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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.
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. treatment of hemolytic disease of the newborn
parainfluenza - RSV - Influenza A&B - M. pneumonia
Phototherapy - exchange transfusion
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
dysfunction of the lower esophageal sphincter and delayed gastric emptying time

2. What are the four main causes of viral croup?
Airborne and contact
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
Barium enema

3. Signs and Symptoms of Bilirubin Kernicterus (encephalopathy)
Between 6-12 months
gum hypertrophy
Group B Streptococcus
lethargy - irritability - decrease feedings - fever - seizures

4. Age of children at half their adult height
3 years
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
2 years
fever and infection

5. Normal Bilirubin
< 1
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)

6. Kawasaki Disease
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
Brain damage - hearing loss and learning disabilities
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
E. Coli

7. S/SX of Hirschsprungs
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
A narrowing within the Aorta resulting in collateral circulation

8. What has the HIB vaccine been successful in reducing?
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis

9. Asthma
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli

10. S/Sx of pyloric stenosis
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
Viral---Varicella or influenza
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis

11. Basic defect in coarctation of the aorta
Kawasaki disease - w/o treatment 25% will have permanent heart damage
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
A narrowing within the Aorta resulting in collateral circulation
diazepam - lorazapam

12. Where does the adolescent experience rapid growth?
hearing loss - scarring - mastoiditis - meningitis
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
trunk - gonads and associative tissue

13. Cause of bronchiolitis
5 inches
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
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

14. Complications of meningitis
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
Brain damage - hearing loss and learning disabilities
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

15. Clinical signs of infection wilth sickle cell disease
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death

16. Rheumatic Fever
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
< 5%
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
gum hypertrophy

17. Signs and Symptoms of Hemolytic Disease of the newborn
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
Swelling of the airways - mucous production - bronchospasms
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

18. treatment of intussusception
Swelling or obstruction of the Larynx
high protien and calorie - multivitamins - extra enzymes for high fat food
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium

19. At 6-24 months - head circumference is what size in relationship to chest circumference
Length board standiometer
9 months
No - it can only be controlled
Equal to

20. Pathophysiology of a fever and infection with sickle cell disease
parainfluenza - RSV - Influenza A&B - M. pneumonia
chest x-ray following a Positive PPD skin test
GERD is the complications and symptoms that happen because of GER
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old

21. What level does the bilirubin need to be at in order for jaundice to occur?
Hepatoxicity - pancreatitis
5ml/dl
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Delayed puberty - viscous cervical secretions - difficulty getting pregnant

22. Part of body that grows the fastest in infancy
Urethral opening is positioned below the glans penis
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
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
head

23. What is heart failure?
Length Chart
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
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
Kawasaki disease - w/o treatment 25% will have permanent heart damage

24. Two examples of benzodiazepines
Group B Streptococcus
diazepam - lorazapam
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility

25. Varicella communicable
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void

26. Age range that is appropriate to use a length chart
Contact isolation - gown - gloves and handwashing
birth-36 months
Sterile-caused by blockage of thick mucous at the vas deferens
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

27. What Pharmalogical measures can be used to treat GERD?
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
O2 status of blood - acid-base balance
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

28. Sequence of resp distress
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure

29. Treatment of a bleed in hemophilia
measures the largest velocity which occurs during a forced exhale
passage of abdominal contents to the esophagus
School age
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

30. Signs of increased ICP
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus

31. What foods are prohibited for a person with Celiac Disease?
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
2.5 inches
hearing loss - scarring - mastoiditis - meningitis
Milk - Ice cream - Malts - Grains

32. What is physiologic Jaundice?
Hepatoxicity - pancreatitis
Group B Streptococcus
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
Maternal infection - premature rupture of membranes

33. Focus of adolescent discipline
Successful management is based on early diagnosis and aggressive therapy
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Give freedom and choices - save battles for the important things
Bacteria enter the blood stream from a site of localized infection and grows in the heart

34. Contraindications to all vaccines
Previous history of life threatening reaction - Mod-severe illness w/wo fever
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Adequate O2 adequatte hydration

35. Nursing care of patient with Meningitis
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
crowded living conditions - homeless and low income
used for prolonged sz's

36. What is used to diagnose pyloric stenosis?
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Abdominal ultrasound - Upper GI
Small bowel biopsy
Enteropathy caused by an insensitivity to the gluten found in wheat

37. Signs and symptoms of Reye's Syndrome
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
diazepam - lorazapam
No - it can only be controlled
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

38. 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
Rinse mouth and brush teeth
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting

39. Diet for Hirschsprung's prior to corrction and treatment
Low fiber - high calorie and protein
9 months
12-24 days
Length Chart

40. What promotes unsickling of RBC's?
Adequate O2 adequatte hydration
O2 status of blood - acid-base balance
10 years
Give freedom and choices - save battles for the important things

41. Teaching for RSV
Maternal infection - premature rupture of membranes
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
passage of abdominal contents to the esophagus
head

42. Signs and Symptoms of Asthma
36 months
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
9 months

43. Two important assessment rules related to coarctation of the aorta?
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
high protien and calorie - multivitamins - extra enzymes for high fat food
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
Swelling of the airways - mucous production - bronchospasms

44. During an abdominal assessment when should auscultation occur
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
Phototherapy - exchange transfusion
birth-36 months
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications

45. Which growth chart is appropriate for use - Growth for the young child who is measured laying down?
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Length Chart
trunk
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough

46. Males Reproductive issues for CF patients
Sterile-caused by blockage of thick mucous at the vas deferens
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
Mechanical Ventalation - high inhaled o2 concentration
none

47. At what age is a stadiometer required to measure linear growth?
36 months
Small bowel biopsy
birth-36 months
up to 14 days

48. Treatment of Meningitis

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49. Most cases of Reye's Syndrome follows what type of illness?
chest x-ray following a Positive PPD skin test
from trunk to extremities
Viral---Varicella or influenza
5ml/dl

50. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
Viral---Varicella or influenza
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption