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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. What should a child's wt be at 1 yr compared to birth weight?
Triple
chest x-ray following a Positive PPD skin test
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
dysfunction of the lower esophageal sphincter and delayed gastric emptying time

2. At birth - head circumference is ____ compared to chest circumference
5ml/dl
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
larger
Excessive stool fat

3. Teaching for Croup
Cool mist therapy - encourage oral intake - s/sx of resp. distress
They are people - need a balance of limits and independence
Triple
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus

4. What is an acute otitis media?
high protien and calorie - multivitamins - extra enzymes for high fat food
Time and discription of seizure
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
inflammation located in the middle ear

5. Reyes Syndrome
Less than 120 f.
lethargy - irritability - decrease feedings - fever - seizures
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness

6. Teaching for Mononucleosis
Rinse mouth and brush teeth
Epstein Barr Virus - transmitted with intimate contact
A typical lymphocytosis - mono-spot - EBV serology
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

7. Signs and symptoms of neonatal meningitis
Salicylates
No - it can only be controlled
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice

8. 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
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
0-24 months
fever - malaise - poor appetite - wt loss -cough - night sweats and chills

9. Causes of Bronchopulmonary Dysplasia
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
2 snacks
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Mechanical Ventalation - high inhaled o2 concentration

10. Pathophysiology of celiac disease
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting

11. Pathophysiology of a fever and infection with sickle cell disease
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
fever and infection
2 years
Dust - mold - animal dander - viral infections

12. Where does the adolescent experience rapid growth?
from head to toe
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
12 years
trunk - gonads and associative tissue

13. 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
high protien and calorie - multivitamins - extra enzymes for high fat food
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
fever and infection
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure

14. Part of body that grows the fastest in infancy
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
head
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Rinse mouth and brush teeth

15. What is the treatment for epiglottitis?
prevention - po antibiotics should be given before and after an invasive procedure
Mechanical Ventalation - high inhaled o2 concentration
Swelling or obstruction of the Larynx
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days

16. Signs and symptoms of tuberculosis
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)

17. first tooth
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
Liver Biopsy
6 months

18. 2 key factors to consider when caring for a preschooler
They are people - need a balance of limits and independence
diazepam - lorazapam
<25 yrs old
< 1

19. Steatorrhea
Excessive stool fat
Viral---Varicella or influenza
Give freedom and choices - save battles for the important things
36 months

20. BMI-@ risk for overweight
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
85-95%
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

21. What are development considerations for hemophilia?
Between 6-12 months
85-95%
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Rinse mouth and brush teeth

22. What should be observed in a case of a seizure?
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
BMI chart
12 years
Time and discription of seizure

23. Treatment of Kawasaki disease
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
4 years
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
from trunk to extremities

24. Temp of home water heater to avoid burns
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Less than 120 f.
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US

25. When does the surgery to correct hypospadias usually occur?
Low fiber - high calorie and protein
Between 6-12 months
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash

26. Treatment for mononucleosis
MVA - bike accidents and falls
parainfluenza - RSV - Influenza A&B - M. pneumonia
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
none

27. Head circumference should be assessed until what age
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Family history - EEG - CBC - LP and MRI
3 years
Mechanical Ventalation - high inhaled o2 concentration

28. Varicella communicable
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
85-95%
Cool mist therapy - encourage oral intake - s/sx of resp. distress

29. treatment of intussusception
Small bowel biopsy
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
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
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache

30. S/sx of GERD
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
A typical lymphocytosis - mono-spot - EBV serology
from head to toe

31. 3 main causes of Bacterial meningitis in children
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
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
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
GERD is the complications and symptoms that happen because of GER

32. Average rate of growth for the 2nd year of lif
birth-36 months
5 inches
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
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

33. Normal presentation of cystic fibrosis
Liver Biopsy
9 months
GERD is the complications and symptoms that happen because of GER
Steatorrhea - frequent respiratory infections during infancy - failure to thrive

34. Prevention of bronchiolitis spreading
Contact isolation - gown - gloves and handwashing
Between 6-12 months
Repeated involuntary urination in a child who should already by toilet trained at night
Small bowel biopsy

35. Average rate of growth for the 1st year
10 inches
School age
< 1
Dental procedures - gum disease and urinary tract infections

36. Why is early diagnosis important w. Reye's Syndrome?
Successful management is based on early diagnosis and aggressive therapy
12-24 days
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

37. GER (gastroesophageal reflux)
passage of abdominal contents to the esophagus
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
lethargy - irritability - decrease feedings - fever - seizures
E. Coli

38. Cephalocaudal
from head to toe
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Previous history of life threatening reaction - Mod-severe illness w/wo fever

39. Basic defect in coarctation of the aorta
A narrowing within the Aorta resulting in collateral circulation
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
< 5%
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia

40. Diet for a child with glumerlonephritis
< 5%
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
Regular diet with low sodium an no added salt
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2

41. Treatment and nursing care for pertussis
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Foreskin is used during the surgical repair
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Regular diet with low sodium an no added salt

42. How is mononucleosis diagnosed
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Epstein Barr Virus - transmitted with intimate contact
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
A typical lymphocytosis - mono-spot - EBV serology

43. Females reproductive issues for CF patients
Liver Biopsy
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects

44. What are the four main causes of viral croup?
from trunk to extremities
parainfluenza - RSV - Influenza A&B - M. pneumonia
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
2 years

45. Normal Bilirubin
< 1
maternal nutrition and genetics
Dust - mold - animal dander - viral infections
Between 6-12 months

46. Average age of breast development
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
10 years
Kawasaki disease - w/o treatment 25% will have permanent heart damage

47. Which growth chart is appropriate for use - Growth for the young child who is measured laying down?
Length Chart
Dental procedures - gum disease and urinary tract infections
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
< 1

48. Kawasaki Disease
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
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
inflammation located in the middle ear
Urethral opening is positioned below the glans penis

49. Clinicla manifestations of sickle cell disease
Vaso-occulisive crisis - infection and sepsis
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides

50. Why avoid circumcision in a baby with hypospadias?
Foreskin is used during the surgical repair
Successful management is based on early diagnosis and aggressive therapy
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2