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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. 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
Viral---Varicella or influenza
double birth weight
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
fever and infection

2. Define Proximodistal
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
No - it can only be controlled
3 years
from trunk to extremities

3. Lead screening should begin. at ..
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
9 months
inflammation located in the middle ear
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy

4. Diet for a child with glumerlonephritis
crowded living conditions - homeless and low income
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Regular diet with low sodium an no added salt
Dust - mold - animal dander - viral infections

5. 3 main causes of Bacterial meningitis in children
Group B Streptococcus
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides

6. Where does the adolescent experience rapid growth?
trunk - gonads and associative tissue
9 months
6 months
hearing loss - scarring - mastoiditis - meningitis

7. 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
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Salicylates
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds

8. Diagnose Intussusception by
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
chest x-ray following a Positive PPD skin test
Barium enema

9. Signs and Symptoms of Celiac Disease
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
13 years
12 years

10. Causes of Bronchopulmonary Dysplasia
Mechanical Ventalation - high inhaled o2 concentration
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Airborne and contact

11. Pancreatic enzyme therapy for cystic fibrosis is adjusted based on what factors growth and development?
Length board standiometer
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
# of stools per day - goal=2-3 stools per day
Viral---Varicella or influenza

12. At 6-24 months - head circumference is what size in relationship to chest circumference
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Equal to
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia

13. Post Op treatment of a VP shunt
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
hearing loss - scarring - mastoiditis - meningitis
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support

14. Average Birth Length
20 inches
head
double birth weight
measures the largest velocity which occurs during a forced exhale

15. Growth spurt for adolescent boys
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
from trunk to extremities
Mid puberty
Vaso-occulisive crisis - infection and sepsis

16. What can promote dryness in a child with enuresis?
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void

17. Treatment of Meningitis

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18. Why is early diagnosis important w. Reye's Syndrome?
Brain damage - hearing loss and learning disabilities
Successful management is based on early diagnosis and aggressive therapy
Mid puberty
Contact isolation - gown - gloves and handwashing

19. What is heart failure?
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
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
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
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

20. Peak flow meter
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Swelling or obstruction of the Larynx
Small bowel biopsy
measures the largest velocity which occurs during a forced exhale

21. Nursing care for a child with Reye's Syndrome
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Vaso-occulisive crisis - infection and sepsis
36 months

22. Nursing interventions for hemophilia
Family history - EEG - CBC - LP and MRI
2 years
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds

23. Diet for Hirschsprung's prior to corrction and treatment
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Low fiber - high calorie and protein
Sterile-caused by blockage of thick mucous at the vas deferens

24. Characteristics of the RBC's in sickle cell

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25. Age range that is appropriate to use a length chart
birth-36 months
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

26. GER (gastroesophageal reflux)
4 years
passage of abdominal contents to the esophagus
measures the largest velocity which occurs during a forced exhale
Viral---Varicella or influenza

27. Pathophysiology of hirschsprung's disease
3 years
Growth spurt
used for prolonged sz's
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated

28. S/SX of Hirschsprungs
They are people - need a balance of limits and independence
passage of abdominal contents to the esophagus
20 inches
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention

29. Average rate of growth for the 1st year
10 inches
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
Equal to
Delayed puberty - viscous cervical secretions - difficulty getting pregnant

30. Leading cause of acquired heart disease in children
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Length Chart
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
passage of abdominal contents to the esophagus

31. What is the cause of mononucleosis and its method of transmission?
School age
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
Epstein Barr Virus - transmitted with intimate contact
Length Chart

32. Treatment of Kawasaki disease
2.5 inches
No - it can only be controlled
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
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

33. What are the four main causes of viral croup?
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
Length board standiometer
maternal nutrition and genetics
parainfluenza - RSV - Influenza A&B - M. pneumonia

34. S/sx of GERD
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
Day 3 of life
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy

35. Rheumatic Fever
5ml/dl
inflammation located in the middle ear
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
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection

36. Signs and Symptoms of Asthma
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Time and discription of seizure

37. signs and symptoms of meningitis in older children
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
inflammation located in the middle ear

38. Teaching for RSV
0-24 months
3 years
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration

39. Males Reproductive issues for CF patients
Sterile-caused by blockage of thick mucous at the vas deferens
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Vaso-occulisive crisis - infection and sepsis
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting

40. Precaustions needed for pt's with varicella
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Airborne and contact
9 months

41. Main cause of urinary tract infections
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
85-95%
Hepatoxicity - pancreatitis
E. Coli

42. How does pertussis present?
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
0-24 months

43. Treatment for mononucleosis
passage of abdominal contents to the esophagus
Milk - Ice cream - Malts - Grains
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
none

44. Varicella communicable
Between 6-12 months
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

45. Test to evaluate a Seizure disorder
Family history - EEG - CBC - LP and MRI
head
parainfluenza - RSV - Influenza A&B - M. pneumonia
Delayed puberty - viscous cervical secretions - difficulty getting pregnant

46. How many days after birth do bilirubin levels return to normal limits?
An Acute inflamation of the meninges and CSF often caused by Enterovirus
12-24 days
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
up to 14 days

47. 2 key factors to consider when caring for a preschooler
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
School age
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
They are people - need a balance of limits and independence

48. Clinical signs of infection wilth sickle cell disease
A typical lymphocytosis - mono-spot - EBV serology
none
fever and infection
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death

49. Temp of home water heater to avoid burns
Less than 120 f.
Mechanical Ventalation - high inhaled o2 concentration
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
Contact isolation - gown - gloves and handwashing

50. Screening for overweight or underweight child on chart
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
BMI chart
No - it can only be controlled
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

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Certified Pediatric Nurse Exam

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