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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.
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. Treatment for Hirschsprungs
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Erythroblastosis Fetalis
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
birth-36 months

2. 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
GERD is the complications and symptoms that happen because of GER
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml

3. Pathophysiology of intussusception
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
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
Equal to
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

4. Leading cause of bacterial meningitis in Neonates
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
Group B Streptococcus
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Swelling of the airways - mucous production - bronchospasms

5. When does the surgery to correct hypospadias usually occur?
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Between 6-12 months
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy

6. Pathophysiology of celiac disease
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
School age
drooling

7. What is Cystic Fibrosis?
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)

8. Age group the limbs grow the fastest
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
School age
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
drooling

9. Signs and symptoms of varicella Prodromal
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
5 inches
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
Foreskin is used during the surgical repair

10. Two examples of benzodiazepines
5 inches
diazepam - lorazapam
larger
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

11. Neonatal Jaundice
>95%
Penicillin Prophylaxis (BID)
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

12. Pathophysiology related to Head Trauma
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
A narrowing within the Aorta resulting in collateral circulation
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

13. Treatment for sickle cell disease
Time and discription of seizure
measures the largest velocity which occurs during a forced exhale
Cool mist therapy - encourage oral intake - s/sx of resp. distress
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

14. Celiac Disease
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
Length Chart
They are people - need a balance of limits and independence
Enteropathy caused by an insensitivity to the gluten found in wheat

15. Cephalocaudal
from head to toe
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Time and discription of seizure
larger

16. What is Hemolytic Disease of the Newborn
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
birth-36 months
head

17. Part of the body that grows the fastest in the toddler-preschool age
trunk
Between 6-12 months
10 inches
4 years

18. Post Op treatment of a VP shunt
They are people - need a balance of limits and independence
Vaso-occulisive crisis - infection and sepsis
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Previous history of life threatening reaction - Mod-severe illness w/wo fever

19. Viral Croup
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
Family history - EEG - CBC - LP and MRI
Swelling or obstruction of the Larynx

20. Nursing care for Kawasaki Disease
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
Mechanical Ventalation - high inhaled o2 concentration
hearing loss - scarring - mastoiditis - meningitis
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks

21. S/SX of Hirschsprungs
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention

22. Reyes Syndrome
up to 14 days
double birth weight
12-24 days
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness

23. Complications related to varicella
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Excessive stool fat
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)

24. Puberty for boys
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
12 years
<25 yrs old
5ml/dl

25. What is physiologic Jaundice?
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
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
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus

26. 3 symptoms of coarctation of the aorta
crowded living conditions - homeless and low income
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Length board standiometer

27. Diet for CF patients
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
high protien and calorie - multivitamins - extra enzymes for high fat food
No - it can only be controlled
Maternal infection - premature rupture of membranes

28. Childs weight at 6 months compared to birth weight
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
double birth weight
birth-36 months
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

29. 2 factors that determine birth weight
Growth spurt
maternal nutrition and genetics
Foreskin is used during the surgical repair
Previous history of life threatening reaction - Mod-severe illness w/wo fever

30. Cause of bronchiolitis
12 years
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
An Acute inflamation of the meninges and CSF often caused by Enterovirus

31. Signs and Symptoms of intussusception
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
maternal nutrition and genetics
Cool mist therapy - encourage oral intake - s/sx of resp. distress

32. Prevention of infection in Sickle Cell Disease
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Penicillin Prophylaxis (BID)
Maternal infection - premature rupture of membranes
dysfunction of the lower esophageal sphincter and delayed gastric emptying time

33. Basic defect in coarctation of the aorta
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
A narrowing within the Aorta resulting in collateral circulation
Group B Streptococcus
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

34. Growth spurt for adolescent boys
Mid puberty
Low fiber - high calorie and protein
trunk - gonads and associative tissue
fecal soiling

35. Another name for Hemolytic Disease of the Newborn
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Erythroblastosis Fetalis
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
>95%

36. Signs and symptoms of Reye's Syndrome
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
maternal nutrition and genetics
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages

37. Nursing care of the infant with pyloric stenosis
Successful management is based on early diagnosis and aggressive therapy
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

38. [email protected] risk for overweight
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
85-95%
>95%
Dental procedures - gum disease and urinary tract infections

39. Equipment used to measure a 24 to 36 month old height
Penicillin Prophylaxis (BID)
none
Between 6-12 months
Length board standiometer

40. Asthma
double birth weight
School age
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli

41. Signs and Symptoms that indicate and adverse reaction to a vaccine
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Epstein Barr Virus - transmitted with intimate contact

42. What is the cause of mononucleosis and its method of transmission?
Erythroblastosis Fetalis
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Epstein Barr Virus - transmitted with intimate contact

43. Why is early diagnosis important w. Reye's Syndrome?
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Successful management is based on early diagnosis and aggressive therapy
inflammation located in the middle ear

44. Key nursing intervention for subacute bacterial endocarditis
Family history - EEG - CBC - LP and MRI
Equal to
12 years
prevention - po antibiotics should be given before and after an invasive procedure

45. What should be done to minimize the risks of Sudden infant death syndrome?
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Brain damage - hearing loss and learning disabilities
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant

46. Complications of meningitis
head
Brain damage - hearing loss and learning disabilities
Dust - mold - animal dander - viral infections
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

47. treatment of hemolytic disease of the newborn
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
12-24 days
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
Phototherapy - exchange transfusion

48. treatment of intussusception
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Phototherapy - exchange transfusion
13 years
Time and discription of seizure

49. Can Asthma be cured?
No - it can only be controlled
double birth weight
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Foreskin is used during the surgical repair

50. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Penicillin Prophylaxis (BID)
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption

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