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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. Which growth chart is appropriate for use - Growth for the young child who is measured laying down?
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
maternal nutrition and genetics
A typical lymphocytosis - mono-spot - EBV serology
Length Chart

2. How many days after birth do bilirubin levels return to normal limits?
20 inches
Urethral opening is positioned below the glans penis
12-24 days
2 snacks

3. Peak flow meter
Excessive stool fat
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
measures the largest velocity which occurs during a forced exhale

4. What are the S/SX of bleeds in hemophilia?
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Salicylates
9 months
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)

5. 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
Give freedom and choices - save battles for the important things
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
GERD is the complications and symptoms that happen because of GER

6. Focus of adolescent discipline
Give freedom and choices - save battles for the important things
Foreskin is used during the surgical repair
Enteropathy caused by an insensitivity to the gluten found in wheat
double birth weight

7. Leading cause of head injury
Barium enema
MVA - bike accidents and falls
Equal to
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void

8. Side effects of benzodiazepines
They are people - need a balance of limits and independence
drooling
up to 14 days
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

9. Teaching for Mononucleosis
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

10. Asthma inhaler - what can be done to decrease risk of thrush
from head to toe
Epstein Barr Virus - transmitted with intimate contact
Rinse mouth and brush teeth
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics

11. Define Proximodistal
Less than 120 f.
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
from trunk to extremities
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

12. Cause of bronchiolitis
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
< 1
<25 yrs old

13. What can promote dryness in a child with enuresis?
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
fecal soiling
Mid puberty
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening

14. first tooth
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
6 months
Regular diet with low sodium an no added salt

15. What promotes unsickling of RBC's?
passage of abdominal contents to the esophagus
Adequate O2 adequatte hydration
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
# of stools per day - goal=2-3 stools per day

16. Define Magical thinking

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17. What level does the bilirubin need to be at in order for jaundice to occur?
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
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
5ml/dl

18. Signs and Symptoms of mononucleosis
Hepatoxicity - pancreatitis
Liver Biopsy
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice

19. Pathophysiology of celiac disease
Viral---Varicella or influenza
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
85-95%
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash

20. Diet for a child with glumerlonephritis
Regular diet with low sodium an no added salt
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
crowded living conditions - homeless and low income
Cool mist therapy - encourage oral intake - s/sx of resp. distress

21. Signs and Symptoms of Bilirubin Kernicterus (encephalopathy)
Abdominal ultrasound - Upper GI
maternal nutrition and genetics
lethargy - irritability - decrease feedings - fever - seizures
fever and infection

22. What is used to diagnose pyloric stenosis?
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Maternal infection - premature rupture of membranes
Abdominal ultrasound - Upper GI
< 5%

23. Two important assessment rules related to coarctation of the aorta?
Salicylates
Swelling of the airways - mucous production - bronchospasms
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures

24. How many meals and snacks should a 1-3 yr old have in a day 3 meals
diazepam - lorazapam
inflammation located in the middle ear
Dental procedures - gum disease and urinary tract infections
2 snacks

25. Cephalocaudal
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Milk - Ice cream - Malts - Grains
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
from head to toe

26. How is Celiac Disease diagnosed?
Small bowel biopsy
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Abdominal ultrasound - Upper GI
birth-36 months

27. Diastat rectal diazepam gel

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28. BMI- overweight
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
>95%
Phototherapy - exchange transfusion

29. Complications of meningitis
85-95%
Epstein Barr Virus - transmitted with intimate contact
Brain damage - hearing loss and learning disabilities
< 5%

30. Diet for CF patients
high protien and calorie - multivitamins - extra enzymes for high fat food
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
Length Chart

31. Temp of home water heater to avoid burns
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
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
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
Less than 120 f.

32. Nursing care for child with seizure

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33. 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
10 inches
4 years
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping

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
Liver Biopsy
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Swelling or obstruction of the Larynx
fever and infection

35. Signs and Symptoms of Asthma
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
used for prolonged sz's
>95%
Small bowel biopsy

36. Hourly maintenance Fluid Requirements
Triple
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months

37. Key nursing intervention for subacute bacterial endocarditis
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
Vaso-occulisive crisis - infection and sepsis
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
prevention - po antibiotics should be given before and after an invasive procedure

38. Hypospadias
BMI chart
Urethral opening is positioned below the glans penis
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Group B Streptococcus

39. Treatment of Kawasaki disease
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
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
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy

40. Signs and symptoms of tuberculosis
inflammation and hypersensitivity to triggers
Salicylates
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures

41. What is physiologic Jaundice?
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
lethargy - irritability - decrease feedings - fever - seizures
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
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection

42. What is the treatment for epiglottitis?
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
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
1-6 months

43. At birth - head circumference is ____ compared to chest circumference
larger
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Small bowel biopsy
poor feeding - wt loss - fatigue - develop. delays - edema

44. What interventions prevent urinary tract infections?
Penicillin Prophylaxis (BID)
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
Viral---Varicella or influenza
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache

45. Signs and symptoms of neonatal meningitis
Dust - mold - animal dander - viral infections
from head to toe
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

46. What are the four main causes of viral croup?
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
parainfluenza - RSV - Influenza A&B - M. pneumonia

47. At what age is a stadiometer required to measure linear growth?
36 months
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Rinse mouth and brush teeth
complete physical and psychosocial assessment to rule out underlying disorders

48. Part of the body that grows the fastest in the toddler-preschool age
trunk
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Growth spurt
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility

49. Steatorrhea
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Excessive stool fat
Contact isolation - gown - gloves and handwashing
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting

50. Part of body that grows the fastest in infancy
Foreskin is used during the surgical repair
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
10 years
head