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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. Can Asthma be cured?
No - it can only be controlled
older preschool age and young school age-believe that they have caused an event such as a sibling's illness or hospitalization is a form of punishment
drooling
fecal soiling

2. Basic defect in coarctation of the aorta
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
A narrowing within the Aorta resulting in collateral circulation
12-24 days
9 months

3. Two important assessment rules related to coarctation of the aorta?
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
2.5 inches
Vaso-occulisive crisis - infection and sepsis

4. At birth - head circumference is ____ compared to chest circumference
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
larger

5. Teaching for Croup
Growth spurt
Brain damage - hearing loss and learning disabilities
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

6. What should be observed in a case of a seizure?
Between 6-12 months
Time and discription of seizure
# of stools per day - goal=2-3 stools per day
Day 3 of life

7. Pathophysiology of celiac disease
fecal soiling
Triple
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

8. How does pertussis present?
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

9. What are the S/SX of bleeds in hemophilia?
prevention - po antibiotics should be given before and after an invasive procedure
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
9 months

10. Main cause of urinary tract infections
A typical lymphocytosis - mono-spot - EBV serology
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
E. Coli
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping

11. Signs and Symptoms of Bilirubin Kernicterus (encephalopathy)
Adequate O2 adequatte hydration
<25 yrs old
Successful management is based on early diagnosis and aggressive therapy
lethargy - irritability - decrease feedings - fever - seizures

12. What has the HIB vaccine been successful in reducing?
# of stools per day - goal=2-3 stools per day
<25 yrs old
Liver Biopsy
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis

13. Incubation period for TB
1-6 months
Day 3 of life
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Adequate O2 adequatte hydration

14. Diastat rectal diazepam gel

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15. Prevention of bronchiolitis spreading
Contact isolation - gown - gloves and handwashing
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
BMI chart
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated

16. 3 symptoms of coarctation of the aorta
An Acute inflamation of the meninges and CSF often caused by Enterovirus
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

17. Signs and Symptoms of Hemolytic Disease of the newborn
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
12-24 days

18. difference btwn GER and GERD
GERD is the complications and symptoms that happen because of GER
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet

19. Diagnose Intussusception by
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Barium enema
parainfluenza - RSV - Influenza A&B - M. pneumonia
older preschool age and young school age-believe that they have caused an event such as a sibling's illness or hospitalization is a form of punishment

20. Encoperesis
Triple
fecal soiling
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
GERD is the complications and symptoms that happen because of GER

21. What can promote dryness in a child with enuresis?
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
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
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
crowded living conditions - homeless and low income

22. What foods are prohibited for a person with Celiac Disease?
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Milk - Ice cream - Malts - Grains
Epstein Barr Virus - transmitted with intimate contact
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks

23. Treatment for mononucleosis
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Dental procedures - gum disease and urinary tract infections
none
6 months

24. GER (gastroesophageal reflux)
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Penicillin Prophylaxis (BID)
passage of abdominal contents to the esophagus
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides

25. What are development considerations for hemophilia?
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
measures the largest velocity which occurs during a forced exhale
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
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support

26. During an abdominal assessment when should auscultation occur
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Adequate O2 adequatte hydration
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

27. Term infant --Bilirubin peaks at what day of life
diazepam - lorazapam
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Day 3 of life
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine

28. Nursing care for child with seizure

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29. How many meals and snacks should a 1-3 yr old have in a day 3 meals
2 snacks
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
Growth spurt
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness

30. Causes of Bronchopulmonary Dysplasia
Mechanical Ventalation - high inhaled o2 concentration
Airborne and contact
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

31. What are major risk factors for neonatal meningitis?
crowded living conditions - homeless and low income
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
Maternal infection - premature rupture of membranes

32. Cephalocaudal
from head to toe
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Mid puberty

33. What occurs in a subacute baterial endocarditis?
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
lethargy - irritability - decrease feedings - fever - seizures
They are people - need a balance of limits and independence
Bacteria enter the blood stream from a site of localized infection and grows in the heart

34. S/SX of Hirschsprungs
Small bowel biopsy
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Hepatoxicity - pancreatitis
An Acute inflamation of the meninges and CSF often caused by Enterovirus

35. What is the cause of mononucleosis and its method of transmission?
Epstein Barr Virus - transmitted with intimate contact
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)

36. Males Reproductive issues for CF patients
double birth weight
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
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Sterile-caused by blockage of thick mucous at the vas deferens

37. Females reproductive issues for CF patients
Successful management is based on early diagnosis and aggressive therapy
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
Low fiber - high calorie and protein

38. Signs and Symptoms of Celiac Disease
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
complete physical and psychosocial assessment to rule out underlying disorders
Adequate O2 adequatte hydration
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli

39. 2 factors that determine birth weight
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
6 months
maternal nutrition and genetics
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds

40. What is enuresis?
Between 6-12 months
Repeated involuntary urination in a child who should already by toilet trained at night
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Kawasaki disease - w/o treatment 25% will have permanent heart damage

41. Define Proximodistal
from trunk to extremities
Airborne and contact
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

42. What is physiologic Jaundice?
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
Penicillin Prophylaxis (BID)
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
high protien and calorie - multivitamins - extra enzymes for high fat food

43. Pathophysiology of Acute Asthma
high protien and calorie - multivitamins - extra enzymes for high fat food
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
< 1
Swelling of the airways - mucous production - bronchospasms

44. Treatment for Hirschsprungs
maternal nutrition and genetics
Contact isolation - gown - gloves and handwashing
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Triple

45. Viral Croup
up to 14 days
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Swelling or obstruction of the Larynx
An Acute inflamation of the meninges and CSF often caused by Enterovirus

46. Focus of adolescent discipline
Give freedom and choices - save battles for the important things
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old

47. Treatment of Meningitis

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48. Signs and symptoms of Reye's Syndrome
GERD is the complications and symptoms that happen because of GER
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
3 years
Liver Biopsy

49. Sequence of resp distress
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Contact isolation - gown - gloves and handwashing

50. Signs and symptoms of tuberculosis
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Viral---Varicella or influenza
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin

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Certified Pediatric Nurse Exam

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