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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. Precaustions needed for pt's with varicella
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
Airborne and contact
85-95%
MVA - bike accidents and falls

2. Bronchiolitis
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
crowded living conditions - homeless and low income
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection

3. 3 main causes of Bacterial meningitis in children
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
lethargy - irritability - decrease feedings - fever - seizures
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus

4. Treatment for Hirschsprungs
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
high protien and calorie - multivitamins - extra enzymes for high fat food
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Urethral opening is positioned below the glans penis

5. Hirschsprung's Disease
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
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
2.5 inches
A typical lymphocytosis - mono-spot - EBV serology

6. Basic defect in coarctation of the aorta
trunk - gonads and associative tissue
A narrowing within the Aorta resulting in collateral circulation
up to 14 days
Family history - EEG - CBC - LP and MRI

7. What Component of Aspirin cause's Reye's Syndrome?
13 years
Salicylates
Viral---Varicella or influenza
Urethral opening is positioned below the glans penis

8. Reyes Syndrome
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
poor feeding - wt loss - fatigue - develop. delays - edema
inflammation and hypersensitivity to triggers

9. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
BMI chart
Growth spurt
Repeated involuntary urination in a child who should already by toilet trained at night

10. Hypospadias
Adequate O2 adequatte hydration
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
Urethral opening is positioned below the glans penis

11. Part of body that grows the fastest in infancy
used for prolonged sz's
head
O2 status of blood - acid-base balance
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function

12. Prevention of infection in Sickle Cell Disease
fever and infection
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Penicillin Prophylaxis (BID)
4 years

13. What is Pyloric stenosis?
12-24 days
10 years
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
A narrowing within the Aorta resulting in collateral circulation

14. When does the surgery to correct hypospadias usually occur?
Mechanical Ventalation - high inhaled o2 concentration
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
Between 6-12 months
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml

15. Why is early diagnosis important w. Reye's Syndrome?
Give freedom and choices - save battles for the important things
9 months
Successful management is based on early diagnosis and aggressive therapy
12-24 days

16. 3 symptoms of coarctation of the aorta
Epstein Barr Virus - transmitted with intimate contact
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
A narrowing within the Aorta resulting in collateral circulation
Maternal infection - premature rupture of membranes

17. Which growth chart is appropriate for use - Growth for the young child who is measured laying down?
complete physical and psychosocial assessment to rule out underlying disorders
Length Chart
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
Kawasaki disease - w/o treatment 25% will have permanent heart damage

18. Puberty for boys
Family history - EEG - CBC - LP and MRI
poor feeding - wt loss - fatigue - develop. delays - edema
12 years
0-24 months

19. What are development considerations for hemophilia?
Penicillin Prophylaxis (BID)
Swelling of the airways - mucous production - bronchospasms
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia

20. What is an acute otitis media?
poor feeding - wt loss - fatigue - develop. delays - edema
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
inflammation located in the middle ear
crowded living conditions - homeless and low income

21. Treatment and nursing care for pertussis
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Maternal infection - premature rupture of membranes
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds

22. Varicella communicable
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
>95%
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Dental procedures - gum disease and urinary tract infections

23. Diagnose Reye's Syndrome
trunk
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Liver Biopsy
They are people - need a balance of limits and independence

24. What should be used for feeding a child during the post operative period following cleft palate surgery?
Airborne and contact
Rinse mouth and brush teeth
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
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects

25. Treatment for mononucleosis
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
none
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration

26. Two examples of benzodiazepines
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Foreskin is used during the surgical repair
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
diazepam - lorazapam

27. Complications of meningitis
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
Brain damage - hearing loss and learning disabilities
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Penicillin Prophylaxis (BID)

28. Hourly maintenance Fluid Requirements
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
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics

29. Nursing care for Cystic Fibrosis
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
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Day 3 of life

30. Signs and Symptoms of Asthma
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
inflammation located in the middle ear
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
Day 3 of life

31. Steatorrhea
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
GERD is the complications and symptoms that happen because of GER
Excessive stool fat

32. What can promote dryness in a child with enuresis?
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Milk - Ice cream - Malts - Grains
12-24 days

33. Head circumference should be assessed until what age
Mechanical Ventalation - high inhaled o2 concentration
Vaso-occulisive crisis - infection and sepsis
3 years
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml

34. Sickle Cell Disease
36 months
Repeated involuntary urination in a child who should already by toilet trained at night
5 inches
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin

35. How many days after birth do bilirubin levels return to normal limits?
BMI chart
12-24 days
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Equal to

36. Diet for CF patients
high protien and calorie - multivitamins - extra enzymes for high fat food
10 inches
inflammation and hypersensitivity to triggers
Barium enema

37. Age group the limbs grow the fastest
used for prolonged sz's
School age
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
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

38. Pathophysiology of hirschsprung's disease
none
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
from head to toe

39. Treatment for sickle cell disease
Between 6-12 months
Viral---Varicella or influenza
Barium enema
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

40. Age of children at half their adult height
2 years
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
high protien and calorie - multivitamins - extra enzymes for high fat food
Liver Biopsy

41. Where does the adolescent experience rapid growth?
Low fiber - high calorie and protein
trunk - gonads and associative tissue
Equal to
2.5 inches

42. Incubation period for TB
Length board standiometer
1-6 months
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

43. At what age is a stadiometer required to measure linear growth?
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Enteropathy caused by an insensitivity to the gluten found in wheat
2 snacks
36 months

44. treatment of intussusception
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Barium enema
fever - malaise - poor appetite - wt loss -cough - night sweats and chills

45. Assess the cause of enuresis
complete physical and psychosocial assessment to rule out underlying disorders
2.5 inches
from head to toe
passage of abdominal contents to the esophagus

46. What interventions prevent urinary tract infections?
Day 3 of life
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks

47. Common Asthma irritants
prevention - po antibiotics should be given before and after an invasive procedure
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
fever and infection
Dust - mold - animal dander - viral infections

48. Females reproductive issues for CF patients
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
A typical lymphocytosis - mono-spot - EBV serology

49. Average age of breast development
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Repeated involuntary urination in a child who should already by toilet trained at night
10 years
Length board standiometer

50. Signs of increased ICP
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis