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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. Predisposing factors to subacute bacterial endocarditis
Time and discription of seizure
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
Swelling of the airways - mucous production - bronchospasms
Dental procedures - gum disease and urinary tract infections

2. Teaching for RSV
An Acute inflamation of the meninges and CSF often caused by Enterovirus
double birth weight
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
head

3. Celiac Disease
>95%
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
Hepatoxicity - pancreatitis
Enteropathy caused by an insensitivity to the gluten found in wheat

4. Contraindications to all vaccines
Length board standiometer
Regular diet with low sodium an no added salt
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Length Chart

5. Normal Bilirubin
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Kawasaki disease - w/o treatment 25% will have permanent heart damage
< 1
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes

6. Bronchiolitis
Group B Streptococcus
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
fever and infection

7. ABG
Abdominal ultrasound - Upper GI
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
O2 status of blood - acid-base balance

8. Nursing care for Cystic Fibrosis
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
Milk - Ice cream - Malts - Grains
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
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection

9. What is Cystic Fibrosis?
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Excessive stool fat
< 1
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)

10. Signs of heart failure
4 years
poor feeding - wt loss - fatigue - develop. delays - edema
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash

11. Treatment for Hirschsprungs
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Small bowel biopsy

12. 2 factors that determine birth weight
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
<25 yrs old
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
maternal nutrition and genetics

13. Post Op treatment of a VP shunt
6 months
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
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. Hourly maintenance Fluid Requirements
BMI chart
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Day 3 of life
Family history - EEG - CBC - LP and MRI

15. Average age of menarche
Brain damage - hearing loss and learning disabilities
An Acute inflamation of the meninges and CSF often caused by Enterovirus
13 years
Steatorrhea - frequent respiratory infections during infancy - failure to thrive

16. Pathophysiology related to Head Trauma
double birth weight
BMI chart
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
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

17. What is used to diagnose GER?
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
lethargy - irritability - decrease feedings - fever - seizures
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor

18. Clinicla manifestations of sickle cell disease
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Vaso-occulisive crisis - infection and sepsis
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
passage of abdominal contents to the esophagus

19. Non-pharmalogical measures to treat GER
0-24 months
Excessive stool fat
Urethral opening is positioned below the glans penis
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping

20. How does pertussis present?
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
none
Phototherapy - exchange transfusion

21. Term infant --Bilirubin peaks at what day of life
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
A typical lymphocytosis - mono-spot - EBV serology
Day 3 of life

22. Sequence of resp distress
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Penicillin Prophylaxis (BID)
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
13 years

23. Complications related to varicella
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Swelling of the airways - mucous production - bronchospasms
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

24. Peak flow meter
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
measures the largest velocity which occurs during a forced exhale
Length Chart
up to 14 days

25. At what age is a length board required?
fever and infection
Between 6-12 months
from head to toe
0-24 months

26. Diagnose Reye's Syndrome
fecal soiling
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Liver Biopsy
Growth spurt

27. Neonatal Jaundice
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Erythroblastosis Fetalis
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
4 years

28. What are the four main causes of viral croup?
high protien and calorie - multivitamins - extra enzymes for high fat food
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
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
parainfluenza - RSV - Influenza A&B - M. pneumonia

29. What should be done to minimize the risks of Sudden infant death syndrome?
6 months
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
gum hypertrophy
12-24 days

30. Pathophysiology of Chronic Asthma
diazepam - lorazapam
Enteropathy caused by an insensitivity to the gluten found in wheat
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
inflammation and hypersensitivity to triggers

31. Test to evaluate a Seizure disorder
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Family history - EEG - CBC - LP and MRI
from trunk to extremities
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen

32. signs and symptoms of meningitis in older children
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
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

33. What foods are prohibited for a person with Celiac Disease?
>95%
Milk - Ice cream - Malts - Grains
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
A typical lymphocytosis - mono-spot - EBV serology

34. Considerations should be taken when treating a child with cystic fibrosis who has a ___________ tx promptly since bacterial colonization increases destruction of lung tissue----prevention is key
fever and infection
Enteropathy caused by an insensitivity to the gluten found in wheat
Less than 120 f.
used for prolonged sz's

35. Teaching for Mononucleosis
< 1
Maternal infection - premature rupture of membranes
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
Repeated involuntary urination in a child who should already by toilet trained at night

36. Head circumference should be assessed until what age
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
3 years
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
E. Coli

37. Pathophysiology of celiac disease
inflammation and hypersensitivity to triggers
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy

38. Complications of meningitis
Brain damage - hearing loss and learning disabilities
Successful management is based on early diagnosis and aggressive therapy
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
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

39. Females reproductive issues for CF patients
Repeated involuntary urination in a child who should already by toilet trained at night
trunk - gonads and associative tissue
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
5ml/dl

40. Side effects of dilatin hirsuitism (body hair)
Viral---Varicella or influenza
gum hypertrophy
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Dental procedures - gum disease and urinary tract infections

41. Pathophysiology of a fever and infection with sickle cell disease
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
diazepam - lorazapam
Dental procedures - gum disease and urinary tract infections
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old

42. Clinical signs of infection wilth sickle cell disease
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
crowded living conditions - homeless and low income
Liver Biopsy
passage of abdominal contents to the esophagus

43. Average rate of growth for the 1st year
Repeated involuntary urination in a child who should already by toilet trained at night
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
10 inches

44. Treatment for mononucleosis
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
none
A typical lymphocytosis - mono-spot - EBV serology

45. 3 symptoms of coarctation of the aorta
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Brain damage - hearing loss and learning disabilities
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
parainfluenza - RSV - Influenza A&B - M. pneumonia

46. Signs and Symptoms that indicate and adverse reaction to a vaccine
complete physical and psychosocial assessment to rule out underlying disorders
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia

47. Part of body that grows the fastest in infancy
head
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption

48. 2 key factors to consider when caring for a preschooler
They are people - need a balance of limits and independence
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
inflammation located in the middle ear

49. Two examples of benzodiazepines
6 months
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
E. Coli
diazepam - lorazapam

50. Assess the cause of enuresis
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
Dental procedures - gum disease and urinary tract infections
complete physical and psychosocial assessment to rule out underlying disorders