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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. Kawasaki Disease
13 years
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
larger
none

2. BMI- overweight
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Maternal infection - premature rupture of membranes
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
>95%

3. Two examples of benzodiazepines
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Maternal infection - premature rupture of membranes
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
diazepam - lorazapam

4. Pathophysiology of a fever and infection with sickle cell disease
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Rinse mouth and brush teeth

5. What is used to diagnose pyloric stenosis?
Abdominal ultrasound - Upper GI
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
E. Coli
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain

6. Viral Meningitis
5 inches
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Barium enema
parainfluenza - RSV - Influenza A&B - M. pneumonia

7. Teaching for Mononucleosis
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
Swelling or obstruction of the Larynx
< 5%
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old

8. Equipment used to measure a 24 to 36 month old height
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Mid puberty
Length board standiometer
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds

9. Rheumatic Fever
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
13 years

10. What is the treatment for epiglottitis?
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
They are people - need a balance of limits and independence
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days

11. What is used to diagnose GER?
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Bacteria enter the blood stream from a site of localized infection and grows in the heart
5 inches

12. How many meals and snacks should a 1-3 yr old have in a day 3 meals
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
2 years
2 snacks
Phototherapy - exchange transfusion

13. Head circumference should be assessed until what age
4 years
Length Chart
3 years
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia

14. Where does the adolescent experience rapid growth?
13 years
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
fecal soiling
trunk - gonads and associative tissue

15. Signs and symptoms of Reye's Syndrome
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
drooling

16. What should be observed in a case of a seizure?
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
Time and discription of seizure
measures the largest velocity which occurs during a forced exhale
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)

17. At what age is a stadiometer required to measure linear growth?
< 1
36 months
<25 yrs old
Small bowel biopsy

18. What should a child's wt be at 1 yr compared to birth weight?
Swelling or obstruction of the Larynx
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
12-24 days
Triple

19. Term infant --Bilirubin peaks at what day of life
Day 3 of life
Dental procedures - gum disease and urinary tract infections
lethargy - irritability - decrease feedings - fever - seizures
Less than 120 f.

20. Nursing care for Cystic Fibrosis
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
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
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
poor feeding - wt loss - fatigue - develop. delays - edema

21. What is epiglottitis?
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
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
crowded living conditions - homeless and low income

22. signs and symptoms of meningitis in older children
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Urethral opening is positioned below the glans penis
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
trunk - gonads and associative tissue

23. Pathophysiology of Chronic Asthma
from head to toe
0-24 months
inflammation and hypersensitivity to triggers
diazepam - lorazapam

24. Cause of bronchiolitis
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
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness

25. Age group affected by mononucleosis
<25 yrs old
Urethral opening is positioned below the glans penis
Day 3 of life
from head to toe

26. Leading cause of head injury
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
MVA - bike accidents and falls
5 inches
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications

27. Diagnose Intussusception by
13 years
larger
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Barium enema

28. Contraindications to all vaccines
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Previous history of life threatening reaction - Mod-severe illness w/wo fever

29. treatment of hemolytic disease of the newborn
Growth spurt
high protien and calorie - multivitamins - extra enzymes for high fat food
Phototherapy - exchange transfusion
E. Coli

30. BMI-@ risk for overweight
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
85-95%
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen

31. Growth spurt for adolescent boys
School age
They are people - need a balance of limits and independence
Successful management is based on early diagnosis and aggressive therapy
Mid puberty

32. Nursing care of the infant with pyloric stenosis
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
< 1
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

33. Treatment of celiac disease
1-6 months
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Mid puberty
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

34. Complications of meningitis
Brain damage - hearing loss and learning disabilities
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Triple

35. Part of the body that grows the fastest in the toddler-preschool age
trunk
A typical lymphocytosis - mono-spot - EBV serology
gum hypertrophy
< 1

36. Signs and symptoms of varicella Prodromal
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Give freedom and choices - save battles for the important things
trunk
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages

37. Sickle Cell Disease
Small bowel biopsy
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
prevention - po antibiotics should be given before and after an invasive procedure

38. Normal presentation of cystic fibrosis
10 years
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
parainfluenza - RSV - Influenza A&B - M. pneumonia
Steatorrhea - frequent respiratory infections during infancy - failure to thrive

39. Two important assessment rules related to coarctation of the aorta?
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
They are people - need a balance of limits and independence
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping

40. Diet for CF patients
high protien and calorie - multivitamins - extra enzymes for high fat food
Mid puberty
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
Dental procedures - gum disease and urinary tract infections

41. Prevention of infection in Sickle Cell Disease
Penicillin Prophylaxis (BID)
poor feeding - wt loss - fatigue - develop. delays - edema
O2 status of blood - acid-base balance
No - it can only be controlled

42. Signs of heart failure
poor feeding - wt loss - fatigue - develop. delays - edema
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Barium enema
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough

43. Females reproductive issues for CF patients
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Mid puberty
Hepatoxicity - pancreatitis
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days

44. Test to evaluate a Seizure disorder
20 inches
Cool mist therapy - encourage oral intake - s/sx of resp. distress
Family history - EEG - CBC - LP and MRI
Swelling or obstruction of the Larynx

45. Pathophysiology of hirschsprung's disease
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
20 inches
prevention - po antibiotics should be given before and after an invasive procedure

46. Treatment of Kawasaki disease
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Mechanical Ventalation - high inhaled o2 concentration
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
gum hypertrophy

47. GER (gastroesophageal reflux)
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
Previous history of life threatening reaction - Mod-severe illness w/wo fever
passage of abdominal contents to the esophagus
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

48. Diagnose Reye's Syndrome
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
Viral---Varicella or influenza
Liver Biopsy
<25 yrs old

49. Lead screening should begin. at ..
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
9 months
Length Chart

50. Signs and Symptoms of intussusception
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
complete physical and psychosocial assessment to rule out underlying disorders

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Certified Pediatric Nurse Exam

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