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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. 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
13 years
Maternal infection - premature rupture of membranes
Successful management is based on early diagnosis and aggressive therapy

2. Which growth chart is appropriate for use - Growth for the young child who is measured laying down?
Length Chart
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
A typical lymphocytosis - mono-spot - EBV serology
<25 yrs old

3. Diagnose Reye's Syndrome
maternal nutrition and genetics
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
A typical lymphocytosis - mono-spot - EBV serology
Liver Biopsy

4. Reyes Syndrome
Enteropathy caused by an insensitivity to the gluten found in wheat
Swelling of the airways - mucous production - bronchospasms
Contact isolation - gown - gloves and handwashing
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness

5. Head circumference should be assessed until what age
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
3 years
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth

6. What is used to diagnose pyloric stenosis?
Phototherapy - exchange transfusion
Abdominal ultrasound - Upper GI
Dust - mold - animal dander - viral infections
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting

7. What is broncho-pulmonary dysplasia?
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
Family history - EEG - CBC - LP and MRI
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support

8. What are the four main causes of viral croup?
parainfluenza - RSV - Influenza A&B - M. pneumonia
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
>95%

9. Hourly maintenance Fluid Requirements
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
head
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml

10. Causes of Bronchopulmonary Dysplasia
O2 status of blood - acid-base balance
head
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
Mechanical Ventalation - high inhaled o2 concentration

11. Treatment of Kawasaki disease
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
double birth weight

12. Age of children at half their adult height
birth-36 months
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
2 years
Family history - EEG - CBC - LP and MRI

13. Treatment for mononucleosis
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
Swelling of the airways - mucous production - bronchospasms
none
high protien and calorie - multivitamins - extra enzymes for high fat food

14. Signs and Symptoms of Hemolytic Disease of the newborn
Vaso-occulisive crisis - infection and sepsis
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
36 months

15. Two examples of benzodiazepines
Enteropathy caused by an insensitivity to the gluten found in wheat
diazepam - lorazapam
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Mechanical Ventalation - high inhaled o2 concentration

16. What is enuresis?
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
6 months
from head to toe
Repeated involuntary urination in a child who should already by toilet trained at night

17. Key nursing intervention for subacute bacterial endocarditis
lethargy - irritability - decrease feedings - fever - seizures
prevention - po antibiotics should be given before and after an invasive procedure
double birth weight
Contact isolation - gown - gloves and handwashing

18. Signs and symptoms of neonatal meningitis
12-24 days
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

19. Signs of heart failure
Group B Streptococcus
poor feeding - wt loss - fatigue - develop. delays - edema
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
from head to toe

20. Sequence of resp distress
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
Dust - mold - animal dander - viral infections
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure

21. Pathophysiology of cystic fibrosis
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
chest x-ray following a Positive PPD skin test
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
gum hypertrophy

22. At what age is a stadiometer required to measure linear growth?
prevention - po antibiotics should be given before and after an invasive procedure
36 months
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
used for prolonged sz's

23. Prevention of infection in Sickle Cell Disease
prevention - po antibiotics should be given before and after an invasive procedure
O2 status of blood - acid-base balance
3 years
Penicillin Prophylaxis (BID)

24. Prevention of bronchiolitis spreading
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
10 inches
Contact isolation - gown - gloves and handwashing
School age

25. Pathophysiology of a fever and infection with sickle cell disease
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Family history - EEG - CBC - LP and MRI
Brain damage - hearing loss and learning disabilities
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening

26. What is used to diagnose GER?
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
85-95%
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor

27. Screening for overweight or underweight child on chart
double birth weight
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
BMI chart

28. What foods are prohibited for a person with Celiac Disease?
Give freedom and choices - save battles for the important things
< 1
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Milk - Ice cream - Malts - Grains

29. Define Magical thinking

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30. What should be done to minimize the risks of Sudden infant death syndrome?
<25 yrs old
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Family history - EEG - CBC - LP and MRI

31. Nursing care for child with seizure

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32. Part of body that grows the fastest in infancy
Viral---Varicella or influenza
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
head
Brain damage - hearing loss and learning disabilities

33. 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
BMI chart
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Delayed puberty - viscous cervical secretions - difficulty getting pregnant

34. Side effects of benzodiazepines
Brain damage - hearing loss and learning disabilities
BMI chart
drooling
chest x-ray following a Positive PPD skin test

35. Cephalocaudal
from head to toe
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

36. Teaching for Croup
none
Cool mist therapy - encourage oral intake - s/sx of resp. distress
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
fever and infection

37. Average age of menarche
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
A narrowing within the Aorta resulting in collateral circulation
13 years

38. Pertussis?
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
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

39. Hirschsprung's Disease
Less than 120 f.
10 inches
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
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine

40. Nursing care for a child with Reye's Syndrome
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Dust - mold - animal dander - viral infections

41. Temp of home water heater to avoid burns
Less than 120 f.
Mechanical Ventalation - high inhaled o2 concentration
Low fiber - high calorie and protein
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated

42. treatment of hemolytic disease of the newborn
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Phototherapy - exchange transfusion
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

43. GER (gastroesophageal reflux)
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
none
Sterile-caused by blockage of thick mucous at the vas deferens
passage of abdominal contents to the esophagus

44. Precaustions needed for pt's with varicella
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Airborne and contact
inflammation and hypersensitivity to triggers
Rinse mouth and brush teeth

45. Why avoid circumcision in a baby with hypospadias?
# of stools per day - goal=2-3 stools per day
inflammation and hypersensitivity to triggers
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Foreskin is used during the surgical repair

46. Pathophysiology of celiac disease
Small bowel biopsy
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
passage of abdominal contents to the esophagus
Dental procedures - gum disease and urinary tract infections

47. Average rate of growth for the 2nd year of lif
5 inches
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Liver Biopsy
12 years

48. Test to evaluate a Seizure disorder
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Family history - EEG - CBC - LP and MRI
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
inflammation and hypersensitivity to triggers

49. What is Hemolytic Disease of the Newborn
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor

50. Leading cause of acquired heart disease in children
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
parainfluenza - RSV - Influenza A&B - M. pneumonia
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Kawasaki disease - w/o treatment 25% will have permanent heart damage

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Certified Pediatric Nurse Exam

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