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Certified Pediatric Nurse Exam

Subjects : certifications, health-sciences, nursing

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Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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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. Key nursing intervention for subacute bacterial endocarditis
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
prevention - po antibiotics should be given before and after an invasive procedure
Enteropathy caused by an insensitivity to the gluten found in wheat
12-24 days

2. Signs and Symptoms of Bilirubin Kernicterus (encephalopathy)
drooling
Milk - Ice cream - Malts - Grains
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
lethargy - irritability - decrease feedings - fever - seizures

3. Nursing care for child with seizure

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4. Term infant --Bilirubin peaks at what day of life
Day 3 of life
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing

5. Hirschsprung's Disease
from head to toe
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
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

6. What is Pyloric stenosis?
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Equal to
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

7. Signs and Symptoms of Celiac Disease
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Adequate O2 adequatte hydration
inflammation and hypersensitivity to triggers
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting

8. Risk factors of tuberculosis
crowded living conditions - homeless and low income
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Contact isolation - gown - gloves and handwashing

9. Signs and symptoms of Reye's Syndrome
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
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
6 months
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

10. Age that birth length doubles
4 years
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
larger
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides

11. What interventions prevent urinary tract infections?
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Give freedom and choices - save battles for the important things
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes

12. Signs and Symptoms of intussusception
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
A narrowing within the Aorta resulting in collateral circulation
Group B Streptococcus
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting

13. Pathophysiology of a fever and infection with sickle cell disease
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)

14. 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
Sterile-caused by blockage of thick mucous at the vas deferens
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old

15. Treatment for Varicella
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
9 months
10 years

16. What is Hemolytic Disease of the Newborn
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
Barium enema
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine

17. Incubation period for TB
Salicylates
1-6 months
Mid puberty
MVA - bike accidents and falls

18. Treatment of Meningitis

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19. S/SX of Hirschsprungs
from trunk to extremities
85-95%
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention

20. Treatment of Kawasaki disease
Mid puberty
Brain damage - hearing loss and learning disabilities
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
36 months

21. Common Asthma irritants
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
Dust - mold - animal dander - viral infections
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting

22. Average age of breast development
10 years
drooling
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
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

23. Age group the limbs grow the fastest
Dust - mold - animal dander - viral infections
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
School age
Contact isolation - gown - gloves and handwashing

24. What is the treatment for epiglottitis?
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
hearing loss - scarring - mastoiditis - meningitis
20 inches

25. At what age is a length board required?
A narrowing within the Aorta resulting in collateral circulation
0-24 months
Previous history of life threatening reaction - Mod-severe illness w/wo fever
gum hypertrophy

26. Complications of acute otitis media
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
hearing loss - scarring - mastoiditis - meningitis
Brain damage - hearing loss and learning disabilities
Between 6-12 months

27. Encoperesis
crowded living conditions - homeless and low income
fecal soiling
poor feeding - wt loss - fatigue - develop. delays - edema
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

28. Lead screening should begin. at ..
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
# of stools per day - goal=2-3 stools per day
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
9 months

29. Why is early diagnosis important w. Reye's Syndrome?
hearing loss - scarring - mastoiditis - meningitis
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
Successful management is based on early diagnosis and aggressive therapy
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)

30. signs and symptoms of meningitis in older children
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
used for prolonged sz's
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Viral---Varicella or influenza

31. Bronchiolitis
prevention - po antibiotics should be given before and after an invasive procedure
Penicillin Prophylaxis (BID)
none
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection

32. Kawasaki Disease
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
Less than 120 f.
9 months
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

33. Average age of menarche
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
No - it can only be controlled
trunk
13 years

34. How does pertussis present?
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
20 inches

35. What occurs in a subacute baterial endocarditis?
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Rinse mouth and brush teeth
Time and discription of seizure
Bacteria enter the blood stream from a site of localized infection and grows in the heart

36. Cause of bronchiolitis
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Repeated involuntary urination in a child who should already by toilet trained at night
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus

37. S/sx of GERD
An Acute inflamation of the meninges and CSF often caused by Enterovirus
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

38. What is the rate of growth each year from 3 yrs until puberty?
Cool mist therapy - encourage oral intake - s/sx of resp. distress
Abdominal ultrasound - Upper GI
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
2.5 inches

39. Asthma
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
5 inches
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli

40. What are major risk factors for neonatal meningitis?
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
Maternal infection - premature rupture of membranes
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
A typical lymphocytosis - mono-spot - EBV serology

41. Nursing care for Kawasaki Disease
Erythroblastosis Fetalis
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Regular diet with low sodium an no added salt
chest x-ray following a Positive PPD skin test

42. Pathophysiology of hirschsprung's disease
6 months
prevention - po antibiotics should be given before and after an invasive procedure
School age
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated

43. Etiology of GERD
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Enteropathy caused by an insensitivity to the gluten found in wheat
Swelling or obstruction of the Larynx

44. Pertussis?
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
0-24 months
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough

45. When does the surgery to correct hypospadias usually occur?
Between 6-12 months
diazepam - lorazapam
Barium enema
Swelling or obstruction of the Larynx

46. What Component of Aspirin cause's Reye's Syndrome?
Salicylates
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
Successful management is based on early diagnosis and aggressive therapy
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)

47. Define Proximodistal
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
3 years
No - it can only be controlled
from trunk to extremities

48. What is heart failure?
Erythroblastosis Fetalis
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
Steatorrhea - frequent respiratory infections during infancy - failure to thrive

49. Hourly maintenance Fluid Requirements
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Length Chart
They are people - need a balance of limits and independence
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

50. Males Reproductive issues for CF patients
complete physical and psychosocial assessment to rule out underlying disorders
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
Sterile-caused by blockage of thick mucous at the vas deferens

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Certified Pediatric Nurse Exam

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