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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.
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. ABG
O2 status of blood - acid-base balance
Day 3 of life
measures the largest velocity which occurs during a forced exhale
up to 14 days

2. What is Hemolytic Disease of the Newborn
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Abdominal ultrasound - Upper GI
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility

3. 3 main causes of Bacterial meningitis in children
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Mid puberty
Liver Biopsy
passage of abdominal contents to the esophagus

4. Bronchiolitis
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
5 inches
< 5%

5. What are the four main causes of viral croup?
Less than 120 f.
parainfluenza - RSV - Influenza A&B - M. pneumonia
85-95%
Epstein Barr Virus - transmitted with intimate contact

6. Asthma inhaler - what can be done to decrease risk of thrush
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
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
Rinse mouth and brush teeth
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages

7. S/Sx of pyloric stenosis
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months

8. Signs and Symptoms of mononucleosis
A typical lymphocytosis - mono-spot - EBV serology
Vaso-occulisive crisis - infection and sepsis
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes

9. Steatorrhea
9 months
Excessive stool fat
Milk - Ice cream - Malts - Grains
12-24 days

10. How many days after birth do bilirubin levels return to normal limits?
Phototherapy - exchange transfusion
Swelling of the airways - mucous production - bronchospasms
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
12-24 days

11. Pathophysiology of cystic fibrosis
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache

12. Treatment for mononucleosis
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Phototherapy - exchange transfusion
none
Less than 120 f.

13. Average rate of growth for the 1st year
10 inches
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
36 months
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days

14. Two examples of benzodiazepines
5 inches
diazepam - lorazapam
Length board standiometer
BMI chart

15. treatment of hemolytic disease of the newborn
complete physical and psychosocial assessment to rule out underlying disorders
85-95%
maternal nutrition and genetics
Phototherapy - exchange transfusion

16. RSV contagious for ...
up to 14 days
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
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
Hepatoxicity - pancreatitis

17. Define Magical thinking

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18. Viral Meningitis
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
trunk
# of stools per day - goal=2-3 stools per day

19. Treatment for Varicella
Salicylates
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
passage of abdominal contents to the esophagus

20. At birth - head circumference is ____ compared to chest circumference
up to 14 days
larger
Epstein Barr Virus - transmitted with intimate contact
MVA - bike accidents and falls

21. At what age is a length board required?
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Cool mist therapy - encourage oral intake - s/sx of resp. distress
0-24 months
complete physical and psychosocial assessment to rule out underlying disorders

22. Average age of menarche
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Day 3 of life
Mechanical Ventalation - high inhaled o2 concentration
13 years

23. Signs of heart failure
poor feeding - wt loss - fatigue - develop. delays - edema
Growth spurt
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening

24. Pathophysiology of intussusception

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25. What is epiglottitis?
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
An Acute inflamation of the meninges and CSF often caused by Enterovirus
lethargy - irritability - decrease feedings - fever - seizures

26. What is the cause of mononucleosis and its method of transmission?
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
13 years
Epstein Barr Virus - transmitted with intimate contact
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet

27. Side effects of dilatin hirsuitism (body hair)
Excessive stool fat
< 1
gum hypertrophy
Hepatoxicity - pancreatitis

28. Childs weight at 6 months compared to birth weight
12-24 days
double birth weight
Abdominal ultrasound - Upper GI
drooling

29. Most cases of Reye's Syndrome follows what type of illness?
Viral---Varicella or influenza
2 snacks
A narrowing within the Aorta resulting in collateral circulation
lethargy - irritability - decrease feedings - fever - seizures

30. Age that birth length doubles
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
4 years
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

31. Post Op treatment of a VP shunt
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Viral---Varicella or influenza
A typical lymphocytosis - mono-spot - EBV serology
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death

32. 2 factors that determine birth weight
Foreskin is used during the surgical repair
School age
A typical lymphocytosis - mono-spot - EBV serology
maternal nutrition and genetics

33. Diet for Hirschsprung's prior to corrction and treatment
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Low fiber - high calorie and protein
Foreskin is used during the surgical repair
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant

34. difference btwn GER and GERD
Mechanical Ventalation - high inhaled o2 concentration
GERD is the complications and symptoms that happen because of GER
Bacteria enter the blood stream from a site of localized infection and grows in the heart
5ml/dl

35. Assessment of a patient with suspected epiglottitis
Day 3 of life
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects

36. GER (gastroesophageal reflux)
Group B Streptococcus
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
passage of abdominal contents to the esophagus
parainfluenza - RSV - Influenza A&B - M. pneumonia

37. What occurs in a subacute baterial endocarditis?
Less than 120 f.
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth

38. Key nursing intervention for subacute bacterial endocarditis
Repeated involuntary urination in a child who should already by toilet trained at night
prevention - po antibiotics should be given before and after an invasive procedure
Low fiber - high calorie and protein
Adequate O2 adequatte hydration

39. Neonatal Jaundice
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Rinse mouth and brush teeth
from trunk to extremities

40. Prevention of infection in Sickle Cell Disease
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Penicillin Prophylaxis (BID)

41. Signs and Symptoms of Celiac Disease
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting

42. treatment of intussusception
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Enteropathy caused by an insensitivity to the gluten found in wheat

43. Treatment of a bleed in hemophilia
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
Triple

44. Puberty for boys
E. Coli
12 years
3 years
Less than 120 f.

45. Risk factors of tuberculosis
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
trunk - gonads and associative tissue
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
crowded living conditions - homeless and low income

46. Temp of home water heater to avoid burns
birth-36 months
Less than 120 f.
Group B Streptococcus
Cool mist therapy - encourage oral intake - s/sx of resp. distress

47. How is Celiac Disease diagnosed?
Small bowel biopsy
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
lethargy - irritability - decrease feedings - fever - seizures

48. Pathophysiology of Chronic Asthma
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
inflammation and hypersensitivity to triggers
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides

49. Precaustions needed for pt's with varicella
Family history - EEG - CBC - LP and MRI
Urethral opening is positioned below the glans penis
Airborne and contact
Less than 120 f.

50. How is mononucleosis diagnosed
4 years
A typical lymphocytosis - mono-spot - EBV serology
Salicylates
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy