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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. ABG
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Milk - Ice cream - Malts - Grains
1-6 months
O2 status of blood - acid-base balance

2. Celiac Disease
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Milk - Ice cream - Malts - Grains
Enteropathy caused by an insensitivity to the gluten found in wheat
2 snacks

3. Pathophysiology of cystic fibrosis
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
inflammation located in the middle ear

4. Clinicla manifestations of sickle cell disease
Erythroblastosis Fetalis
5ml/dl
Between 6-12 months
Vaso-occulisive crisis - infection and sepsis

5. Signs and Symptoms that indicate and adverse reaction to a vaccine
Sterile-caused by blockage of thick mucous at the vas deferens
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
2 snacks

6. What is used to diagnose GER?
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
School age
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Kawasaki disease - w/o treatment 25% will have permanent heart damage

7. S/Sx of pyloric stenosis
used for prolonged sz's
Foreskin is used during the surgical repair
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth

8. Hirschsprung's Disease
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
measures the largest velocity which occurs during a forced exhale
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine

9. 3 symptoms of coarctation of the aorta
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
<25 yrs old
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

10. Prevention of infection in Sickle Cell Disease
Successful management is based on early diagnosis and aggressive therapy
Penicillin Prophylaxis (BID)
Triple
inflammation and hypersensitivity to triggers

11. Signs and Symptoms of Celiac Disease
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
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

12. What interventions prevent urinary tract infections?
Maternal infection - premature rupture of membranes
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
Liver Biopsy

13. 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
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
10 years
MVA - bike accidents and falls

14. Predisposing factors to subacute bacterial endocarditis
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Dental procedures - gum disease and urinary tract infections
prevention - po antibiotics should be given before and after an invasive procedure
Repeated involuntary urination in a child who should already by toilet trained at night

15. Normal Bilirubin
larger
<25 yrs old
< 1
Vaso-occulisive crisis - infection and sepsis

16. Temp of home water heater to avoid burns
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Less than 120 f.
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Previous history of life threatening reaction - Mod-severe illness w/wo fever

17. Post Op treatment of a VP shunt
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
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
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

18. Signs and symptoms of varicella Prodromal
Airborne and contact
An Acute inflamation of the meninges and CSF often caused by Enterovirus
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages

19. Define Proximodistal
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
from trunk to extremities
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old

20. What are the four main causes of viral croup?
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
parainfluenza - RSV - Influenza A&B - M. pneumonia
9 months
Urethral opening is positioned below the glans penis

21. Age that birth length doubles
Maternal infection - premature rupture of membranes
Swelling or obstruction of the Larynx
4 years
larger

22. Average age of menarche
Salicylates
13 years
Length board standiometer
BMI chart

23. What are the side effects of depakote?
Hepatoxicity - pancreatitis
3 years
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
A typical lymphocytosis - mono-spot - EBV serology

24. Nursing care for Cystic Fibrosis
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Adequate O2 adequatte hydration
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
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

25. Puberty for boys
12 years
BMI chart
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
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

26. 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
Dental procedures - gum disease and urinary tract infections
used for prolonged sz's
passage of abdominal contents to the esophagus

27. Where does the adolescent experience rapid growth?
trunk - gonads and associative tissue
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
12 years
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet

28. 2 factors that determine birth weight
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
maternal nutrition and genetics
Excessive stool fat

29. How is mononucleosis diagnosed
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
12-24 days
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
A typical lymphocytosis - mono-spot - EBV serology

30. Pathophysiology of Acute Asthma
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
fecal soiling
used for prolonged sz's
Swelling of the airways - mucous production - bronchospasms

31. Sequence of resp distress
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film

32. What are the S/SX of bleeds in hemophilia?
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
10 inches
# of stools per day - goal=2-3 stools per day
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting

33. What is broncho-pulmonary dysplasia?
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
36 months
2 years
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support

34. How many meals and snacks should a 1-3 yr old have in a day 3 meals
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
2 snacks
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
No - it can only be controlled

35. At 6-24 months - head circumference is what size in relationship to chest circumference
Airborne and contact
Equal to
Day 3 of life
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain

36. Define Magical thinking

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37. During an abdominal assessment when should auscultation occur
A typical lymphocytosis - mono-spot - EBV serology
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
none

38. Sickle Cell Disease
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
Mid puberty
10 years

39. What should be used for feeding a child during the post operative period following cleft palate surgery?
Length board standiometer
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
inflammation and hypersensitivity to triggers

40. Screening for overweight or underweight child on chart
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
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
BMI chart
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

41. Treatment of Meningitis

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42. Signs and symptoms of Reye's Syndrome
diazepam - lorazapam
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated

43. Varicella communicable
< 5%
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
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

44. At what age is a stadiometer required to measure linear growth?
A narrowing within the Aorta resulting in collateral circulation
Group B Streptococcus
36 months
Urethral opening is positioned below the glans penis

45. Why is early diagnosis important w. Reye's Syndrome?
birth-36 months
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
maternal nutrition and genetics
Successful management is based on early diagnosis and aggressive therapy

46. Etiology of GERD
# of stools per day - goal=2-3 stools per day
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
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

47. GER (gastroesophageal reflux)
Family history - EEG - CBC - LP and MRI
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
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
passage of abdominal contents to the esophagus

48. Linear growth event happens in Adolescents
Growth spurt
2.5 inches
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes

49. Another name for Hemolytic Disease of the Newborn
Urethral opening is positioned below the glans penis
A narrowing within the Aorta resulting in collateral circulation
Erythroblastosis Fetalis
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)

50. Head circumference should be assessed until what age
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
passage of abdominal contents to the esophagus
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
3 years