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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. Where does the adolescent experience rapid growth?
Small bowel biopsy
trunk - gonads and associative tissue
# of stools per day - goal=2-3 stools per day
GERD is the complications and symptoms that happen because of GER

2. Pancreatic enzyme therapy for cystic fibrosis is adjusted based on what factors growth and development?
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
# of stools per day - goal=2-3 stools per day
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
Erythroblastosis Fetalis

3. What is physiologic Jaundice?
They are people - need a balance of limits and independence
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
passage of abdominal contents to the esophagus
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds

4. Assessment of a patient with suspected epiglottitis
Regular diet with low sodium an no added salt
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film

5. How does pertussis present?
from trunk to extremities
complete physical and psychosocial assessment to rule out underlying disorders
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection

6. Treatment for sickle cell disease
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
< 5%
Mechanical Ventalation - high inhaled o2 concentration
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

7. Hirschsprung's Disease
from trunk to extremities
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine

8. ABG
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
O2 status of blood - acid-base balance
measures the largest velocity which occurs during a forced exhale
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping

9. Signs and symptoms of neonatal meningitis
Triple
GERD is the complications and symptoms that happen because of GER
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)

10. Encoperesis
E. Coli
fecal soiling
Hepatoxicity - pancreatitis
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting

11. Teaching for RSV
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
up to 14 days
Between 6-12 months
Phototherapy - exchange transfusion

12. What can promote dryness in a child with enuresis?
5 inches
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
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

13. Causes of Bronchopulmonary Dysplasia
12-24 days
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Mechanical Ventalation - high inhaled o2 concentration
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache

14. Define Proximodistal
>95%
from trunk to extremities
chest x-ray following a Positive PPD skin test
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml

15. Males Reproductive issues for CF patients
birth-36 months
Sterile-caused by blockage of thick mucous at the vas deferens
# of stools per day - goal=2-3 stools per day
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

16. What is an acute otitis media?
inflammation located in the middle ear
Brain damage - hearing loss and learning disabilities
4 years
# of stools per day - goal=2-3 stools per day

17. What are the S/SX of bleeds in hemophilia?
Foreskin is used during the surgical repair
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)

18. What are major risk factors for neonatal meningitis?
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
Barium enema
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
Maternal infection - premature rupture of membranes

19. Normal Bilirubin
< 1
Hepatoxicity - pancreatitis
1-6 months
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

20. BMI- overweight
>95%
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Growth spurt
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

21. What are the four main causes of viral croup?
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
parainfluenza - RSV - Influenza A&B - M. pneumonia
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
3 years

22. Head circumference should be assessed until what age
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
3 years
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
12-24 days

23. Why avoid circumcision in a baby with hypospadias?
Foreskin is used during the surgical repair
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Family history - EEG - CBC - LP and MRI

24. Leading cause of acquired heart disease in children
Kawasaki disease - w/o treatment 25% will have permanent heart damage
2.5 inches
from trunk to extremities
13 years

25. Pathophysiology of Acute Asthma
inflammation and hypersensitivity to triggers
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
Swelling of the airways - mucous production - bronchospasms
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects

26. Neonatal Jaundice
Length board standiometer
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
An Acute inflamation of the meninges and CSF often caused by Enterovirus
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

27. Cephalocaudal
Sterile-caused by blockage of thick mucous at the vas deferens
from head to toe
5ml/dl
Salicylates

28. Nursing care for child with seizure

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29. Incubation period for TB
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
1-6 months
Growth spurt

30. What occurs in a subacute baterial endocarditis?
drooling
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Rinse mouth and brush teeth

31. Signs of increased ICP
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
20 inches
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days

32. Treatment of Meningitis

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33. Can Asthma be cured?
20 inches
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
No - it can only be controlled

34. Two examples of benzodiazepines
diazepam - lorazapam
larger
Erythroblastosis Fetalis
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system

35. Non-pharmalogical measures to treat GER
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
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
lethargy - irritability - decrease feedings - fever - seizures

36. Pathophysiology of hirschsprung's disease
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
passage of abdominal contents to the esophagus

37. What is Hemolytic Disease of the Newborn
Repeated involuntary urination in a child who should already by toilet trained at night
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Contact isolation - gown - gloves and handwashing
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility

38. Sequence of resp distress
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks

39. Pathophysiology of a fever and infection with sickle cell disease
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Erythroblastosis Fetalis
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Day 3 of life

40. Clinical signs of infection wilth sickle cell disease
Penicillin Prophylaxis (BID)
85-95%
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Phototherapy - exchange transfusion

41. What Pharmalogical measures can be used to treat GERD?
5ml/dl
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Less than 120 f.

42. Average rate of growth for the 2nd year of lif
5 inches
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Swelling of the airways - mucous production - bronchospasms
Abdominal ultrasound - Upper GI

43. 3 symptoms of coarctation of the aorta
2.5 inches
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Brain damage - hearing loss and learning disabilities

44. Signs and Symptoms of Hemolytic Disease of the newborn
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
high protien and calorie - multivitamins - extra enzymes for high fat food
fever - malaise - poor appetite - wt loss -cough - night sweats and chills

45. RSV contagious for ...
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
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
up to 14 days

46. How is mononucleosis diagnosed
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
A typical lymphocytosis - mono-spot - EBV serology
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

47. Age group affected by mononucleosis
<25 yrs old
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor

48. Age range that is appropriate to use a length chart
birth-36 months
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption

49. Screening for overweight or underweight child on chart
BMI chart
from head to toe
Penicillin Prophylaxis (BID)
double birth weight

50. S/SX of Hirschsprungs
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
gum hypertrophy
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention