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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. Childs weight at 6 months compared to birth weight
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Abdominal ultrasound - Upper GI
Family history - EEG - CBC - LP and MRI
double birth weight

2. BMI - underweight
double birth weight
< 5%
3 years
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium

3. Diagnose Reye's Syndrome
Regular diet with low sodium an no added salt
Liver Biopsy
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
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention

4. Treatment of Meningitis

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5. What can promote dryness in a child with enuresis?
maternal nutrition and genetics
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

6. Pathophysiology of cystic fibrosis
Sterile-caused by blockage of thick mucous at the vas deferens
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
birth-36 months

7. Predisposing factors to subacute bacterial endocarditis
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
double birth weight
36 months
Dental procedures - gum disease and urinary tract infections

8. What promotes unsickling of RBC's?
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
Bacteria enter the blood stream from a site of localized infection and grows in the heart
double birth weight
Adequate O2 adequatte hydration

9. first tooth
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
13 years
6 months
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

10. ABG
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Maternal infection - premature rupture of membranes
O2 status of blood - acid-base balance
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth

11. Pathophysiology of hirschsprung's disease
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
13 years

12. Diet for a child with glumerlonephritis
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
Regular diet with low sodium an no added salt
none
6 months

13. Signs and Symptoms of mononucleosis
used for prolonged sz's
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Rinse mouth and brush teeth
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days

14. Signs and Symptoms that indicate and adverse reaction to a vaccine
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
chest x-ray following a Positive PPD skin test
drooling

15. At what age is a length board required?
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
0-24 months
Kawasaki disease - w/o treatment 25% will have permanent heart damage
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness

16. Basic defect in coarctation of the aorta
A narrowing within the Aorta resulting in collateral circulation
from trunk to extremities
3 years
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications

17. What foods are prohibited for a person with Celiac Disease?
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
They are people - need a balance of limits and independence
hearing loss - scarring - mastoiditis - meningitis
Milk - Ice cream - Malts - Grains

18. Age range that is appropriate to use a length chart
Dental procedures - gum disease and urinary tract infections
A narrowing within the Aorta resulting in collateral circulation
birth-36 months
Swelling of the airways - mucous production - bronchospasms

19. At what age is a stadiometer required to measure linear growth?
12 years
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
36 months
Erythroblastosis Fetalis

20. Pathophysiology of Acute Asthma
5ml/dl
Swelling of the airways - mucous production - bronchospasms
Family history - EEG - CBC - LP and MRI
5 inches

21. Signs and symptoms of neonatal meningitis
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Phototherapy - exchange transfusion
none

22. Pathophysiology of intussusception

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23. Can Asthma be cured?
Swelling of the airways - mucous production - bronchospasms
No - it can only be controlled
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
They are people - need a balance of limits and independence

24. What are major risk factors for neonatal meningitis?
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
passage of abdominal contents to the esophagus
complete physical and psychosocial assessment to rule out underlying disorders
Maternal infection - premature rupture of membranes

25. Hourly maintenance Fluid Requirements
used for prolonged sz's
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
trunk - gonads and associative tissue
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml

26. Pathophysiology of a fever and infection with sickle cell disease
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Family history - EEG - CBC - LP and MRI
Dental procedures - gum disease and urinary tract infections
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old

27. Signs and symptoms of tuberculosis
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

28. What is epiglottitis?
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
4 years
Cool mist therapy - encourage oral intake - s/sx of resp. distress
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening

29. 3 main causes of Bacterial meningitis in children
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void

30. What interventions prevent urinary tract infections?
fecal soiling
Cool mist therapy - encourage oral intake - s/sx of resp. distress
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
School age

31. Complications of meningitis
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
< 1
Less than 120 f.
Brain damage - hearing loss and learning disabilities

32. What level does the bilirubin need to be at in order for jaundice to occur?
10 years
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Enteropathy caused by an insensitivity to the gluten found in wheat
5ml/dl

33. Prevention of infection in Sickle Cell Disease
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
Penicillin Prophylaxis (BID)
>95%
Bacteria enter the blood stream from a site of localized infection and grows in the heart

34. What is Hemolytic Disease of the Newborn
inflammation located in the middle ear
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Length board standiometer

35. Signs and Symptoms of intussusception
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
double birth weight
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

36. At birth - head circumference is ____ compared to chest circumference
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
larger

37. Treatment of celiac disease
Length board standiometer
Rinse mouth and brush teeth
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
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting

38. Pancreatic enzyme therapy for cystic fibrosis is adjusted based on what factors growth and development?
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
# of stools per day - goal=2-3 stools per day
13 years
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin

39. RSV contagious for ...
Family history - EEG - CBC - LP and MRI
up to 14 days
Maternal infection - premature rupture of membranes
from trunk to extremities

40. Key nursing intervention for subacute bacterial endocarditis
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Between 6-12 months
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
prevention - po antibiotics should be given before and after an invasive procedure

41. Treatment for mononucleosis
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Dust - mold - animal dander - viral infections
none
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

42. Main cause of urinary tract infections
E. Coli
double birth weight
2 years
Airborne and contact

43. Treatment of Kawasaki disease
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Previous history of life threatening reaction - Mod-severe illness w/wo fever

44. Females reproductive issues for CF patients
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
measures the largest velocity which occurs during a forced exhale
Low fiber - high calorie and protein
Delayed puberty - viscous cervical secretions - difficulty getting pregnant

45. Another name for Hemolytic Disease of the Newborn
Successful management is based on early diagnosis and aggressive therapy
Airborne and contact
Erythroblastosis Fetalis
diazepam - lorazapam

46. What is enuresis?
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Repeated involuntary urination in a child who should already by toilet trained at night
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
13 years

47. Celiac Disease
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Enteropathy caused by an insensitivity to the gluten found in wheat
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old

48. Why is early diagnosis important w. Reye's Syndrome?
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
from trunk to extremities
Successful management is based on early diagnosis and aggressive therapy
20 inches

49. Clinicla manifestations of sickle cell disease
Vaso-occulisive crisis - infection and sepsis
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting

50. Teaching for Croup
larger
0-24 months
up to 14 days
Cool mist therapy - encourage oral intake - s/sx of resp. distress

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Certified Pediatric Nurse Exam

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