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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. Cephalocaudal
Rinse mouth and brush teeth
from head to toe
GERD is the complications and symptoms that happen because of GER
hearing loss - scarring - mastoiditis - meningitis

2. 3 main causes of Bacterial meningitis in children
4 years
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
from head to toe
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides

3. Contraindications to all vaccines
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Swelling or obstruction of the Larynx

4. 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
fever and infection
chest x-ray following a Positive PPD skin test
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia

5. Complications related to varicella
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
diazepam - lorazapam
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Time and discription of seizure

6. Pathophysiology of Chronic Asthma
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
Rinse mouth and brush teeth
inflammation and hypersensitivity to triggers
Liver Biopsy

7. Characteristics of the RBC's in sickle cell

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8. What occurs in a subacute baterial endocarditis?
Maternal infection - premature rupture of membranes
Bacteria enter the blood stream from a site of localized infection and grows in the heart
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
maternal nutrition and genetics

9. What has the HIB vaccine been successful in reducing?
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Brain damage - hearing loss and learning disabilities
crowded living conditions - homeless and low income

10. S/sx of GERD
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
3 years
6 months
Brain damage - hearing loss and learning disabilities

11. Etiology of GERD
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
# of stools per day - goal=2-3 stools per day
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
2 snacks

12. Sickle Cell Disease
head
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
Liver Biopsy
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin

13. Signs of heart failure
poor feeding - wt loss - fatigue - develop. delays - edema
passage of abdominal contents to the esophagus
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Day 3 of life

14. What is broncho-pulmonary dysplasia?
Group B Streptococcus
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
gum hypertrophy

15. Cause of bronchiolitis
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
An Acute inflamation of the meninges and CSF often caused by Enterovirus
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
chest x-ray following a Positive PPD skin test

16. Diet for Hirschsprung's prior to corrction and treatment
>95%
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Low fiber - high calorie and protein
from head to toe

17. Teaching for RSV
used for prolonged sz's
fecal soiling
Length board standiometer
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration

18. Viral Meningitis
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
>95%
An Acute inflamation of the meninges and CSF often caused by Enterovirus
trunk

19. GER (gastroesophageal reflux)
passage of abdominal contents to the esophagus
Adequate O2 adequatte hydration
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
< 5%

20. Hypospadias
Length Chart
Urethral opening is positioned below the glans penis
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

21. Signs and Symptoms of Celiac Disease
Growth spurt
lethargy - irritability - decrease feedings - fever - seizures
A typical lymphocytosis - mono-spot - EBV serology
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting

22. What is used to diagnose pyloric stenosis?
Viral---Varicella or influenza
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
Abdominal ultrasound - Upper GI
13 years

23. Which growth chart is appropriate for use - Growth for the young child who is measured laying down?
5 inches
Length Chart
2 snacks
10 years

24. Key nursing intervention for subacute bacterial endocarditis
prevention - po antibiotics should be given before and after an invasive procedure
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Between 6-12 months
complete physical and psychosocial assessment to rule out underlying disorders

25. What are the four main causes of viral croup?
20 inches
parainfluenza - RSV - Influenza A&B - M. pneumonia
1-6 months
2.5 inches

26. What are the S/SX of bleeds in hemophilia?
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)
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function

27. Pathophysiology of Acute Asthma
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Repeated involuntary urination in a child who should already by toilet trained at night
Swelling of the airways - mucous production - bronchospasms
fever and infection

28. Assessment of a patient with suspected epiglottitis
high protien and calorie - multivitamins - extra enzymes for high fat food
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film

29. Average age of breast development
Less than 120 f.
Viral---Varicella or influenza
10 years
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

30. 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
from trunk to extremities
Cool mist therapy - encourage oral intake - s/sx of resp. distress
A typical lymphocytosis - mono-spot - EBV serology

31. Signs and Symptoms of mononucleosis
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
gum hypertrophy

32. Steatorrhea
used for prolonged sz's
Excessive stool fat
Regular diet with low sodium an no added salt
0-24 months

33. Childs weight at 6 months compared to birth weight
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
double birth weight
6 months

34. What level does the bilirubin need to be at in order for jaundice to occur?
School age
5ml/dl
Urethral opening is positioned below the glans penis
Cool mist therapy - encourage oral intake - s/sx of resp. distress

35. At what age is a length board required?
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
20 inches
0-24 months

36. Viral Croup
Swelling or obstruction of the Larynx
inflammation and hypersensitivity to triggers
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
inflammation located in the middle ear

37. During an abdominal assessment when should auscultation occur
from trunk to extremities
An Acute inflamation of the meninges and CSF often caused by Enterovirus
up to 14 days
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds

38. S/SX of Hirschsprungs
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
<25 yrs old
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention

39. Bilirubin encephalopathy
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days

40. Pathophysiology of a fever and infection with sickle cell disease
A typical lymphocytosis - mono-spot - EBV serology
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
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
double birth weight

41. What are the side effects of depakote?
E. Coli
Hepatoxicity - pancreatitis
A typical lymphocytosis - mono-spot - EBV serology
Family history - EEG - CBC - LP and MRI

42. Why avoid circumcision in a baby with 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
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
Foreskin is used during the surgical repair
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)

43. Age range that is appropriate to use a length chart
birth-36 months
Salicylates
drooling
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant

44. Treatment of a bleed in hemophilia
from trunk to extremities
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
Salicylates
fever - malaise - poor appetite - wt loss -cough - night sweats and chills

45. Diet for CF patients
high protien and calorie - multivitamins - extra enzymes for high fat food
Enteropathy caused by an insensitivity to the gluten found in wheat
Group B Streptococcus
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility

46. Nursing care for Cystic Fibrosis
maternal nutrition and genetics
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
9 months
head

47. ABG
<25 yrs old
O2 status of blood - acid-base balance
13 years
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds

48. Age of children at half their adult height
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
2 years
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
lethargy - irritability - decrease feedings - fever - seizures

49. What is Hemolytic Disease of the Newborn
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
Contact isolation - gown - gloves and handwashing
Viral---Varicella or influenza

50. Leading cause of head injury
MVA - bike accidents and falls
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
>95%