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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. Key nursing intervention for subacute bacterial endocarditis
passage of abdominal contents to the esophagus
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
prevention - po antibiotics should be given before and after an invasive procedure
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth

2. What is physiologic Jaundice?
fever and infection
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
2 years
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

3. How many meals and snacks should a 1-3 yr old have in a day 3 meals
Swelling or obstruction of the Larynx
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
fever and infection
2 snacks

4. difference btwn GER and GERD
School age
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
from trunk to extremities
GERD is the complications and symptoms that happen because of GER

5. Teaching for Croup
Cool mist therapy - encourage oral intake - s/sx of resp. distress
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
birth-36 months

6. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
hearing loss - scarring - mastoiditis - meningitis
diazepam - lorazapam
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption

7. Nursing care for Cystic Fibrosis
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
Contact isolation - gown - gloves and handwashing
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
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

8. Hypospadias
36 months
Urethral opening is positioned below the glans penis
diazepam - lorazapam
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

9. Signs and Symptoms that indicate and adverse reaction to a vaccine
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
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
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash

10. Can Asthma be cured?
They are people - need a balance of limits and independence
No - it can only be controlled
6 months
complete physical and psychosocial assessment to rule out underlying disorders

11. Side effects of dilatin hirsuitism (body hair)
Penicillin Prophylaxis (BID)
GERD is the complications and symptoms that happen because of GER
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
gum hypertrophy

12. first tooth
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
6 months
Day 3 of life
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system

13. Treatment of a bleed in hemophilia
Equal to
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping

14. Pathophysiology of a fever and infection with sickle cell disease
Phototherapy - exchange transfusion
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
E. Coli

15. Nursing care for child with seizure

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16. Treatment of celiac disease
lethargy - irritability - decrease feedings - fever - seizures
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
GERD is the complications and symptoms that happen because of GER
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

17. Considerations should be taken when treating a child with cystic fibrosis who has a ___________ tx promptly since bacterial colonization increases destruction of lung tissue----prevention is key
from head to toe
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
MVA - bike accidents and falls
fever and infection

18. Signs and symptoms of neonatal meningitis
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
# of stools per day - goal=2-3 stools per day

19. Signs and symptoms of Reye's Syndrome
Liver Biopsy
trunk - gonads and associative tissue
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
head

20. Average Birth Length
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
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
10 inches
20 inches

21. Treatment for mononucleosis
none
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
trunk
# of stools per day - goal=2-3 stools per day

22. Term infant --Bilirubin peaks at what day of life
Day 3 of life
poor feeding - wt loss - fatigue - develop. delays - edema
Regular diet with low sodium an no added salt
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)

23. Pathophysiology of Acute Asthma
Swelling of the airways - mucous production - bronchospasms
Growth spurt
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
gum hypertrophy

24. Assess the cause of enuresis
complete physical and psychosocial assessment to rule out underlying disorders
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Growth spurt
5 inches

25. Encoperesis
complete physical and psychosocial assessment to rule out underlying disorders
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
fecal soiling
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

26. Age group affected by mononucleosis
<25 yrs old
4 years
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Penicillin Prophylaxis (BID)

27. 2 key factors to consider when caring for a preschooler
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
They are people - need a balance of limits and independence
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old

28. S/sx of GERD
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
larger
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

29. What should be observed in a case of a seizure?
Time and discription of seizure
Swelling of the airways - mucous production - bronchospasms
drooling
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

30. Head circumference should be assessed until what age
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
double birth weight
poor feeding - wt loss - fatigue - develop. delays - edema
3 years

31. Age that birth length doubles
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
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
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

32. How is Celiac Disease diagnosed?
BMI chart
Small bowel biopsy
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough

33. Bilirubin encephalopathy
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
Give freedom and choices - save battles for the important things
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds

34. Part of body that grows the fastest in infancy
head
1-6 months
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
prevention - po antibiotics should be given before and after an invasive procedure

35. Characteristics of the RBC's in sickle cell

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36. What is enuresis?
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
< 5%
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Repeated involuntary urination in a child who should already by toilet trained at night

37. Males Reproductive issues for CF patients
1-6 months
Sterile-caused by blockage of thick mucous at the vas deferens
Dental procedures - gum disease and urinary tract infections
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection

38. Where does the adolescent experience rapid growth?
trunk - gonads and associative tissue
A typical lymphocytosis - mono-spot - EBV serology
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
# of stools per day - goal=2-3 stools per day

39. Nursing care for Kawasaki Disease
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
high protien and calorie - multivitamins - extra enzymes for high fat food
13 years
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks

40. Viral Meningitis
2.5 inches
Swelling or obstruction of the Larynx
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Length board standiometer

41. Average age of breast development
Brain damage - hearing loss and learning disabilities
Repeated involuntary urination in a child who should already by toilet trained at night
10 years
Length board standiometer

42. Kawasaki Disease
up to 14 days
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
used for prolonged sz's
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

43. Age of children at half their adult height
Repeated involuntary urination in a child who should already by toilet trained at night
2 years
maternal nutrition and genetics
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli

44. What promotes unsickling of RBC's?
Equal to
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
Epstein Barr Virus - transmitted with intimate contact
Adequate O2 adequatte hydration

45. Cephalocaudal
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
from head to toe
Liver Biopsy

46. Childs weight at 6 months compared to birth weight
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
double birth weight
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
lethargy - irritability - decrease feedings - fever - seizures

47. Females reproductive issues for CF patients
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

48. Test to evaluate a Seizure disorder
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
Family history - EEG - CBC - LP and MRI
Abdominal ultrasound - Upper GI
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen

49. Signs and Symptoms of Bilirubin Kernicterus (encephalopathy)
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Family history - EEG - CBC - LP and MRI
lethargy - irritability - decrease feedings - fever - seizures
BMI chart

50. Prevention of bronchiolitis spreading
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
inflammation located in the middle ear
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Contact isolation - gown - gloves and handwashing

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Certified Pediatric Nurse Exam

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