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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. At birth - head circumference is ____ compared to chest circumference
larger
Erythroblastosis Fetalis
diazepam - lorazapam
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)

2. 2 key factors to consider when caring for a preschooler
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
They are people - need a balance of limits and independence
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Salicylates

3. Nursing interventions for hemophilia
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
trunk
diazepam - lorazapam

4. Average rate of growth for the 2nd year of lif
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
5 inches
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache

5. Post Op treatment of a VP shunt
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Urethral opening is positioned below the glans penis
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

6. Age of children at half their adult height
An Acute inflamation of the meninges and CSF often caused by Enterovirus
measures the largest velocity which occurs during a forced exhale
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
2 years

7. treatment of hemolytic disease of the newborn
Mechanical Ventalation - high inhaled o2 concentration
Length board standiometer
Phototherapy - exchange transfusion
Brain damage - hearing loss and learning disabilities

8. 3 symptoms of coarctation of the aorta
6 months
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
Small bowel biopsy
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

9. Nursing care for a child with Reye's Syndrome
trunk - gonads and associative tissue
Rinse mouth and brush teeth
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
36 months

10. How does pertussis present?
chest x-ray following a Positive PPD skin test
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
gum hypertrophy
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months

11. Why is early diagnosis important w. Reye's Syndrome?
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Successful management is based on early diagnosis and aggressive therapy
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
Sterile-caused by blockage of thick mucous at the vas deferens

12. Females reproductive issues for CF patients
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
from head to toe
Delayed puberty - viscous cervical secretions - difficulty getting pregnant

13. Asthma
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
An Acute inflamation of the meninges and CSF often caused by Enterovirus
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli

14. Equipment used to measure a 24 to 36 month old height
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
Length board standiometer

15. Common Asthma irritants
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Dust - mold - animal dander - viral infections
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Abdominal ultrasound - Upper GI

16. Bilirubin encephalopathy
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
Liver Biopsy
Triple

17. What is Cystic Fibrosis?
5 inches
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
chest x-ray following a Positive PPD skin test
Dental procedures - gum disease and urinary tract infections

18. Treatment of Kawasaki disease
2 years
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
BMI chart
2 snacks

19. What should be used for feeding a child during the post operative period following cleft palate surgery?
hearing loss - scarring - mastoiditis - meningitis
trunk
larger
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects

20. Nursing care for Kawasaki Disease
Swelling or obstruction of the Larynx
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Repeated involuntary urination in a child who should already by toilet trained at night
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough

21. Treatment and nursing care for pertussis
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
3 years
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
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

22. Define Magical thinking

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23. Pathophysiology of hirschsprung's disease
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
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
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated

24. Leading cause of acquired heart disease in children
Kawasaki disease - w/o treatment 25% will have permanent heart damage
BMI chart
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
2 years

25. Part of body that grows the fastest in infancy
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Penicillin Prophylaxis (BID)
head

26. What is heart failure?
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
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
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure

27. What is used to diagnose GER?
A narrowing within the Aorta resulting in collateral circulation
none
< 5%
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor

28. How is Celiac Disease diagnosed?
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
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
O2 status of blood - acid-base balance
Small bowel biopsy

29. Pathophysiology of cystic fibrosis
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
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
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
0-24 months

30. What is an acute otitis media?
Kawasaki disease - w/o treatment 25% will have permanent heart damage
inflammation located in the middle ear
from head to toe
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks

31. Key nursing intervention for subacute bacterial endocarditis
up to 14 days
36 months
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
prevention - po antibiotics should be given before and after an invasive procedure

32. Cause of bronchiolitis
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Sterile-caused by blockage of thick mucous at the vas deferens
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
head

33. BMI- overweight
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
>95%
School age
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function

34. BMI - underweight
85-95%
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
< 5%

35. Sequence of resp distress
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Dust - mold - animal dander - viral infections
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

36. Nursing care for Cystic Fibrosis
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
diazepam - lorazapam
Abdominal ultrasound - Upper GI
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

37. Clinicla manifestations of sickle cell disease
Vaso-occulisive crisis - infection and sepsis
Hepatoxicity - pancreatitis
5ml/dl
Day 3 of life

38. Contraindications to all vaccines
6 months
Previous history of life threatening reaction - Mod-severe illness w/wo fever
5 inches
chest x-ray following a Positive PPD skin test

39. Predisposing factors to subacute bacterial endocarditis
Low fiber - high calorie and protein
Vaso-occulisive crisis - infection and sepsis
Dental procedures - gum disease and urinary tract infections
Excessive stool fat

40. 2 factors that determine birth weight
maternal nutrition and genetics
Brain damage - hearing loss and learning disabilities
double birth weight
Abdominal ultrasound - Upper GI

41. Prevention of infection in Sickle Cell Disease
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Penicillin Prophylaxis (BID)
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes

42. difference btwn GER and GERD
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
GERD is the complications and symptoms that happen because of GER
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes

43. Bronchiolitis
prevention - po antibiotics should be given before and after an invasive procedure
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
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures

44. Basic defect in coarctation of the aorta
Maternal infection - premature rupture of membranes
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
A narrowing within the Aorta resulting in collateral circulation

45. Complications of acute otitis media
gum hypertrophy
inflammation and hypersensitivity to triggers
hearing loss - scarring - mastoiditis - meningitis
Airborne and contact

46. Pathophysiology of celiac disease
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Salicylates
10 inches
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption

47. Most cases of Reye's Syndrome follows what type of illness?
Viral---Varicella or influenza
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
Bacteria enter the blood stream from a site of localized infection and grows in the heart
3 years

48. What are the S/SX of bleeds in hemophilia?
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Enteropathy caused by an insensitivity to the gluten found in wheat
inflammation and hypersensitivity to triggers

49. signs and symptoms of meningitis in older children
< 1
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
Swelling of the airways - mucous production - bronchospasms
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash

50. Etiology of GERD
Previous history of life threatening reaction - Mod-severe illness w/wo fever
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Regular diet with low sodium an no added salt
dysfunction of the lower esophageal sphincter and delayed gastric emptying time