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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. Age range that is appropriate to use a length chart
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
No - it can only be controlled
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
birth-36 months

2. What is the cause of mononucleosis and its method of transmission?
Epstein Barr Virus - transmitted with intimate contact
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
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film

3. Predisposing factors to subacute bacterial endocarditis
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Mechanical Ventalation - high inhaled o2 concentration
Dental procedures - gum disease and urinary tract infections
Urethral opening is positioned below the glans penis

4. Complications related to varicella
5 inches
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Regular diet with low sodium an no added salt
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects

5. Treatment for sickle cell disease
Abdominal ultrasound - Upper GI
Hepatoxicity - pancreatitis
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

6. Age group affected by mononucleosis
<25 yrs old
from head to toe
Regular diet with low sodium an no added salt
Foreskin is used during the surgical repair

7. 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
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
4 years
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen

8. Nursing care for Kawasaki Disease
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
A narrowing within the Aorta resulting in collateral circulation
2 years
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache

9. Precaustions needed for pt's with varicella
Airborne and contact
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
larger
none

10. What has the HIB vaccine been successful in reducing?
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
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
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure

11. Linear growth event happens in Adolescents
Phototherapy - exchange transfusion
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
Growth spurt
Erythroblastosis Fetalis

12. At birth - head circumference is ____ compared to chest circumference
larger
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
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
Equal to

13. Post Op treatment of a VP shunt
Barium enema
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
13 years

14. Pathophysiology of intussusception

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15. Diagnose Reye's Syndrome
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Liver Biopsy

16. Pancreatic enzyme therapy for cystic fibrosis is adjusted based on what factors growth and development?
# of stools per day - goal=2-3 stools per day
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support

17. Focus of adolescent discipline
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Cool mist therapy - encourage oral intake - s/sx of resp. distress
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Give freedom and choices - save battles for the important things

18. Signs and Symptoms of Hemolytic Disease of the newborn
A typical lymphocytosis - mono-spot - EBV serology
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Length Chart
chest x-ray following a Positive PPD skin test

19. Sequence of resp distress
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
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
E. Coli
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure

20. Cephalocaudal
E. Coli
from head to toe
85-95%
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications

21. Teaching for RSV
GERD is the complications and symptoms that happen because of GER
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
from trunk to extremities
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium

22. What is the treatment for epiglottitis?
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days

23. Asthma inhaler - what can be done to decrease risk of thrush
poor feeding - wt loss - fatigue - develop. delays - edema
Swelling of the airways - mucous production - bronchospasms
Dental procedures - gum disease and urinary tract infections
Rinse mouth and brush teeth

24. treatment of hemolytic disease of the newborn
0-24 months
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
Phototherapy - exchange transfusion
none

25. 2 key factors to consider when caring for a preschooler
fever and infection
They are people - need a balance of limits and independence
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old

26. Pertussis?
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
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
9 months
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough

27. Term infant --Bilirubin peaks at what day of life
2.5 inches
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
Day 3 of life
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection

28. Childs weight at 6 months compared to birth weight
used for prolonged sz's
maternal nutrition and genetics
0-24 months
double birth weight

29. Males Reproductive issues for CF patients
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
Sterile-caused by blockage of thick mucous at the vas deferens
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Cool mist therapy - encourage oral intake - s/sx of resp. distress

30. Nursing care for a child with Reye's Syndrome
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
GERD is the complications and symptoms that happen because of GER
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
85-95%

31. What is physiologic Jaundice?
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
inflammation and hypersensitivity to triggers
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
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

32. What occurs in a subacute baterial endocarditis?
Length Chart
Bacteria enter the blood stream from a site of localized infection and grows in the heart
2 years
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

33. Puberty for boys
12 years
Rinse mouth and brush teeth
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days

34. Growth spurt for adolescent boys
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
Mid puberty
Brain damage - hearing loss and learning disabilities
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

35. Celiac Disease
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
poor feeding - wt loss - fatigue - develop. delays - edema
Enteropathy caused by an insensitivity to the gluten found in wheat
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system

36. Bilirubin encephalopathy
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness

37. Risk factors of tuberculosis
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
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
5 inches
crowded living conditions - homeless and low income

38. What is heart failure?
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
Between 6-12 months
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Length board standiometer

39. Teaching for Mononucleosis
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Repeated involuntary urination in a child who should already by toilet trained at night
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

40. Why avoid circumcision in a baby with hypospadias?
Foreskin is used during the surgical repair
< 5%
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
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

41. Signs and symptoms of tuberculosis
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
hearing loss - scarring - mastoiditis - meningitis
parainfluenza - RSV - Influenza A&B - M. pneumonia

42. 3 symptoms of coarctation of the aorta
They are people - need a balance of limits and independence
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower 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

43. 3 main causes of Bacterial meningitis in children
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides

44. Diet for Hirschsprung's prior to corrction and treatment
2 snacks
2 years
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
Low fiber - high calorie and protein

45. BMI-@ risk for overweight
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
36 months
85-95%
No - it can only be controlled

46. Pathophysiology of Chronic Asthma
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
inflammation and hypersensitivity to triggers
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void

47. Treatment and nursing care for pertussis
chest x-ray following a Positive PPD skin test
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Length Chart
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

48. Signs and symptoms of varicella Prodromal
Triple
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
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

49. Clinicla manifestations of sickle cell disease
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Vaso-occulisive crisis - infection and sepsis
Dental procedures - gum disease and urinary tract infections
A narrowing within the Aorta resulting in collateral circulation

50. Nursing interventions for hemophilia
Mid puberty
Excessive stool fat
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds