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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. Teaching for Croup
Cool mist therapy - encourage oral intake - s/sx of resp. distress
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
4 years
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated

2. At what age is a stadiometer required to measure linear growth?
poor feeding - wt loss - fatigue - develop. delays - edema
36 months
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Day 3 of life

3. Treatment and nursing care for pertussis
Length Chart
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Kawasaki disease - w/o treatment 25% will have permanent heart damage
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

4. 2 factors that determine birth weight
A typical lymphocytosis - mono-spot - EBV serology
maternal nutrition and genetics
85-95%
complete physical and psychosocial assessment to rule out underlying disorders

5. What is an acute otitis media?
used for prolonged sz's
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
inflammation located in the middle ear
Length Chart

6. Pathophysiology of intussusception

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7. Precaustions needed for pt's with varicella
Less than 120 f.
Airborne and contact
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Equal to

8. Clinical signs of infection wilth sickle cell disease
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Milk - Ice cream - Malts - Grains
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death

9. Prevention of infection in Sickle Cell Disease
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
Penicillin Prophylaxis (BID)

10. Test to evaluate a Seizure disorder
Family history - EEG - CBC - LP and MRI
hearing loss - scarring - mastoiditis - meningitis
crowded living conditions - homeless and low income
trunk - gonads and associative tissue

11. Can Asthma be cured?
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
2.5 inches
hearing loss - scarring - mastoiditis - meningitis
No - it can only be controlled

12. signs and symptoms of meningitis in older children
<25 yrs old
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
poor feeding - wt loss - fatigue - develop. delays - edema
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)

13. Common Asthma irritants
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Dust - mold - animal dander - viral infections
Group B Streptococcus

14. Leading cause of acquired heart disease in children
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
passage of abdominal contents to the esophagus
# of stools per day - goal=2-3 stools per day
Kawasaki disease - w/o treatment 25% will have permanent heart damage

15. What is used to diagnose GER?
GERD is the complications and symptoms that happen because of GER
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
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough

16. Asthma
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
maternal nutrition and genetics
Equal to

17. Two examples of benzodiazepines
larger
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
diazepam - lorazapam
2 years

18. Basic defect in coarctation of the aorta
inflammation and hypersensitivity to triggers
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
A narrowing within the Aorta resulting in collateral circulation
Bacteria enter the blood stream from a site of localized infection and grows in the heart

19. Two important assessment rules related to coarctation of the aorta?
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Foreskin is used during the surgical repair
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2

20. Kawasaki Disease
1-6 months
Previous history of life threatening reaction - Mod-severe illness w/wo fever
High persistent fever for 5 days - swelling of the conjunctiva w/o drainage - inflammation of the mouth-lips-tongue - swollen red hands & feet - rash - cervical lymphadinopathy
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption

21. Females reproductive issues for CF patients
A typical lymphocytosis - mono-spot - EBV serology
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Dental procedures - gum disease and urinary tract infections

22. Why is early diagnosis important w. Reye's Syndrome?
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Successful management is based on early diagnosis and aggressive therapy
Foreskin is used during the surgical repair
lethargy - irritability - decrease feedings - fever - seizures

23. At 6-24 months - head circumference is what size in relationship to chest circumference
from trunk to extremities
Equal to
10 years
hearing loss - scarring - mastoiditis - meningitis

24. Non-pharmalogical measures to treat GER
inflammation located in the middle ear
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption

25. Age that birth length doubles
School age
4 years
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Barium enema

26. Diet for CF patients
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Adequate O2 adequatte hydration
parainfluenza - RSV - Influenza A&B - M. pneumonia
high protien and calorie - multivitamins - extra enzymes for high fat food

27. How many days after birth do bilirubin levels return to normal limits?
none
Foreskin is used during the surgical repair
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
12-24 days

28. Signs and symptoms of neonatal meningitis
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
larger

29. BMI-@ risk for overweight
Swelling or obstruction of the Larynx
20 inches
lethargy - irritability - decrease feedings - fever - seizures
85-95%

30. BMI- overweight
1-6 months
Equal to
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
>95%

31. Assessment of a patient with suspected epiglottitis
School age
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

32. Normal presentation of cystic fibrosis
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Steatorrhea - frequent respiratory infections during infancy - failure to thrive

33. What is the cause of mononucleosis and its method of transmission?
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Epstein Barr Virus - transmitted with intimate contact
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
10 inches

34. When does the surgery to correct hypospadias usually occur?
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Between 6-12 months
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
gum hypertrophy

35. first tooth
trunk
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
none
6 months

36. Signs and symptoms of Reye's Syndrome
trunk - gonads and associative tissue
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
Delayed puberty - viscous cervical secretions - difficulty getting pregnant

37. At birth - head circumference is ____ compared to chest circumference
Viral---Varicella or influenza
larger
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

38. What should be done to minimize the risks of Sudden infant death syndrome?
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Kawasaki disease - w/o treatment 25% will have permanent heart damage

39. Average age of menarche
13 years
Day 3 of life
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
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

40. Treatment for sickle cell disease
trunk - gonads and associative tissue
Cool mist therapy - encourage oral intake - s/sx of resp. distress
hearing loss - scarring - mastoiditis - meningitis
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

41. Part of body that grows the fastest in infancy
head
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
from trunk to extremities
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides

42. 3 symptoms of coarctation of the aorta
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Urethral opening is positioned below the glans penis
Adequate O2 adequatte hydration

43. What should be observed in a case of a seizure?
Time and discription of seizure
complete physical and psychosocial assessment to rule out underlying disorders
2.5 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

44. What foods are prohibited for a person with Celiac Disease?
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Milk - Ice cream - Malts - Grains
Day 3 of life
2.5 inches

45. Diet for a child with glumerlonephritis
Abdominal ultrasound - Upper GI
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
Regular diet with low sodium an no added salt
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine

46. Peak flow meter
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Adequate O2 adequatte hydration
measures the largest velocity which occurs during a forced exhale
passage of abdominal contents to the esophagus

47. Signs and Symptoms of Hemolytic Disease of the newborn
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks

48. What occurs in a subacute baterial endocarditis?
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant

49. Pancreatic enzyme therapy for cystic fibrosis is adjusted based on what factors growth and development?
passage of abdominal contents to the esophagus
6 months
# of stools per day - goal=2-3 stools per day
prevention - po antibiotics should be given before and after an invasive procedure

50. Pathophysiology of Acute Asthma
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Swelling of the airways - mucous production - bronchospasms
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

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Certified Pediatric Nurse Exam

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