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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.
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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. Normal presentation of cystic fibrosis
5ml/dl
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
20 inches
drooling

2. What is Cystic Fibrosis?
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
fever - malaise - poor appetite - wt loss -cough - night sweats and chills

3. Precaustions needed for pt's with varicella
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
hearing loss - scarring - mastoiditis - meningitis
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Airborne and contact

4. What is broncho-pulmonary dysplasia?
Enteropathy caused by an insensitivity to the gluten found in wheat
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Small bowel biopsy

5. At what age is a length board required?
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
Triple
0-24 months
Dental procedures - gum disease and urinary tract infections

6. Viral Meningitis
An Acute inflamation of the meninges and CSF often caused by Enterovirus
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
# of stools per day - goal=2-3 stools per day
2 snacks

7. Asthma inhaler - what can be done to decrease risk of thrush
Milk - Ice cream - Malts - Grains
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
inflammation located in the middle ear
Rinse mouth and brush teeth

8. S/sx of GERD
complete physical and psychosocial assessment to rule out underlying disorders
used for prolonged sz's
Enteropathy caused by an insensitivity to the gluten found in wheat
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

9. Prevention of bronchiolitis spreading
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Contact isolation - gown - gloves and handwashing
10 inches
4 years

10. Risk factors of tuberculosis
9 months
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
crowded living conditions - homeless and low income
complete physical and psychosocial assessment to rule out underlying disorders

11. Define Proximodistal
from trunk to extremities
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Family history - EEG - CBC - LP and MRI
>95%

12. What level does the bilirubin need to be at in order for jaundice to occur?
GERD is the complications and symptoms that happen because of GER
Salicylates
Cool mist therapy - encourage oral intake - s/sx of resp. distress
5ml/dl

13. Puberty for boys
12 years
3 years
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Rinse mouth and brush teeth

14. Bilirubin encephalopathy
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
older preschool age and young school age-believe that they have caused an event such as a sibling's illness or hospitalization is a form of punishment

15. signs and symptoms of meningitis in older children
prevention - po antibiotics should be given before and after an invasive procedure
Length board standiometer
used for prolonged sz's
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash

16. Pathophysiology of intussusception

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17. Age that birth length doubles
Dental procedures - gum disease and urinary tract infections
4 years
12 years
Contact isolation - gown - gloves and handwashing

18. How many days after birth do bilirubin levels return to normal limits?
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Successful management is based on early diagnosis and aggressive therapy
12-24 days

19. Sequence of resp distress
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Repeated involuntary urination in a child who should already by toilet trained at night
Abdominal ultrasound - Upper GI

20. Treatment for mononucleosis
4 years
head
none
trunk

21. Cause of bronchiolitis
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Mid puberty
double birth weight

22. Normal Bilirubin
up to 14 days
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
Salicylates
< 1

23. Rheumatic Fever
Repeated involuntary urination in a child who should already by toilet trained at night
< 5%
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth

24. 2 key factors to consider when caring for a preschooler
They are people - need a balance of limits and independence
gum hypertrophy
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
Mid puberty

25. Age group affected by mononucleosis
<25 yrs old
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Swelling of the airways - mucous production - bronchospasms
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing

26. Leading cause of head injury
Viral---Varicella or influenza
MVA - bike accidents and falls
Milk - Ice cream - Malts - Grains
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

27. Equipment used to measure a 24 to 36 month old height
hearing loss - scarring - mastoiditis - meningitis
Sterile-caused by blockage of thick mucous at the vas deferens
Length board standiometer
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)

28. Where does the adolescent experience rapid growth?
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
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
trunk - gonads and associative tissue

29. Steatorrhea
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - 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
Excessive stool fat
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia

30. Signs and symptoms of varicella Prodromal
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
passage of abdominal contents to the esophagus
fecal soiling
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages

31. Neonatal Jaundice
crowded living conditions - homeless and low income
Dental procedures - gum disease and urinary tract infections
<25 yrs old
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system

32. Treatment for sickle cell disease
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Excessive stool fat
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

33. Test to evaluate a Seizure disorder
Family history - EEG - CBC - LP and MRI
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
maternal nutrition and genetics

34. What interventions prevent urinary tract infections?
trunk
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
3 years

35. difference btwn GER and GERD
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
GERD is the complications and symptoms that happen because of GER
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy

36. Assess the cause of enuresis
complete physical and psychosocial assessment to rule out underlying disorders
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Previous history of life threatening reaction - Mod-severe illness w/wo fever
fecal soiling

37. How does pertussis present?
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Urethral opening is positioned below the glans penis
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated

38. How many meals and snacks should a 1-3 yr old have in a day 3 meals
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
2 snacks
head
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

39. Most cases of Reye's Syndrome follows what type of illness?
Erythroblastosis Fetalis
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
Viral---Varicella or influenza
Equal to

40. At 6-24 months - head circumference is what size in relationship to chest circumference
Equal to
An Acute inflamation of the meninges and CSF often caused by Enterovirus
12 years
0-24 months

41. Diagnose Intussusception by
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
Airborne and contact
Barium enema

42. How is Celiac Disease diagnosed?
Small bowel biopsy
Contact isolation - gown - gloves and handwashing
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
inflammation and hypersensitivity to triggers

43. Why avoid circumcision in a baby with hypospadias?
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Foreskin is used during the surgical repair
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
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus

44. Signs of increased ICP
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
trunk - gonads and associative tissue
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system

45. Hourly maintenance Fluid Requirements
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
measures the largest velocity which occurs during a forced exhale
Epstein Barr Virus - transmitted with intimate contact
maternal nutrition and genetics

46. Two important assessment rules related to coarctation of the aorta?
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
none
dysfunction of the lower esophageal sphincter and delayed gastric emptying time

47. Treatment and nursing care for pertussis
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Repeated involuntary urination in a child who should already by toilet trained at night
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Kawasaki disease - w/o treatment 25% will have permanent heart damage

48. Age of children at half their adult height
Less than 120 f.
Milk - Ice cream - Malts - Grains
2 years
A narrowing within the Aorta resulting in collateral circulation

49. Part of the body that grows the fastest in the toddler-preschool age
fever and infection
Give freedom and choices - save battles for the important things
trunk
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

50. Childs weight at 6 months compared to birth weight
double birth weight
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
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

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Certified Pediatric Nurse Exam

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