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Certified Pediatric Nurse Exam

Subjects : certifications, health-sciences, nursing

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
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. Basic defect in coarctation of the aorta
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
A narrowing within the Aorta resulting in collateral circulation
Length Chart
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia

2. Pathophysiology of Chronic Asthma
inflammation and hypersensitivity to triggers
School age
Airborne and contact
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

3. Bronchiolitis
Swelling or obstruction of the Larynx
from head to toe
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds

4. Complications of acute otitis media
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
Foreskin is used during the surgical repair
Milk - Ice cream - Malts - Grains
hearing loss - scarring - mastoiditis - meningitis

5. Define Proximodistal
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Sterile-caused by blockage of thick mucous at the vas deferens
Regular diet with low sodium an no added salt
from trunk to extremities

6. What Pharmalogical measures can be used to treat GERD?
Low fiber - high calorie and protein
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
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
from head to toe

7. Signs of increased ICP
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
crowded living conditions - homeless and low income
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli

8. Nursing care for a child with Reye's Syndrome
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
2 snacks
2.5 inches
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

9. Precaustions needed for pt's with varicella
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Excessive stool fat
Airborne and contact
>95%

10. Signs and Symptoms of Asthma
MVA - bike accidents and falls
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
double birth weight
0-24 months

11. Part of the body that grows the fastest in the toddler-preschool age
Adequate O2 adequatte hydration
trunk
trunk - gonads and associative tissue
hearing loss - scarring - mastoiditis - meningitis

12. Clinicla manifestations of sickle cell disease
Vaso-occulisive crisis - infection and sepsis
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
Brain damage - hearing loss and learning disabilities

13. BMI - underweight
Swelling or obstruction of the Larynx
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
gum hypertrophy
< 5%

14. Main cause of urinary tract infections
2 years
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
E. Coli

15. What confirms a positive TB infection?
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
An Acute inflamation of the meninges and CSF often caused by Enterovirus
chest x-ray following a Positive PPD skin test
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure

16. How does pertussis present?
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Mid puberty

17. Average Birth Length
larger
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
20 inches
Kawasaki disease - w/o treatment 25% will have permanent heart damage

18. Pathophysiology related to Head Trauma
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Length Chart
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 enema

19. What interventions prevent urinary tract infections?
9 months
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
dysfunction of the lower esophageal sphincter and delayed gastric emptying time

20. Asthma
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
School age
Vaso-occulisive crisis - infection and sepsis

21. Linear growth event happens in Adolescents
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
Phototherapy - exchange transfusion
Growth spurt
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function

22. Diastat rectal diazepam gel

23. What is used to diagnose GER?
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
drooling

24. Leading cause of bacterial meningitis in Neonates
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Group B Streptococcus
birth-36 months

25. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
poor feeding - wt loss - fatigue - develop. delays - edema
fecal soiling

26. Leading cause of acquired heart disease in children
Kawasaki disease - w/o treatment 25% will have permanent heart damage
12 years
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
gum hypertrophy

27. At birth - head circumference is ____ compared to chest circumference
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
larger
< 1
9 months

28. What are the S/SX of bleeds in hemophilia?
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Adequate O2 adequatte hydration
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml

29. Nursing care of patient with Meningitis
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
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
Less than 120 f.

30. Prevention of bronchiolitis spreading
Phototherapy - exchange transfusion
They are people - need a balance of limits and independence
birth-36 months
Contact isolation - gown - gloves and handwashing

31. Most cases of Reye's Syndrome follows what type of illness?
Viral---Varicella or influenza
Dental procedures - gum disease and urinary tract infections
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
hearing loss - scarring - mastoiditis - meningitis

32. Hourly maintenance Fluid Requirements
Maternal infection - premature rupture of membranes
4 years
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
12-24 days

33. difference btwn GER and GERD
>95%
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
GERD is the complications and symptoms that happen because of GER

34. Focus of adolescent discipline
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
13 years
Give freedom and choices - save battles for the important things

35. Treatment for Varicella
BMI chart
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
12-24 days

36. Signs and symptoms of neonatal meningitis
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
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Penicillin Prophylaxis (BID)

37. What level does the bilirubin need to be at in order for jaundice to occur?
Airborne and contact
hearing loss - scarring - mastoiditis - meningitis
5ml/dl
5 inches

38. Treatment for sickle cell disease
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
from trunk to extremities
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium

39. Common Asthma irritants
Liver Biopsy
Dust - mold - animal dander - viral infections
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Time and discription of seizure

40. Complications of meningitis
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
Brain damage - hearing loss and learning disabilities
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)

41. Signs and Symptoms of Hemolytic Disease of the newborn
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days

42. What is heart failure?
Mid puberty
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
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death

43. What are major risk factors for neonatal meningitis?
Enteropathy caused by an insensitivity to the gluten found in wheat
Epstein Barr Virus - transmitted with intimate contact
from head to toe
Maternal infection - premature rupture of membranes

44. What are development considerations for hemophilia?
Rinse mouth and brush teeth
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Between 6-12 months
Dust - mold - animal dander - viral infections

45. How many meals and snacks should a 1-3 yr old have in a day 3 meals
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
high protien and calorie - multivitamins - extra enzymes for high fat food
2 snacks
0-24 months

46. Diet for a child with glumerlonephritis
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Regular diet with low sodium an no added salt
# of stools per day - goal=2-3 stools per day
10 inches

47. Side effects of dilatin hirsuitism (body hair)
inflammation located in the middle ear
lethargy - irritability - decrease feedings - fever - seizures
gum hypertrophy
Cool mist therapy - encourage oral intake - s/sx of resp. distress

48. Diagnose Intussusception by
Excessive stool fat
Barium enema
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml

49. What can promote dryness in a child with enuresis?
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
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting

50. Nursing care for Kawasaki Disease
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Mechanical Ventalation - high inhaled o2 concentration
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
1-6 months