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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. Pathophysiology of cystic fibrosis
Triple
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
A narrowing within the Aorta resulting in collateral circulation
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function

2. What are the side effects of depakote?
Barium enema
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy
Hepatoxicity - pancreatitis
Foreskin is used during the surgical repair

3. Signs and symptoms of neonatal meningitis
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Salicylates
fever and infection

4. What has the HIB vaccine been successful in reducing?
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
Family history - EEG - CBC - LP and MRI
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis

5. 2 key factors to consider when caring for a preschooler
birth-36 months
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
complete physical and psychosocial assessment to rule out underlying disorders
They are people - need a balance of limits and independence

6. Side effects of benzodiazepines
Regular diet with low sodium an no added salt
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
Brain damage - hearing loss and learning disabilities
drooling

7. BMI- overweight
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
>95%
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
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US

8. Females reproductive issues for CF patients
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
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
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Delayed puberty - viscous cervical secretions - difficulty getting pregnant

9. Treatment and nursing care for pertussis
1-6 months
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
from trunk to extremities

10. Celiac Disease
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
Enteropathy caused by an insensitivity to the gluten found in wheat
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
gum hypertrophy

11. Hypospadias
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
< 5%
Urethral opening is positioned below the glans penis
3 years

12. Leading cause of head injury
MVA - bike accidents and falls
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
E. Coli
0-24 months

13. Normal Bilirubin
< 1
lethargy - irritability - decrease feedings - fever - seizures
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
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

14. ABG
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
O2 status of blood - acid-base balance
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
fever and infection

15. Treatment of Kawasaki disease
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Phototherapy - exchange transfusion
13 years
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy

16. Growth spurt for adolescent boys
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Mid puberty
< 1
Less than 120 f.

17. Test to evaluate a Seizure disorder
4 years
Erythroblastosis Fetalis
Family history - EEG - CBC - LP and MRI
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet

18. Nursing care of patient with Meningitis
BMI chart
1-6 months
Regular diet with low sodium an no added salt
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics

19. Rheumatic Fever
12-24 days
5ml/dl
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
none

20. What is heart failure?
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
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
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
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough

21. Which growth chart is appropriate for use - Growth for the young child who is measured laying down?
0-24 months
maternal nutrition and genetics
Length Chart
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice

22. During an abdominal assessment when should auscultation occur
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
Airborne and contact

23. Males Reproductive issues for CF patients
high protien and calorie - multivitamins - extra enzymes for high fat food
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
2 snacks
Sterile-caused by blockage of thick mucous at the vas deferens

24. What is physiologic Jaundice?
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
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
10 inches

25. Reyes Syndrome
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
diazepam - lorazapam
crowded living conditions - homeless and low income
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

26. What is broncho-pulmonary dysplasia?
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
4 years
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Epstein Barr Virus - transmitted with intimate contact

27. Pancreatic enzyme therapy for cystic fibrosis is adjusted based on what factors growth and development?
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
# of stools per day - goal=2-3 stools per day
prevention - po antibiotics should be given before and after an invasive procedure
Low fiber - high calorie and protein

28. Diagnose Intussusception by
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Dust - mold - animal dander - viral infections
Length board standiometer
Barium enema

29. Two examples of benzodiazepines
diazepam - lorazapam
poor feeding - wt loss - fatigue - develop. delays - edema
6 months
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice

30. Asthma inhaler - what can be done to decrease risk of thrush
Swelling of the airways - mucous production - bronchospasms
Epstein Barr Virus - transmitted with intimate contact
Successful management is based on early diagnosis and aggressive therapy
Rinse mouth and brush teeth

31. Childs weight at 6 months compared to birth weight
fecal soiling
double birth weight
Successful management is based on early diagnosis and aggressive therapy
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing

32. Normal presentation of cystic fibrosis
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Erythroblastosis Fetalis
A typical lymphocytosis - mono-spot - EBV serology
Steatorrhea - frequent respiratory infections during infancy - failure to thrive

33. Bilirubin encephalopathy
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
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

34. Assess the cause of enuresis
complete physical and psychosocial assessment to rule out underlying disorders
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
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

35. Signs of increased ICP
4 years
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Less than 120 f.

36. What should be used for feeding a child during the post operative period following cleft palate surgery?
prevention - po antibiotics should be given before and after an invasive procedure
trunk
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death

37. Post Op treatment of a VP shunt
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
20 inches
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

38. Nursing care for a child with Reye's Syndrome
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
from head to toe
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks

39. Temp of home water heater to avoid burns
Vaso-occulisive crisis - infection and sepsis
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Less than 120 f.
Erythroblastosis Fetalis

40. Average rate of growth for the 1st year
10 years
high protien and calorie - multivitamins - extra enzymes for high fat food
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
10 inches

41. Causes of Bronchopulmonary Dysplasia
Mechanical Ventalation - high inhaled o2 concentration
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
2 years

42. Pathophysiology of a fever and infection with sickle cell disease
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
Day 3 of life
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting

43. 3 symptoms of coarctation of the aorta
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor

44. Another name for Hemolytic Disease of the Newborn
Low fiber - high calorie and protein
5ml/dl
Repeated involuntary urination in a child who should already by toilet trained at night
Erythroblastosis Fetalis

45. BMI - underweight
< 5%
Adequate O2 adequatte hydration
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

46. What are major risk factors for neonatal meningitis?
measures the largest velocity which occurs during a forced exhale
A typical lymphocytosis - mono-spot - EBV serology
Maternal infection - premature rupture of membranes
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

47. RSV contagious for ...
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
up to 14 days

48. Diet for CF patients
Repeated involuntary urination in a child who should already by toilet trained at night
double birth weight
high protien and calorie - multivitamins - extra enzymes for high fat food
2 snacks

49. Diastat rectal diazepam gel

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50. Treatment of celiac disease
Day 3 of life
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
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
lethargy - irritability - decrease feedings - fever - seizures