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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. Term infant --Bilirubin peaks at what day of life
Day 3 of life
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
maternal nutrition and genetics

2. What is used to diagnose GER?
1-6 months
Hepatoxicity - pancreatitis
< 1
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor

3. Sequence of resp distress
MVA - bike accidents and falls
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

4. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
Rinse mouth and brush teeth
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Adequate O2 adequatte hydration

5. Side effects of dilatin hirsuitism (body hair)
maternal nutrition and genetics
gum hypertrophy
2 years
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness

6. Bronchiolitis
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet

7. 2 factors that determine birth weight
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
No - it can only be controlled
maternal nutrition and genetics

8. What are the side effects of depakote?
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
from trunk to extremities
Adequate O2 adequatte hydration
Hepatoxicity - pancreatitis

9. Pathophysiology of a fever and infection with sickle cell disease
inflammation and hypersensitivity to triggers
Group B Streptococcus
lethargy - irritability - decrease feedings - fever - seizures
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old

10. S/sx of GERD
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
2 snacks

11. Clinicla manifestations of sickle cell disease
Low fiber - high calorie and protein
10 inches
Vaso-occulisive crisis - infection and sepsis
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. Teaching for Mononucleosis
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Phototherapy - exchange transfusion
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy

13. Asthma inhaler - what can be done to decrease risk of thrush
inflammation located in the middle ear
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
fecal soiling
Rinse mouth and brush teeth

14. During an abdominal assessment when should auscultation occur
Small bowel biopsy
larger
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
birth-36 months

15. What are the four main causes of viral croup?
School age
prevention - po antibiotics should be given before and after an invasive procedure
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
parainfluenza - RSV - Influenza A&B - M. pneumonia

16. Pathophysiology of cystic fibrosis
Length Chart
Liver Biopsy
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old

17. Leading cause of head injury
Sterile-caused by blockage of thick mucous at the vas deferens
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
4 years
MVA - bike accidents and falls

18. Teaching for RSV
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
E. Coli
Group B Streptococcus

19. Two examples of benzodiazepines
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
diazepam - lorazapam
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

20. Contraindications to all vaccines
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Previous history of life threatening reaction - Mod-severe illness w/wo fever
6 months
4 years

21. BMI-@ risk for overweight
85-95%
12 years
3 years
Salicylates

22. Complications related to varicella
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)

23. What is the cause of mononucleosis and its method of transmission?
Viral---Varicella or influenza
Epstein Barr Virus - transmitted with intimate contact
Salicylates
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

24. Hypospadias
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
Urethral opening is positioned below the glans penis
Repeated involuntary urination in a child who should already by toilet trained at night
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting

25. What is Hemolytic Disease of the Newborn
An Acute inflamation of the meninges and CSF often caused by Enterovirus
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
Abdominal ultrasound - Upper GI
2.5 inches

26. Diet for CF patients
maternal nutrition and genetics
Vaso-occulisive crisis - infection and sepsis
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
high protien and calorie - multivitamins - extra enzymes for high fat food

27. What is Pyloric stenosis?
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Phototherapy - exchange transfusion
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages

28. Complications of meningitis
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
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
Mid puberty
Brain damage - hearing loss and learning disabilities

29. Why avoid circumcision in a baby with hypospadias?
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
Foreskin is used during the surgical repair
drooling
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures

30. Average age of menarche
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
prevention - po antibiotics should be given before and after an invasive procedure
13 years
inflammation and hypersensitivity to triggers

31. 3 symptoms of coarctation of the aorta
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
measures the largest velocity which occurs during a forced exhale

32. What are major risk factors for neonatal meningitis?
Phototherapy - exchange transfusion
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Maternal infection - premature rupture of membranes

33. Signs and Symptoms of mononucleosis
from trunk to extremities
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

34. What confirms a positive TB infection?
Airborne and contact
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
trunk
chest x-ray following a Positive PPD skin test

35. Treatment of Meningitis

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36. Rheumatic Fever
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
high protien and calorie - multivitamins - extra enzymes for high fat food
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Swelling or obstruction of the Larynx

37. 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
maternal nutrition and genetics
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Successful management is based on early diagnosis and aggressive therapy

38. Main cause of urinary tract infections
E. Coli
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Group B Streptococcus

39. signs and symptoms of meningitis in older children
Kawasaki disease - w/o treatment 25% will have permanent heart damage
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Length Chart
Give freedom and choices - save battles for the important things

40. Average age of breast development
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
10 years
They are people - need a balance of limits and independence
Time and discription of seizure

41. When does the surgery to correct hypospadias usually occur?
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Between 6-12 months

42. Pertussis?
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
Swelling or obstruction of the Larynx
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention

43. Treatment for sickle cell disease
birth-36 months
larger
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days

44. Reyes Syndrome
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection

45. Diagnose Intussusception by
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
A narrowing within the Aorta resulting in collateral circulation
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Barium enema

46. At birth - head circumference is ____ compared to chest circumference
gum hypertrophy
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
measures the largest velocity which occurs during a forced exhale
larger

47. Encoperesis
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Sterile-caused by blockage of thick mucous at the vas deferens
Cool mist therapy - encourage oral intake - s/sx of resp. distress
fecal soiling

48. Asthma
hearing loss - scarring - mastoiditis - meningitis
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli

49. Which growth chart is appropriate for use - Growth for the young child who is measured laying down?
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Length Chart
Brain damage - hearing loss and learning disabilities
Enteropathy caused by an insensitivity to the gluten found in wheat

50. Signs and Symptoms of Hemolytic Disease of the newborn
maternal nutrition and genetics
9 months
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting