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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. Risk factors of tuberculosis
crowded living conditions - homeless and low income
Enteropathy caused by an insensitivity to the gluten found in wheat
diazepam - lorazapam
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

2. Sequence of resp distress
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
No - it can only be controlled

3. Childs weight at 6 months compared to birth weight
double birth weight
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Kawasaki disease - w/o treatment 25% will have permanent heart damage
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility

4. Treatment for mononucleosis
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
MVA - bike accidents and falls
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
none

5. Signs and symptoms of varicella Prodromal
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
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
12-24 days
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks

6. What are the four main causes of viral croup?
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
parainfluenza - RSV - Influenza A&B - M. pneumonia
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Less than 120 f.

7. Hypospadias
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
Urethral opening is positioned below the glans penis
10 inches
up to 14 days

8. Pathophysiology of hirschsprung's disease
>95%
Between 6-12 months
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
inflammation located in the middle ear

9. Complications of meningitis
Liver Biopsy
Give freedom and choices - save battles for the important things
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Brain damage - hearing loss and learning disabilities

10. Basic defect in coarctation of the aorta
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Triple
A narrowing within the Aorta resulting in collateral circulation

11. Leading cause of acquired heart disease in children
Kawasaki disease - w/o treatment 25% will have permanent heart damage
from trunk to extremities
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Triple

12. Precaustions needed for pt's with varicella
12 years
Airborne and contact
< 5%
Day 3 of life

13. Define Magical thinking

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14. Leading cause of head injury
MVA - bike accidents and falls
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
Vaso-occulisive crisis - infection and sepsis
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death

15. treatment of intussusception
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Group B Streptococcus
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
measures the largest velocity which occurs during a forced exhale

16. Diet for CF patients
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
high protien and calorie - multivitamins - extra enzymes for high fat food
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

17. What is physiologic Jaundice?
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
head
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
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US

18. Side effects of benzodiazepines
>95%
10 inches
3 years
drooling

19. Normal presentation of cystic fibrosis
Hepatoxicity - pancreatitis
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
birth-36 months
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated

20. 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
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
fever and infection
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Small bowel biopsy

21. What is heart failure?
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
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

22. Peak flow meter
parainfluenza - RSV - Influenza A&B - M. pneumonia
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
measures the largest velocity which occurs during a forced exhale
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures

23. S/SX of Hirschsprungs
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
Urethral opening is positioned below the glans penis
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months

24. Diagnose Reye's Syndrome
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Milk - Ice cream - Malts - Grains
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Liver Biopsy

25. When does the surgery to correct hypospadias usually occur?
Between 6-12 months
fever and infection
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

26. Pathophysiology related to Head Trauma
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
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Urethral opening is positioned below the glans penis
12 years

27. Asthma
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
<25 yrs old
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)

28. Key nursing intervention for subacute bacterial endocarditis
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Swelling of the airways - mucous production - bronchospasms
Time and discription of seizure
prevention - po antibiotics should be given before and after an invasive procedure

29. treatment of hemolytic disease of the newborn
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Phototherapy - exchange transfusion
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium

30. Neonatal Jaundice
5 inches
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

31. What are the side effects of depakote?
3 years
Dental procedures - gum disease and urinary tract infections
Hepatoxicity - pancreatitis
12-24 days

32. Define Proximodistal
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
Barium enema
from trunk to extremities
Urethral opening is positioned below the glans penis

33. Pathophysiology of celiac disease
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
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
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

34. Non-pharmalogical measures to treat GER
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
2 snacks
Dust - mold - animal dander - viral infections
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection

35. What are the S/SX of bleeds in hemophilia?
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
No - it can only be controlled
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
# of stools per day - goal=2-3 stools per day

36. What is Pyloric stenosis?
Viral---Varicella or influenza
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Length board standiometer

37. What should a child's wt be at 1 yr compared to birth weight?
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Triple
Viral---Varicella or influenza
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

38. How does pertussis present?
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Penicillin Prophylaxis (BID)
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months

39. What is an acute otitis media?
BMI chart
inflammation located in the middle ear
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Sterile-caused by blockage of thick mucous at the vas deferens

40. 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
Contact isolation - gown - gloves and handwashing
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
5 inches

41. Clinical signs of infection wilth sickle cell disease
trunk
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Salicylates
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death

42. Signs and Symptoms that indicate and adverse reaction to a vaccine
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
Repeated involuntary urination in a child who should already by toilet trained at night
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
85-95%

43. What is used to diagnose GER?
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy

44. Complications related to varicella
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
Group B Streptococcus
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)

45. ABG
Family history - EEG - CBC - LP and MRI
Growth spurt
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

46. Focus of adolescent discipline
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Give freedom and choices - save battles for the important things
crowded living conditions - homeless and low income
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening

47. Predisposing factors to subacute bacterial endocarditis
School age
inflammation located in the middle ear
A typical lymphocytosis - mono-spot - EBV serology
Dental procedures - gum disease and urinary tract infections

48. What level does the bilirubin need to be at in order for jaundice to occur?
5ml/dl
Length board standiometer
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
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor

49. Linear growth event happens in Adolescents
Adequate O2 adequatte hydration
Growth spurt
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
12-24 days

50. Most cases of Reye's Syndrome follows what type of illness?
Foreskin is used during the surgical repair
drooling
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
Viral---Varicella or influenza