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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. Assessment of a patient with suspected epiglottitis
prevention - po antibiotics should be given before and after an invasive procedure
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film

2. Pancreatic enzyme therapy for cystic fibrosis is adjusted based on what factors growth and development?
Foreskin is used during the surgical repair
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
13 years
# of stools per day - goal=2-3 stools per day

3. Most cases of Reye's Syndrome follows what type of illness?
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
inflammation located in the middle ear
from head to toe
Viral---Varicella or influenza

4. Clinical signs of infection wilth sickle cell disease
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
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
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
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility

5. Sickle Cell Disease
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
measures the largest velocity which occurs during a forced exhale
2 years

6. signs and symptoms of meningitis in older children
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
drooling
Mechanical Ventalation - high inhaled o2 concentration

7. Treatment of a bleed in hemophilia
Hepatoxicity - pancreatitis
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects

8. Define Magical thinking

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9. What is epiglottitis?
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Mechanical Ventalation - high inhaled o2 concentration
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Cool mist therapy - encourage oral intake - s/sx of resp. distress

10. 2 factors that determine birth weight
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
Enteropathy caused by an insensitivity to the gluten found in wheat
maternal nutrition and genetics
Foreskin is used during the surgical repair

11. Basic defect in coarctation of the aorta
12-24 days
inflammation located in the middle ear
Rinse mouth and brush teeth
A narrowing within the Aorta resulting in collateral circulation

12. Assess the cause of enuresis
complete physical and psychosocial assessment to rule out underlying disorders
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
BMI chart
Swelling of the airways - mucous production - bronchospasms

13. Two important assessment rules related to coarctation of the aorta?
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Small bowel biopsy
passage of abdominal contents to the esophagus

14. During an abdominal assessment when should auscultation occur
Low fiber - high calorie and protein
No - it can only be controlled
3 years
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds

15. 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
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
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Hepatoxicity - pancreatitis
fever and infection

16. How is mononucleosis diagnosed
A typical lymphocytosis - mono-spot - EBV serology
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
< 1
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

17. Two examples of benzodiazepines
An Acute inflamation of the meninges and CSF often caused by Enterovirus
20 inches
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
diazepam - lorazapam

18. 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
fecal soiling
Penicillin Prophylaxis (BID)
A narrowing within the Aorta resulting in collateral circulation

19. Females reproductive issues for CF patients
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
complete physical and psychosocial assessment to rule out underlying disorders
poor feeding - wt loss - fatigue - develop. delays - edema

20. Leading cause of bacterial meningitis in Neonates
Low fiber - high calorie and protein
Group B Streptococcus
36 months
fever - malaise - poor appetite - wt loss -cough - night sweats and chills

21. Signs and Symptoms of Bilirubin Kernicterus (encephalopathy)
complete physical and psychosocial assessment to rule out underlying disorders
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
lethargy - irritability - decrease feedings - fever - seizures

22. Signs and Symptoms of mononucleosis
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Repeated involuntary urination in a child who should already by toilet trained at night

23. Focus of adolescent discipline
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
Give freedom and choices - save battles for the important things
Less than 120 f.
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

24. At what age is a length board required?
Small bowel biopsy
0-24 months
A narrowing within the Aorta resulting in collateral circulation
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml

25. What level does the bilirubin need to be at in order for jaundice to occur?
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
Group B Streptococcus
5ml/dl
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy

26. Characteristics of the RBC's in sickle cell

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27. Treatment of celiac disease
5 inches
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
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
Cool mist therapy - encourage oral intake - s/sx of resp. distress

28. Encoperesis
85-95%
9 months
fecal soiling
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

29. Define Proximodistal
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
from trunk to extremities
Dust - mold - animal dander - viral infections
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure

30. At what age is a stadiometer required to measure linear growth?
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
A narrowing within the Aorta resulting in collateral circulation
36 months
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin

31. Incubation period for TB
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
1-6 months
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void

32. Risk factors of tuberculosis
Cool mist therapy - encourage oral intake - s/sx of resp. distress
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
10 years
crowded living conditions - homeless and low income

33. Hypospadias
Urethral opening is positioned below the glans penis
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Salicylates
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects

34. How does pertussis present?
Salicylates
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
They are people - need a balance of limits and independence

35. What is used to diagnose pyloric stenosis?
Excessive stool fat
gum hypertrophy
high protien and calorie - multivitamins - extra enzymes for high fat food
Abdominal ultrasound - Upper GI

36. Nursing care for child with seizure

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37. What is Hemolytic Disease of the Newborn
Urethral opening is positioned below the glans penis
parainfluenza - RSV - Influenza A&B - M. pneumonia
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache

38. What is broncho-pulmonary dysplasia?
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
MVA - bike accidents and falls
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Penicillin Prophylaxis (BID)

39. What should be used for feeding a child during the post operative period following cleft palate surgery?
Foreskin is used during the surgical repair
measures the largest velocity which occurs during a forced exhale
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
dysfunction of the lower esophageal sphincter and delayed gastric emptying time

40. Average rate of growth for the 1st year
10 inches
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
12 years

41. Age range that is appropriate to use a length chart
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
0-24 months
birth-36 months
An Acute inflamation of the meninges and CSF often caused by Enterovirus

42. 3 symptoms of coarctation of the aorta
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Barium enema
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Epstein Barr Virus - transmitted with intimate contact

43. Side effects of dilatin hirsuitism (body hair)
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
Length Chart
gum hypertrophy
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth

44. Treatment for Hirschsprungs
85-95%
maternal nutrition and genetics
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
passage of abdominal contents to the esophagus

45. Lead screening should begin. at ..
Mechanical Ventalation - high inhaled o2 concentration
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
9 months
Adequate O2 adequatte hydration

46. BMI-@ risk for overweight
Dental procedures - gum disease and urinary tract infections
Maternal infection - premature rupture of membranes
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
85-95%

47. Celiac Disease
Viral---Varicella or influenza
Enteropathy caused by an insensitivity to the gluten found in wheat
School age
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

48. What is Pyloric stenosis?
2 years
gum hypertrophy
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
double birth weight

49. What confirms a positive TB infection?
trunk
2.5 inches
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
chest x-ray following a Positive PPD skin test

50. Causes of Bronchopulmonary Dysplasia
Between 6-12 months
A typical lymphocytosis - mono-spot - EBV serology
Mechanical Ventalation - high inhaled o2 concentration
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash

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Certified Pediatric Nurse Exam

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