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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. Post Op treatment of a VP shunt
10 years
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
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
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

2. Signs and Symptoms of intussusception
Maternal infection - premature rupture of membranes
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
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

3. Neonatal Jaundice
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Day 3 of life
They are people - need a balance of limits and independence
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth

4. What is an acute otitis media?
inflammation located in the middle ear
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
4 years

5. Nursing care for a child with Reye's Syndrome
none
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Swelling or obstruction of the Larynx
Swelling of the airways - mucous production - bronchospasms

6. ABG
O2 status of blood - acid-base balance
gum hypertrophy
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache

7. Treatment and nursing care for pertussis
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
prevention - po antibiotics should be given before and after an invasive procedure
up to 14 days
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2

8. What is used to diagnose GER?
36 months
Sterile-caused by blockage of thick mucous at the vas deferens
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
complete physical and psychosocial assessment to rule out underlying disorders

9. Growth spurt for adolescent boys
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
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
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
Mid puberty

10. What should a child's wt be at 1 yr compared to birth weight?
Triple
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Give freedom and choices - save battles for the important things
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli

11. Treatment for mononucleosis
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Sterile-caused by blockage of thick mucous at the vas deferens
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
none

12. Predisposing factors to subacute bacterial endocarditis
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Sterile-caused by blockage of thick mucous at the vas deferens
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
Dental procedures - gum disease and urinary tract infections

13. Where does the adolescent experience rapid growth?
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
trunk - gonads and associative tissue
Low fiber - high calorie and protein

14. What is Pyloric stenosis?
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
trunk - gonads and associative tissue
complete physical and psychosocial assessment to rule out underlying disorders

15. How is Celiac Disease diagnosed?
Barium enema
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
13 years
Small bowel biopsy

16. Side effects of dilatin hirsuitism (body hair)
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
Swelling or obstruction of the Larynx
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
gum hypertrophy

17. Kawasaki Disease
5ml/dl
< 5%
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
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

18. Why is early diagnosis important w. Reye's Syndrome?
Successful management is based on early diagnosis and aggressive therapy
gum hypertrophy
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

19. Equipment used to measure a 24 to 36 month old height
Length board standiometer
1-6 months
poor feeding - wt loss - fatigue - develop. delays - edema
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds

20. Varicella communicable
MVA - bike accidents and falls
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
from head to toe
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks

21. Sickle Cell Disease
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin

22. What promotes unsickling of RBC's?
Adequate O2 adequatte hydration
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
5ml/dl
Milk - Ice cream - Malts - Grains

23. Nursing interventions for hemophilia
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
from head to toe
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Excessive stool fat

24. Assessment of a patient with suspected epiglottitis
trunk - gonads and associative tissue
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes

25. 3 main causes of Bacterial meningitis in children
high protien and calorie - multivitamins - extra enzymes for high fat food
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
trunk

26. Nursing care of patient with Meningitis
Growth spurt
from trunk to extremities
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Triple

27. Which growth chart is appropriate for use - Growth for the young child who is measured laying down?
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
Length Chart
Abdominal ultrasound - Upper GI
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics

28. What is broncho-pulmonary dysplasia?
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Abdominal ultrasound - Upper GI
from trunk to extremities
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth

29. Leading cause of bacterial meningitis in Neonates
Group B Streptococcus
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
0-24 months
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

30. Average Birth Length
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
20 inches
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening

31. Treatment of Kawasaki disease
Repeated involuntary urination in a child who should already by toilet trained at night
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Barium enema

32. Clinicla manifestations of sickle cell disease
Swelling or obstruction of the Larynx
Enteropathy caused by an insensitivity to the gluten found in wheat
Vaso-occulisive crisis - infection and sepsis
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

33. Treatment for sickle cell disease
# of stools per day - goal=2-3 stools per day
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
5ml/dl
Mid puberty

34. Pathophysiology of Chronic Asthma
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
inflammation and hypersensitivity to triggers
from head to toe
Low fiber - high calorie and protein

35. Contraindications to all vaccines
A narrowing within the Aorta resulting in collateral circulation
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Previous history of life threatening reaction - Mod-severe illness w/wo fever
none

36. Signs and symptoms of varicella Prodromal
Previous history of life threatening reaction - Mod-severe illness w/wo fever
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
4 years
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages

37. What level does the bilirubin need to be at in order for jaundice to occur?
trunk
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
5ml/dl
Steatorrhea - frequent respiratory infections during infancy - failure to thrive

38. Two important assessment rules related to coarctation of the aorta?
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
A typical lymphocytosis - mono-spot - EBV serology
2 years

39. Signs and symptoms of neonatal meningitis
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Abdominal ultrasound - Upper GI
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
from trunk to extremities

40. Part of the body that grows the fastest in the toddler-preschool age
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
trunk
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics

41. What is used to diagnose pyloric stenosis?
Abdominal ultrasound - Upper GI
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
Give freedom and choices - save battles for the important things
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet

42. How many days after birth do bilirubin levels return to normal limits?
Erythroblastosis Fetalis
12-24 days
No - it can only be controlled
chest x-ray following a Positive PPD skin test

43. 2 key factors to consider when caring for a preschooler
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
They are people - need a balance of limits and independence
Penicillin Prophylaxis (BID)

44. BMI - underweight
BMI chart
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
< 5%
36 months

45. Nursing care for Kawasaki Disease
Urethral opening is positioned below the glans penis
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor

46. Define Magical thinking

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47. What is the rate of growth each year from 3 yrs until puberty?
Low fiber - high calorie and protein
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
2.5 inches
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection

48. Viral Meningitis
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
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Mid puberty
diazepam - lorazapam

49. Complications of meningitis
Brain damage - hearing loss and learning disabilities
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
20 inches

50. Pathophysiology of a fever and infection with sickle cell disease
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
parainfluenza - RSV - Influenza A&B - M. pneumonia
Maternal infection - premature rupture of membranes
drooling

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Certified Pediatric Nurse Exam

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