess the cause of enuresis
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
complete physical and psychosocial assessment to rule out underlying disorders
passage of abdominal contents to the esophagus

20. Pathophysiology of a fever and infection with sickle cell disease
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
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

21. What are the four main causes of viral croup?
Length Chart
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
parainfluenza - RSV - Influenza A&B - M. pneumonia

22. What can promote dryness in a child with enuresis?
prevention - po antibiotics should be given before and after an invasive procedure
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
trunk - gonads and associative tissue

23. What should be observed in a case of a seizure?
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
1-6 months
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
Time and discription of seizure

24. 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
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
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
inflammation located in the middle ear

25. Signs and Symptoms of Asthma
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing

26. What is enuresis?
Repeated involuntary urination in a child who should already by toilet trained at night
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
< 1
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

27. Treatment of Meningitis

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28. Pathophysiology of Chronic Asthma
inflammation and hypersensitivity to triggers
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
12-24 days
Adequate O2 adequatte hydration

29. Side effects of dilatin hirsuitism (body hair)
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
Maternal infection - premature rupture of membranes
gum hypertrophy
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus

30. Rheumatic Fever
MVA - bike accidents and falls
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
hearing loss - scarring - mastoiditis - meningitis

31. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Regular diet with low sodium an no added salt
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

32. Basic defect in coarctation of the aorta
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
A narrowing within the Aorta resulting in collateral circulation
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration

33. Diet for CF patients
high protien and calorie - multivitamins - extra enzymes for high fat food
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
head

34. Kawasaki Disease
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
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia

35. Diet for a child with glumerlonephritis
Abdominal ultrasound - Upper GI
Regular diet with low sodium an no added salt
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
0-24 months

36. Puberty for boys
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
12 years
GERD is the complications and symptoms that happen because of GER
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping

37. 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
Adequate O2 adequatte hydration
BMI chart

38. What is Pyloric stenosis?
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds

39. 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
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
birth-36 months
1-6 months

40. Prevention of infection in Sickle Cell Disease
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Penicillin Prophylaxis (BID)
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli

41. Most cases of Reye's Syndrome follows what type of illness?
Foreskin is used during the surgical repair
Viral---Varicella or influenza
GERD is the complications and symptoms that happen because of GER
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages

42. Can Asthma be cured?
Swelling or obstruction of the Larynx
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
No - it can only be controlled

43. Key nursing intervention for subacute bacterial endocarditis
chest x-ray following a Positive PPD skin test
prevention - po antibiotics should be given before and after an invasive procedure
Family history - EEG - CBC - LP and MRI
diazepam - lorazapam

44. Main cause of urinary tract infections
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
poor feeding - wt loss - fatigue - develop. delays - edema
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
E. Coli

45. Another name for Hemolytic Disease of the Newborn
Erythroblastosis Fetalis
Urethral opening is positioned below the glans penis
fever and infection
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)

46. Characteristics of the RBC's in sickle cell

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47. Diastat rectal diazepam gel

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48. What interventions prevent urinary tract infections?
Adequate O2 adequatte hydration
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks

49. Sequence of resp distress
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
chest x-ray following a Positive PPD skin test
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure

50. At what age is a stadiometer required to measure linear growth?
36 months
12 years
lethargy - irritability - decrease feedings - fever - seizures
2.5 inches

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Certified Pediatric Nurse Exam

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