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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. Assessment of a patient with suspected epiglottitis
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
Kawasaki disease - w/o treatment 25% will have permanent heart damage
10 years
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film

2. What is heart failure?
Rinse mouth and brush teeth
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
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
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

3. Teaching for Mononucleosis
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
fever and infection

4. Diagnose Intussusception by
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Barium enema
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache

5. Growth spurt for adolescent boys
Mid puberty
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
6 months
Rinse mouth and brush teeth

6. What is the treatment for epiglottitis?
Low fiber - high calorie and protein
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
E. Coli
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function

7. difference btwn GER and GERD
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
Hepatoxicity - pancreatitis
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
GERD is the complications and symptoms that happen because of GER

8. Cause of bronchiolitis
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
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
School age
10 inches

9. What are major risk factors for neonatal meningitis?
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
double birth weight
Maternal infection - premature rupture of membranes

10. Main cause of urinary tract infections
E. Coli
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
diazepam - lorazapam
No - it can only be controlled

11. What is Pyloric stenosis?
Foreskin is used during the surgical repair
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Epstein Barr Virus - transmitted with intimate contact
complete physical and psychosocial assessment to rule out underlying disorders

12. Head circumference should be assessed until what age
Epstein Barr Virus - transmitted with intimate contact
lethargy - irritability - decrease feedings - fever - seizures
3 years
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)

13. Side effects of benzodiazepines
drooling
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
Group B Streptococcus
Contact isolation - gown - gloves and handwashing

14. BMI- overweight
5 inches
Foreskin is used during the surgical repair
>95%
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping

15. Diet for Hirschsprung's prior to corrction and treatment
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
Low fiber - high calorie and protein
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

16. Pancreatic enzyme therapy for cystic fibrosis is adjusted based on what factors growth and development?
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
# 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
measures the largest velocity which occurs during a forced exhale

17. What is enuresis?
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
prevention - po antibiotics should be given before and after an invasive procedure
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
Repeated involuntary urination in a child who should already by toilet trained at night

18. Term infant --Bilirubin peaks at what day of life
Day 3 of life
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting

19. Define Proximodistal
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
Foreskin is used during the surgical repair
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
from trunk to extremities

20. Non-pharmalogical measures to treat GER
chest x-ray following a Positive PPD skin test
Vaso-occulisive crisis - infection and sepsis
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping

21. Reyes Syndrome
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
< 5%
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache

22. Signs and Symptoms of Bilirubin Kernicterus (encephalopathy)
Viral---Varicella or influenza
Triple
lethargy - irritability - decrease feedings - fever - seizures
Mid puberty

23. What interventions prevent urinary tract infections?
Airborne and contact
Family history - EEG - CBC - LP and MRI
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth

24. Age group affected by mononucleosis
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
<25 yrs old
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Barium enema

25. Nursing interventions for hemophilia
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
Length Chart
Cool mist therapy - encourage oral intake - s/sx of resp. distress

26. What are the S/SX of bleeds in hemophilia?
O2 status of blood - acid-base balance
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
double birth weight
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)

27. How is mononucleosis diagnosed
A typical lymphocytosis - mono-spot - EBV serology
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
Equal to
fecal soiling

28. What level does the bilirubin need to be at in order for jaundice to occur?
School age
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
diazepam - lorazapam
5ml/dl

29. Nursing care for a child with Reye's Syndrome
Hepatoxicity - pancreatitis
12-24 days
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

30. How many days after birth do bilirubin levels return to normal limits?
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
12-24 days
double birth weight
Enteropathy caused by an insensitivity to the gluten found in wheat

31. Signs and symptoms of neonatal meningitis
Previous history of life threatening reaction - Mod-severe illness w/wo fever
fever and infection
# of stools per day - goal=2-3 stools per day
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

32. Rheumatic Fever
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Urethral opening is positioned below the glans penis

33. Sickle Cell Disease
6 months
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Phototherapy - exchange transfusion

34. Teaching for Croup
maternal nutrition and genetics
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Cool mist therapy - encourage oral intake - s/sx of resp. distress

35. Pathophysiology of hirschsprung's disease
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Vaso-occulisive crisis - infection and sepsis
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption

36. What is physiologic Jaundice?
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Give freedom and choices - save battles for the important things
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
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

37. Pathophysiology of Chronic Asthma
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Urethral opening is positioned below the glans penis
inflammation and hypersensitivity to triggers

38. S/sx of GERD
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Enteropathy caused by an insensitivity to the gluten found in wheat
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
maternal nutrition and genetics

39. Males Reproductive issues for CF patients
Sterile-caused by blockage of thick mucous at the vas deferens
gum hypertrophy
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth

40. Signs and Symptoms of Celiac Disease
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
complete physical and psychosocial assessment to rule out underlying disorders
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Urethral opening is positioned below the glans penis

41. 2 factors that determine birth weight
Previous history of life threatening reaction - Mod-severe illness w/wo fever
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
maternal nutrition and genetics
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2

42. Average rate of growth for the 2nd year of lif
5 inches
<25 yrs old
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2

43. Where does the adolescent experience rapid growth?
trunk - gonads and associative tissue
diazepam - lorazapam
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting

44. Treatment for Hirschsprungs
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
drooling
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Viral---Varicella or influenza

45. How is Celiac Disease diagnosed?
Small bowel biopsy
trunk - gonads and associative tissue
lethargy - irritability - decrease feedings - fever - seizures
Mechanical Ventalation - high inhaled o2 concentration

46. Asthma
1-6 months
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli

47. Signs of increased ICP
Airborne and contact
# of stools per day - goal=2-3 stools per day
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen

48. first tooth
Time and discription of seizure
85-95%
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
6 months

49. How many meals and snacks should a 1-3 yr old have in a day 3 meals
9 months
diazepam - lorazapam
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
2 snacks

50. BMI - underweight
< 5%
Hepatoxicity - pancreatitis
36 months
Triple