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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. What is broncho-pulmonary dysplasia?
poor feeding - wt loss - fatigue - develop. delays - edema
Airborne and contact
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
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

2. Leading cause of bacterial meningitis in Neonates
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Group B Streptococcus
trunk
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

3. Which growth chart is appropriate for use - Growth for the young child who is measured laying down?
Length Chart
No - it can only be controlled
from head to toe
Mid puberty

4. Age range that is appropriate to use a length chart
2.5 inches
Phototherapy - exchange transfusion
birth-36 months
Viral---Varicella or influenza

5. At 6-24 months - head circumference is what size in relationship to chest circumference
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Equal to
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

6. Signs and symptoms of varicella Prodromal
Salicylates
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects

7. Where does the adolescent experience rapid growth?
trunk - gonads and associative tissue
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)

8. Average rate of growth for the 2nd year of lif
trunk
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
5 inches
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes

9. 2 factors that determine birth weight
maternal nutrition and genetics
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
4 years

10. Sickle Cell Disease
from head to toe
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Group B Streptococcus
>95%

11. Why avoid circumcision in a baby with hypospadias?
Regular diet with low sodium an no added salt
Between 6-12 months
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Foreskin is used during the surgical repair

12. Pathophysiology of hirschsprung's disease
Barium enema
Milk - Ice cream - Malts - Grains
O2 status of blood - acid-base balance
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated

13. Females reproductive issues for CF patients
poor feeding - wt loss - fatigue - develop. delays - edema
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain

14. When does the surgery to correct hypospadias usually occur?
Length board standiometer
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Between 6-12 months
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption

15. How many meals and snacks should a 1-3 yr old have in a day 3 meals
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
head
Mechanical Ventalation - high inhaled o2 concentration
2 snacks

16. Asthma inhaler - what can be done to decrease risk of thrush
# of stools per day - goal=2-3 stools per day
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Rinse mouth and brush teeth
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus

17. Prevention of infection in Sickle Cell Disease
Penicillin Prophylaxis (BID)
chest x-ray following a Positive PPD skin test
<25 yrs old
Growth spurt

18. What are development considerations for hemophilia?
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
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
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

19. Teaching for Croup
Penicillin Prophylaxis (BID)
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
>95%
Cool mist therapy - encourage oral intake - s/sx of resp. distress

20. Age group the limbs grow the fastest
School age
2.5 inches
lethargy - irritability - decrease feedings - fever - seizures
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth

21. Average rate of growth for the 1st year
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
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
10 inches
5ml/dl

22. Complications of meningitis
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Phototherapy - exchange transfusion
A typical lymphocytosis - mono-spot - EBV serology
Brain damage - hearing loss and learning disabilities

23. Treatment for Varicella
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
trunk
parainfluenza - RSV - Influenza A&B - M. pneumonia

24. Cause of bronchiolitis
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
poor feeding - wt loss - fatigue - develop. delays - edema
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia

25. GER (gastroesophageal reflux)
passage of abdominal contents to the esophagus
Repeated involuntary urination in a child who should already by toilet trained at night
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
maternal nutrition and genetics

26. Risk factors of tuberculosis
Repeated involuntary urination in a child who should already by toilet trained at night
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
crowded living conditions - homeless and low income

27. Linear growth event happens in Adolescents
Length Chart
Growth spurt
13 years
Family history - EEG - CBC - LP and MRI

28. What is epiglottitis?
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
hearing loss - scarring - mastoiditis - meningitis
crowded living conditions - homeless and low income
Day 3 of life

29. Treatment of Meningitis

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30. Nursing interventions for hemophilia
Less than 120 f.
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
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2

31. What is Pyloric stenosis?
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Time and discription of seizure

32. Diet for a child with glumerlonephritis
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Regular diet with low sodium an no added salt
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

33. Hirschsprung's Disease
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
5 inches
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

34. Define Proximodistal
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
from trunk to extremities
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption

35. Contraindications to all vaccines
birth-36 months
A narrowing within the Aorta resulting in collateral circulation
fecal soiling
Previous history of life threatening reaction - Mod-severe illness w/wo fever

36. 2 key factors to consider when caring for a preschooler
5ml/dl
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
They are people - need a balance of limits and independence
BMI chart

37. Clinical signs of infection wilth sickle cell disease
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
Swelling of the airways - mucous production - bronchospasms

38. Signs and Symptoms that indicate and adverse reaction to a vaccine
up to 14 days
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
2 years
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

39. During an abdominal assessment when should auscultation occur
Urethral opening is positioned below the glans penis
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
maternal nutrition and genetics
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old

40. difference btwn GER and GERD
gum hypertrophy
6 months
< 5%
GERD is the complications and symptoms that happen because of GER

41. What occurs in a subacute baterial endocarditis?
up to 14 days
maternal nutrition and genetics
parainfluenza - RSV - Influenza A&B - M. pneumonia
Bacteria enter the blood stream from a site of localized infection and grows in the heart

42. Test to evaluate a Seizure disorder
Family history - EEG - CBC - LP and MRI
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Enteropathy caused by an insensitivity to the gluten found in wheat
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml

43. Two important assessment rules related to coarctation of the aorta?
Enteropathy caused by an insensitivity to the gluten found in wheat
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
trunk
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures

44. Treatment and nursing care for pertussis
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Steatorrhea - frequent respiratory infections during infancy - failure to thrive

45. Diagnose Reye's Syndrome
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Vaso-occulisive crisis - infection and sepsis
O2 status of blood - acid-base balance
Liver Biopsy

46. Asthma
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
inflammation and hypersensitivity to triggers

47. What is heart failure?
4 years
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
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
< 5%

48. Treatment of Kawasaki disease
none
Epstein Barr Virus - transmitted with intimate contact
Cool mist therapy - encourage oral intake - s/sx of resp. distress
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy

49. 3 symptoms of coarctation of the aorta
Family history - EEG - CBC - LP and MRI
poor feeding - wt loss - fatigue - develop. delays - edema
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

50. Pathophysiology of Acute Asthma
Swelling of the airways - mucous production - bronchospasms
Liver Biopsy
gum hypertrophy
2 years

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Certified Pediatric Nurse Exam

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