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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. Signs and Symptoms of Celiac Disease
36 months
none
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Less than 120 f.

2. Signs and Symptoms of intussusception
A narrowing within the Aorta resulting in collateral circulation
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Small bowel biopsy
9 months

3. treatment of hemolytic disease of the newborn
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
Phototherapy - exchange transfusion
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

4. Cause of bronchiolitis
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
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

5. Celiac Disease
1-6 months
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Enteropathy caused by an insensitivity to the gluten found in wheat
Airborne and contact

6. Signs and symptoms of tuberculosis
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
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
fever - malaise - poor appetite - wt loss -cough - night sweats and chills

7. 2 factors that determine birth weight
Day 3 of life
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
maternal nutrition and genetics
E. Coli

8. What level does the bilirubin need to be at in order for jaundice to occur?
Dust - mold - animal dander - viral infections
5ml/dl
from trunk to extremities
Barium enema

9. What Pharmalogical measures can be used to treat GERD?
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
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
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

10. Average age of breast development
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
10 years
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system

11. 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
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Bacteria enter the blood stream from a site of localized infection and grows in the heart
fever and infection
Previous history of life threatening reaction - Mod-severe illness w/wo fever

12. Kawasaki Disease
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
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
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Salicylates

13. Normal presentation of cystic fibrosis
Repeated involuntary urination in a child who should already by toilet trained at night
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
birth-36 months
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

14. During an abdominal assessment when should auscultation occur
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
20 inches
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds

15. Signs and Symptoms that indicate and adverse reaction to a vaccine
Length Chart
Sterile-caused by blockage of thick mucous at the vas deferens
2 years
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia

16. What is enuresis?
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
36 months
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Repeated involuntary urination in a child who should already by toilet trained at night

17. Treatment of Meningitis

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18. Pathophysiology of cystic fibrosis
2 years
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
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
12-24 days

19. Age range that is appropriate to use a length chart
birth-36 months
<25 yrs old
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
1-6 months

20. Nursing care for child with seizure

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21. When does the surgery to correct hypospadias usually occur?
crowded living conditions - homeless and low income
Between 6-12 months
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Steatorrhea - frequent respiratory infections during infancy - failure to thrive

22. Side effects of benzodiazepines
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
drooling
gum hypertrophy
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

23. How is Celiac Disease diagnosed?
gum hypertrophy
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Epstein Barr Virus - transmitted with intimate contact
Small bowel biopsy

24. What are the side effects of depakote?
Enteropathy caused by an insensitivity to the gluten found in wheat
Hepatoxicity - pancreatitis
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides

25. Diet for Hirschsprung's prior to corrction and treatment
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Less than 120 f.
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
Low fiber - high calorie and protein

26. Average Birth Length
Dental procedures - gum disease and urinary tract infections
20 inches
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system

27. Pathophysiology of a fever and infection with sickle cell disease
Barium enema
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
12 years
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old

28. How many meals and snacks should a 1-3 yr old have in a day 3 meals
Between 6-12 months
3 years
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
2 snacks

29. What is physiologic Jaundice?
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
13 years
12 years
Maternal infection - premature rupture of membranes

30. Peak flow meter
passage of abdominal contents to the esophagus
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
measures the largest velocity which occurs during a forced exhale
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

31. BMI - underweight
< 5%
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
MVA - bike accidents and falls
Salicylates

32. ABG
Dust - mold - animal dander - viral infections
Viral---Varicella or influenza
O2 status of blood - acid-base balance
Brain damage - hearing loss and learning disabilities

33. Signs and symptoms of varicella Prodromal
complete physical and psychosocial assessment to rule out underlying disorders
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
2 years
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages

34. Term infant --Bilirubin peaks at what day of life
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
complete physical and psychosocial assessment to rule out underlying disorders
Day 3 of life

35. Age group affected by mononucleosis
from head to toe
2.5 inches
<25 yrs old
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks

36. What occurs in a subacute baterial endocarditis?
Airborne and contact
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

37. What Component of Aspirin cause's Reye's Syndrome?
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
Salicylates
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas

38. Assess the cause of enuresis
birth-36 months
Kawasaki disease - w/o treatment 25% will have permanent heart damage
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
complete physical and psychosocial assessment to rule out underlying disorders

39. What is Hemolytic Disease of the Newborn
Barium enema
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)

40. Normal Bilirubin
Liver Biopsy
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
< 1
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

41. Pancreatic enzyme therapy for cystic fibrosis is adjusted based on what factors growth and development?
lethargy - irritability - decrease feedings - fever - seizures
double birth weight
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
# of stools per day - goal=2-3 stools per day

42. What confirms a positive TB infection?
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
chest x-ray following a Positive PPD skin test
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
parainfluenza - RSV - Influenza A&B - M. pneumonia

43. Average rate of growth for the 1st year
< 1
10 inches
passage of abdominal contents to the esophagus
<25 yrs old

44. 3 main causes of Bacterial meningitis in children
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
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

45. Signs and symptoms of Reye's Syndrome
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
12 years
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
Dust - mold - animal dander - viral infections

46. Diet for a child with glumerlonephritis
Mechanical Ventalation - high inhaled o2 concentration
4 years
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Regular diet with low sodium an no added salt

47. 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
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
inflammation located in the middle ear
4 years

48. Neonatal Jaundice
An Acute inflamation of the meninges and CSF often caused by Enterovirus
inflammation located in the middle ear
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet

49. Hirschsprung's Disease
Regular diet with low sodium an no added salt
E. Coli
Family history - EEG - CBC - LP and MRI
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine

50. Signs of heart failure
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
Airborne and contact
poor feeding - wt loss - fatigue - develop. delays - edema