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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. Viral Croup
Swelling or obstruction of the Larynx
12-24 days
Between 6-12 months
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks

2. What is epiglottitis?
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Urethral opening is positioned below the glans penis
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
10 years

3. Signs and Symptoms of Celiac Disease
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting

4. Incubation period for TB
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Liver Biopsy
School age
1-6 months

5. Screening for overweight or underweight child on chart
BMI chart
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Steatorrhea - frequent respiratory infections during infancy - failure to thrive

6. Head circumference should be assessed until what age
3 years
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
Abdominal ultrasound - Upper GI
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing

7. Part of the body that grows the fastest in the toddler-preschool age
trunk
Foreskin is used during the surgical repair
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
0-24 months

8. How many days after birth do bilirubin levels return to normal limits?
Cool mist therapy - encourage oral intake - s/sx of resp. distress
12-24 days
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing

9. Test to evaluate a Seizure disorder
Family history - EEG - CBC - LP and MRI
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Abdominal ultrasound - Upper GI
maternal nutrition and genetics

10. Complications of acute otitis media
Regular diet with low sodium an no added salt
2 years
hearing loss - scarring - mastoiditis - meningitis
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

11. What interventions prevent urinary tract infections?
poor feeding - wt loss - fatigue - develop. delays - edema
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
Between 6-12 months
1-6 months

12. At what age is a length board required?
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
0-24 months
Less than 120 f.

13. Clinicla manifestations of sickle cell disease
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
Vaso-occulisive crisis - infection and sepsis
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

14. Nursing care for child with seizure

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15. How is mononucleosis diagnosed
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
A typical lymphocytosis - mono-spot - EBV serology
>95%
Regular diet with low sodium an no added salt

16. S/SX of Hirschsprungs
Triple
used for prolonged sz's
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting

17. Asthma inhaler - what can be done to decrease risk of thrush
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Cool mist therapy - encourage oral intake - s/sx of resp. distress
gum hypertrophy
Rinse mouth and brush teeth

18. What Pharmalogical measures can be used to treat GERD?
Barium enema
Length board standiometer
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
complete physical and psychosocial assessment to rule out underlying disorders

19. Diagnose Reye's Syndrome
Liver Biopsy
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

20. Rheumatic Fever
Viral---Varicella or influenza
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection

21. Reyes Syndrome
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
They are people - need a balance of limits and independence

22. During an abdominal assessment when should auscultation occur
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
parainfluenza - RSV - Influenza A&B - M. pneumonia
Regular diet with low sodium an no added salt
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds

23. Nursing care for Cystic Fibrosis
Brain damage - hearing loss and learning disabilities
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
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

24. Treatment of a bleed in hemophilia
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Successful management is based on early diagnosis and aggressive therapy
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
inflammation and hypersensitivity to triggers

25. Pathophysiology related to Head Trauma
Swelling or obstruction of the Larynx
36 months
>95%
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

26. Teaching for Croup
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
10 years
Cool mist therapy - encourage oral intake - s/sx of resp. distress

27. Clinical signs of infection wilth sickle cell disease
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures

28. Neonatal Jaundice
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
gum hypertrophy
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash

29. 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
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

30. Hypospadias
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Mid puberty
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Urethral opening is positioned below the glans penis

31. Post Op treatment of a VP shunt
36 months
Phototherapy - exchange transfusion
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Mid puberty

32. Non-pharmalogical measures to treat GER
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
Mid puberty
Family history - EEG - CBC - LP and MRI
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen

33. Why avoid circumcision in a baby with hypospadias?
Phototherapy - exchange transfusion
36 months
Dental procedures - gum disease and urinary tract infections
Foreskin is used during the surgical repair

34. Bilirubin encephalopathy
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
Urethral opening is positioned below the glans penis
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia

35. Assess the cause of enuresis
complete physical and psychosocial assessment to rule out underlying disorders
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

36. At birth - head circumference is ____ compared to chest circumference
85-95%
Vaso-occulisive crisis - infection and sepsis
larger
No - it can only be controlled

37. Age group the limbs grow the fastest
9 months
School age
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Triple

38. BMI-@ risk for overweight
No - it can only be controlled
85-95%
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

39. Bronchiolitis
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
A typical lymphocytosis - mono-spot - EBV serology
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
12 years

40. Teaching for Mononucleosis
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
Erythroblastosis Fetalis
Length board standiometer
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

41. Complications related to varicella
# of stools per day - goal=2-3 stools per day
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
MVA - bike accidents and falls
head

42. What occurs in a subacute baterial endocarditis?
Bacteria enter the blood stream from a site of localized infection and grows in the heart
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
10 inches

43. How is Celiac Disease diagnosed?
Barium enema
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Small bowel biopsy
Urethral opening is positioned below the glans penis

44. Hirschsprung's Disease
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
none
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
A typical lymphocytosis - mono-spot - EBV serology

45. Assessment of a patient with suspected epiglottitis
Give freedom and choices - save battles for the important things
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention

46. What should be used for feeding a child during the post operative period following cleft palate surgery?
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
5ml/dl
diazepam - lorazapam

47. 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
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
2.5 inches
measures the largest velocity which occurs during a forced exhale

48. When does the surgery to correct hypospadias usually occur?
gum hypertrophy
Salicylates
Enteropathy caused by an insensitivity to the gluten found in wheat
Between 6-12 months

49. What can promote dryness in a child with enuresis?
trunk
Brain damage - hearing loss and learning disabilities
Abdominal ultrasound - Upper GI
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void

50. Signs and symptoms of tuberculosis
Sterile-caused by blockage of thick mucous at the vas deferens
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
fever - malaise - poor appetite - wt loss -cough - night sweats and chills

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