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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. What are development considerations for hemophilia?
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
< 5%
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support

2. Hypospadias
double birth weight
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
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
Urethral opening is positioned below the glans penis

3. What promotes unsickling of RBC's?
0-24 months
Adequate O2 adequatte hydration
No - it can only be controlled
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks

4. What level does the bilirubin need to be at in order for jaundice to occur?
5ml/dl
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
13 years
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages

5. Leading cause of acquired heart disease in children
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 and infection
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Kawasaki disease - w/o treatment 25% will have permanent heart damage

6. Main cause of urinary tract infections
E. Coli
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
Enteropathy caused by an insensitivity to the gluten found in wheat

7. Nursing care for a child with Reye's Syndrome
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
12-24 days
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old

8. Complications related to varicella
Less than 120 f.
Adequate O2 adequatte hydration
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Family history - EEG - CBC - LP and MRI

9. Pathophysiology of hirschsprung's disease
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
drooling
up to 14 days
Adequate O2 adequatte hydration

10. Viral Meningitis
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
high protien and calorie - multivitamins - extra enzymes for high fat food

11. Signs and symptoms of neonatal meningitis
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
0-24 months
Day 3 of life

12. Treatment of a bleed in hemophilia
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Airborne and contact
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
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

13. BMI- overweight
>95%
Low fiber - high calorie and protein
Dental procedures - gum disease and urinary tract infections
inflammation located in the middle ear

14. Age that birth length doubles
13 years
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
4 years
gum hypertrophy

15. difference btwn GER and GERD
GERD is the complications and symptoms that happen because of GER
< 1
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
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

16. Where does the adolescent experience rapid growth?
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
trunk - gonads and associative tissue

17. What is used to diagnose GER?
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
maternal nutrition and genetics
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Enteropathy caused by an insensitivity to the gluten found in wheat

18. Test to evaluate a Seizure disorder
3 years
Regular diet with low sodium an no added salt
Dust - mold - animal dander - viral infections
Family history - EEG - CBC - LP and MRI

19. Average Birth Length
Give freedom and choices - save battles for the important things
20 inches
Mid puberty
Foreskin is used during the surgical repair

20. Hirschsprung's Disease
Barium enema
Less than 120 f.
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia

21. Diagnose Intussusception by
Penicillin Prophylaxis (BID)
Barium enema
School age
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

22. Signs and symptoms of varicella Prodromal
Abdominal ultrasound - Upper GI
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
lethargy - irritability - decrease feedings - fever - seizures

23. Complications of acute otitis media
Kawasaki disease - w/o treatment 25% will have permanent heart damage
hearing loss - scarring - mastoiditis - meningitis
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
from head to toe

24. Side effects of benzodiazepines
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
drooling
birth-36 months
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin

25. Rheumatic Fever
gum hypertrophy
9 months
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
prevention - po antibiotics should be given before and after an invasive procedure

26. Pathophysiology of Chronic Asthma
inflammation and hypersensitivity to triggers
Swelling or obstruction of the Larynx
1-6 months
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium

27. How is mononucleosis diagnosed
head
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
# of stools per day - goal=2-3 stools per day
A typical lymphocytosis - mono-spot - EBV serology

28. Varicella communicable
fecal soiling
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
used for prolonged sz's
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks

29. Lead screening should begin. at ..
9 months
20 inches
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus

30. Cephalocaudal
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Liver Biopsy
from head to toe

31. Non-pharmalogical measures to treat GER
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
Repeated involuntary urination in a child who should already by toilet trained at night

32. Characteristics of the RBC's in sickle cell

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33. Complications of meningitis
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
Brain damage - hearing loss and learning disabilities
36 months
0-24 months

34. Prevention of infection in Sickle Cell Disease
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Penicillin Prophylaxis (BID)
Contact isolation - gown - gloves and handwashing
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

35. first tooth
< 5%
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
6 months
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen

36. RSV contagious for ...
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
up to 14 days
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Barium enema

37. Viral Croup
Swelling or obstruction of the Larynx
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Brain damage - hearing loss and learning disabilities

38. Why avoid circumcision in a baby with hypospadias?
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Foreskin is used during the surgical repair
Length board standiometer
5 inches

39. What are the side effects of depakote?
Between 6-12 months
Hepatoxicity - pancreatitis
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
high protien and calorie - multivitamins - extra enzymes for high fat food

40. Signs and symptoms of tuberculosis
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
Small bowel biopsy
Vaso-occulisive crisis - infection and sepsis
Erythroblastosis Fetalis

41. Prevention of bronchiolitis spreading
Viral---Varicella or influenza
Cool mist therapy - encourage oral intake - s/sx of resp. distress
inflammation and hypersensitivity to triggers
Contact isolation - gown - gloves and handwashing

42. Teaching for Mononucleosis
Barium enema
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
chest x-ray following a Positive PPD skin test

43. Side effects of dilatin hirsuitism (body hair)
gum hypertrophy
Successful management is based on early diagnosis and aggressive therapy
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli

44. How many days after birth do bilirubin levels return to normal limits?
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
12-24 days
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Length board standiometer

45. Nursing care of patient with Meningitis
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Kawasaki disease - w/o treatment 25% will have permanent heart damage

46. Pathophysiology of intussusception

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47. Precaustions needed for pt's with varicella
Mechanical Ventalation - high inhaled o2 concentration
Urethral opening is positioned below the glans penis
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Airborne and contact

48. What are major risk factors for neonatal meningitis?
Length board standiometer
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Maternal infection - premature rupture of membranes
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)

49. Screening for overweight or underweight child on chart
from trunk to extremities
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
BMI chart
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping

50. Etiology of GERD
Less than 120 f.
12 years
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain