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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. What occurs in a subacute baterial endocarditis?
lethargy - irritability - decrease feedings - fever - seizures
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
Growth spurt

2. Bilirubin encephalopathy
Time and discription of seizure
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
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications

3. Hourly maintenance Fluid Requirements
Time and discription of seizure
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain

4. Signs and Symptoms of intussusception
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
Successful management is based on early diagnosis and aggressive therapy
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting

5. Signs of heart failure
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
85-95%
poor feeding - wt loss - fatigue - develop. delays - edema
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash

6. Diagnose Intussusception by
inflammation located in the middle ear
Barium enema
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
drooling

7. Key nursing intervention for subacute bacterial endocarditis
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
prevention - po antibiotics should be given before and after an invasive procedure
Adequate O2 adequatte hydration

8. Why avoid circumcision in a baby with hypospadias?
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Foreskin is used during the surgical repair
3 years
Abdominal ultrasound - Upper GI

9. What is used to diagnose pyloric stenosis?
They are people - need a balance of limits and independence
Abdominal ultrasound - Upper GI
used for prolonged sz's
Erythroblastosis Fetalis

10. What should be done to minimize the risks of Sudden infant death syndrome?
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Give freedom and choices - save battles for the important things
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant

11. Neonatal Jaundice
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
6 months
Abdominal ultrasound - Upper GI
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing

12. Nursing care of the infant with pyloric stenosis
Urethral opening is positioned below the glans penis
A narrowing within the Aorta resulting in collateral circulation
An Acute inflamation of the meninges and CSF often caused by Enterovirus
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

13. Average age of menarche
trunk - gonads and associative tissue
13 years
chest x-ray following a Positive PPD skin test
parainfluenza - RSV - Influenza A&B - M. pneumonia

14. Treatment of Kawasaki disease
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
double birth weight

15. Diagnose Reye's Syndrome
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
An Acute inflamation of the meninges and CSF often caused by Enterovirus
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Liver Biopsy

16. Equipment used to measure a 24 to 36 month old height
Length board standiometer
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Foreskin is used during the surgical repair
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine

17. What has the HIB vaccine been successful in reducing?
Successful management is based on early diagnosis and aggressive therapy
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Delayed puberty - viscous cervical secretions - difficulty getting pregnant

18. Lead screening should begin. at ..
Phototherapy - exchange transfusion
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Triple
9 months

19. Age group the limbs grow the fastest
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
School age
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection

20. At birth - head circumference is ____ compared to chest circumference
Salicylates
Regular diet with low sodium an no added salt
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
larger

21. Treatment of a bleed in hemophilia
< 5%
Urethral opening is positioned below the glans penis
head
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

22. Nursing care for a child with Reye's Syndrome
Enteropathy caused by an insensitivity to the gluten found in wheat
Cool mist therapy - encourage oral intake - s/sx of resp. distress
Less than 120 f.
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old

23. Bronchiolitis
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Maternal infection - premature rupture of membranes

24. Age range that is appropriate to use a length chart
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
birth-36 months

25. Rheumatic Fever
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)

26. Pathophysiology related to Head Trauma
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
fever and infection
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
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing

27. Linear growth event happens in Adolescents
Successful management is based on early diagnosis and aggressive therapy
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Growth spurt

28. first tooth
Milk - Ice cream - Malts - Grains
6 months
Time and discription of seizure
lethargy - irritability - decrease feedings - fever - seizures

29. Diet for Hirschsprung's prior to corrction and treatment
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
Airborne and contact
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Low fiber - high calorie and protein

30. Nursing care for child with seizure
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
2 snacks
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia

31. Viral Meningitis
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
An Acute inflamation of the meninges and CSF often caused by Enterovirus
birth-36 months
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection

32. 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
20 inches
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
Group B Streptococcus

33. During an abdominal assessment when should auscultation occur
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds

34. Complications related to varicella
Enteropathy caused by an insensitivity to the gluten found in wheat
A typical lymphocytosis - mono-spot - EBV serology
Dust - mold - animal dander - viral infections
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)

35. At what age is a stadiometer required to measure linear growth?
Abdominal ultrasound - Upper GI
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
36 months
Low fiber - high calorie and protein

36. What is Pyloric stenosis?
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
< 5%
< 1
Triple

37. Two examples of benzodiazepines
prevention - po antibiotics should be given before and after an invasive procedure
high protien and calorie - multivitamins - extra enzymes for high fat food
diazepam - lorazapam
poor feeding - wt loss - fatigue - develop. delays - edema

38. Clinical signs of infection wilth sickle cell disease
Equal to
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
drooling
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death

39. Characteristics of the RBC's in sickle cell
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Milk - Ice cream - Malts - Grains
Barium enema
Swelling of the airways - mucous production - bronchospasms

40. What is Cystic Fibrosis?
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US

41. What is used to diagnose GER?
A typical lymphocytosis - mono-spot - EBV serology
fecal soiling
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Dust - mold - animal dander - viral infections

42. signs and symptoms of meningitis in older children
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
Barium enema
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support

43. Pathophysiology of hirschsprung's disease
>95%
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
Less than 120 f.
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks

44. What foods are prohibited for a person with Celiac Disease?
Milk - Ice cream - Malts - Grains
Group B Streptococcus
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
School age

45. What confirms a positive TB infection?
chest x-ray following a Positive PPD skin test
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Repeated involuntary urination in a child who should already by toilet trained at night
crowded living conditions - homeless and low income

46. Nursing care of patient with Meningitis
1-6 months
fecal soiling
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Less than 120 f.

47. Signs and Symptoms of Celiac Disease
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
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
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
complete physical and psychosocial assessment to rule out underlying disorders

48. Average rate of growth for the 2nd year of lif
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
Phototherapy - exchange transfusion
5 inches
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

49. Childs weight at 6 months compared to birth weight
double birth weight
gum hypertrophy
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness

50. Risk factors of tuberculosis
crowded living conditions - homeless and low income
Brain damage - hearing loss and learning disabilities
parainfluenza - RSV - Influenza A&B - M. pneumonia
6 months

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