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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. treatment of intussusception
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
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
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months

2. Precaustions needed for pt's with varicella
E. Coli
none
A typical lymphocytosis - mono-spot - EBV serology
Airborne and contact

3. Two important assessment rules related to coarctation of the aorta?
20 inches
< 5%
Equal to
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures

4. Most cases of Reye's Syndrome follows what type of illness?
Small bowel biopsy
Barium enema
Viral---Varicella or influenza
fever - malaise - poor appetite - wt loss -cough - night sweats and chills

5. What is epiglottitis?
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
< 5%
5ml/dl
Sterile-caused by blockage of thick mucous at the vas deferens

6. Hirschsprung's Disease
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
larger

7. Cause of bronchiolitis
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
lethargy - irritability - decrease feedings - fever - seizures
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing

8. Where does the adolescent experience rapid growth?
BMI chart
trunk
trunk - gonads and associative tissue
12-24 days

9. What level does the bilirubin need to be at in order for jaundice to occur?
Small bowel biopsy
Foreskin is used during the surgical repair
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
5ml/dl

10. Reyes Syndrome
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
parainfluenza - RSV - Influenza A&B - M. pneumonia
Barium enema
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness

11. What Pharmalogical measures can be used to treat GERD?
measures the largest velocity which occurs during a forced exhale
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
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
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

12. What are the four main causes of viral croup?
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
parainfluenza - RSV - Influenza A&B - M. pneumonia
12 years
Repeated involuntary urination in a child who should already by toilet trained at night

13. Age range that is appropriate to use a length chart
birth-36 months
Growth spurt
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system

14. What Component of Aspirin cause's Reye's Syndrome?
Salicylates
none
Hepatoxicity - pancreatitis
Excessive stool fat

15. What occurs in a subacute baterial endocarditis?
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
complete physical and psychosocial assessment to rule out underlying disorders
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
Bacteria enter the blood stream from a site of localized infection and grows in the heart

16. Basic defect in coarctation of the aorta
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
A narrowing within the Aorta resulting in collateral circulation
Erythroblastosis Fetalis

17. Age that birth length doubles
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
2 snacks
4 years
GERD is the complications and symptoms that happen because of GER

18. Assess the cause of enuresis
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
complete physical and psychosocial assessment to rule out underlying disorders
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
Phototherapy - exchange transfusion

19. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
Equal to
Phototherapy - exchange transfusion
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

20. GER (gastroesophageal reflux)
passage of abdominal contents to the esophagus
complete physical and psychosocial assessment to rule out underlying disorders
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption

21. Can Asthma be cured?
Repeated involuntary urination in a child who should already by toilet trained at night
No - it can only be controlled
Contact isolation - gown - gloves and handwashing
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

22. Contraindications to all vaccines
Previous history of life threatening reaction - Mod-severe illness w/wo fever
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
5ml/dl
0-24 months

23. At what age is a stadiometer required to measure linear growth?
passage of abdominal contents to the esophagus
E. Coli
36 months
none

24. Treatment of celiac disease
passage of abdominal contents to the esophagus
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
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Day 3 of life

25. Nursing care of patient with Meningitis
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
trunk - gonads and associative tissue
< 5%

26. Hourly maintenance Fluid Requirements
Swelling of the airways - mucous production - bronchospasms
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

27. Nursing care for Kawasaki Disease
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
fever and infection
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
An Acute inflamation of the meninges and CSF often caused by Enterovirus

28. Pathophysiology related to Head Trauma
from head to toe
Adequate O2 adequatte hydration
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
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

29. Nursing care for a child with Reye's Syndrome
Mechanical Ventalation - high inhaled o2 concentration
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old

30. treatment of hemolytic disease of the newborn
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
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
Phototherapy - exchange transfusion

31. Average age of breast development
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
10 years
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

32. ABG
O2 status of blood - acid-base balance
lethargy - irritability - decrease feedings - fever - seizures
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth

33. What is the cause of mononucleosis and its method of transmission?
Regular diet with low sodium an no added salt
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
Epstein Barr Virus - transmitted with intimate contact
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US

34. Steatorrhea
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
Excessive stool fat
Repeated involuntary urination in a child who should already by toilet trained at night
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds

35. Signs and Symptoms that indicate and adverse reaction to a vaccine
9 months
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Day 3 of life
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia

36. Normal Bilirubin
2 snacks
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
lethargy - irritability - decrease feedings - fever - seizures
< 1

37. Assessment of a patient with suspected epiglottitis
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
Brain damage - hearing loss and learning disabilities

38. Childs weight at 6 months compared to birth weight
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
GERD is the complications and symptoms that happen because of GER
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
double birth weight

39. Treatment for Varicella
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
< 1
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

40. What can promote dryness in a child with enuresis?
Excessive stool fat
larger
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
crowded living conditions - homeless and low income

41. Key nursing intervention for subacute bacterial endocarditis
prevention - po antibiotics should be given before and after an invasive procedure
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Sterile-caused by blockage of thick mucous at the vas deferens
measures the largest velocity which occurs during a forced exhale

42. Part of the body that grows the fastest in the toddler-preschool age
<25 yrs old
Repeated involuntary urination in a child who should already by toilet trained at night
3 years
trunk

43. Treatment of Kawasaki disease
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
E. Coli
larger

44. Signs and Symptoms of intussusception
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
fever and infection
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film

45. What should be done to minimize the risks of Sudden infant death syndrome?
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
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
head
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant

46. What is the rate of growth each year from 3 yrs until puberty?
2.5 inches
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Excessive stool fat
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days

47. Post Op treatment of a VP shunt
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
12 years
Triple

48. Asthma inhaler - what can be done to decrease risk of thrush
Between 6-12 months
0-24 months
up to 14 days
Rinse mouth and brush teeth

49. What foods are prohibited for a person with Celiac Disease?
Milk - Ice cream - Malts - Grains
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
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
Time and discription of seizure

50. Nursing care of the infant with pyloric stenosis
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
from trunk to extremities
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

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