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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. What are the four main causes of viral croup?
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
used for prolonged sz's
Rinse mouth and brush teeth
parainfluenza - RSV - Influenza A&B - M. pneumonia

2. Signs and symptoms of tuberculosis
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
passage of abdominal contents to the esophagus
Phototherapy - exchange transfusion

3. Puberty for boys
prevention - po antibiotics should be given before and after an invasive procedure
Time and discription of seizure
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
12 years

4. Non-pharmalogical measures to treat GER
2.5 inches
larger
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
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping

5. 2 key factors to consider when caring for a preschooler
Growth spurt
Length board standiometer
Family history - EEG - CBC - LP and MRI
They are people - need a balance of limits and independence

6. Signs and Symptoms of Hemolytic Disease of the newborn
Time and discription of seizure
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2

7. What are development considerations for hemophilia?
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
2.5 inches

8. What is Hemolytic Disease of the Newborn
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
5ml/dl
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film

9. When does the surgery to correct hypospadias usually occur?
Between 6-12 months
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Viral---Varicella or influenza
Milk - Ice cream - Malts - Grains

10. Steatorrhea
Less than 120 f.
Excessive stool fat
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

11. Sickle Cell Disease
O2 status of blood - acid-base balance
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
parainfluenza - RSV - Influenza A&B - M. pneumonia
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin

12. Nursing interventions for hemophilia
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
13 years
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
2 snacks

13. 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
gum hypertrophy
Swelling or obstruction of the Larynx
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis

14. Pathophysiology related to Head Trauma
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
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
2.5 inches
Maternal infection - premature rupture of membranes

15. Bilirubin encephalopathy
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Small bowel biopsy
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough

16. Leading cause of head injury
5ml/dl
MVA - bike accidents and falls
Swelling of the airways - mucous production - bronchospasms
Vaso-occulisive crisis - infection and sepsis

17. What is used to diagnose GER?
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
from head to toe
crowded living conditions - homeless and low income
They are people - need a balance of limits and independence

18. Complications of acute otitis media
hearing loss - scarring - mastoiditis - meningitis
Hepatoxicity - pancreatitis
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia

19. Pathophysiology of a fever and infection with sickle cell disease
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Length Chart

20. Contraindications to all vaccines
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
No - it can only be controlled
Previous history of life threatening reaction - Mod-severe illness w/wo fever
5 inches

21. At birth - head circumference is ____ compared to chest circumference
larger
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
Adequate O2 adequatte hydration
passage of abdominal contents to the esophagus

22. Signs of heart failure
Length Chart
poor feeding - wt loss - fatigue - develop. delays - edema
3 years
Growth spurt

23. Signs and Symptoms that indicate and adverse reaction to a vaccine
Dental procedures - gum disease and urinary tract infections
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
BMI chart
Day 3 of life

24. first tooth
6 months
crowded living conditions - homeless and low income
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Family history - EEG - CBC - LP and MRI

25. What has the HIB vaccine been successful in reducing?
Dust - mold - animal dander - viral infections
9 months
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium

26. Sequence of resp distress
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
lethargy - irritability - decrease feedings - fever - seizures
Steatorrhea - frequent respiratory infections during infancy - failure to thrive

27. Nursing care for child with seizure

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28. S/Sx of pyloric stenosis
5 inches
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
Excessive stool fat
used for prolonged sz's

29. Complications of meningitis
Brain damage - hearing loss and learning disabilities
Excessive stool fat
Maternal infection - premature rupture of membranes
>95%

30. What is Pyloric stenosis?
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
A typical lymphocytosis - mono-spot - EBV serology
4 years
Abdominal ultrasound - Upper GI

31. treatment of intussusception
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
up to 14 days
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice

32. Side effects of dilatin hirsuitism (body hair)
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
gum hypertrophy
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

33. Clinicla manifestations of sickle cell disease
Vaso-occulisive crisis - infection and sepsis
poor feeding - wt loss - fatigue - develop. delays - edema
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Phototherapy - exchange transfusion

34. What is Cystic Fibrosis?
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
E. Coli
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
high protien and calorie - multivitamins - extra enzymes for high fat food

35. Asthma inhaler - what can be done to decrease risk of thrush
head
Rinse mouth and brush teeth
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Epstein Barr Virus - transmitted with intimate contact

36. Encoperesis
fecal soiling
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
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
Equal to

37. Signs and symptoms of neonatal meningitis
Vaso-occulisive crisis - infection and sepsis
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
from head to toe
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

38. What are major risk factors for neonatal meningitis?
Time and discription of seizure
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Maternal infection - premature rupture of membranes
<25 yrs old

39. Asthma
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Phototherapy - exchange transfusion

40. What should be done to minimize the risks of Sudden infant death syndrome?
Salicylates
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant

41. What is used to diagnose pyloric stenosis?
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Abdominal ultrasound - Upper GI
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Kawasaki disease - w/o treatment 25% will have permanent heart damage

42. Another name for Hemolytic Disease of the Newborn
Erythroblastosis Fetalis
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
3 years
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice

43. Treatment and nursing care for pertussis
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Erythroblastosis Fetalis
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
measures the largest velocity which occurs during a forced exhale

44. Teaching for Mononucleosis
drooling
They are people - need a balance of limits and independence
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia

45. How many days after birth do bilirubin levels return to normal limits?
12-24 days
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void

46. Treatment of celiac disease
Dust - mold - animal dander - viral infections
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
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
Triple

47. Pathophysiology of hirschsprung's disease
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
from trunk to extremities
double birth weight

48. Part of the body that grows the fastest in the toddler-preschool age
Sterile-caused by blockage of thick mucous at the vas deferens
Enteropathy caused by an insensitivity to the gluten found in wheat
Equal to
trunk

49. Risk factors of tuberculosis
5ml/dl
Give freedom and choices - save battles for the important things
head
crowded living conditions - homeless and low income

50. Normal Bilirubin
diazepam - lorazapam
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
drooling
< 1