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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.
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. Precaustions needed for pt's with varicella
Airborne and contact
Liver Biopsy
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
birth-36 months

2. Age group the limbs grow the fastest
School age
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
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
< 5%

3. What are the side effects of depakote?
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
Hepatoxicity - pancreatitis
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications

4. Signs of heart failure
poor feeding - wt loss - fatigue - develop. delays - edema
2 snacks
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
5 inches

5. Asthma inhaler - what can be done to decrease risk of thrush
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Rinse mouth and brush teeth
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Liver Biopsy

6. Complications of acute otitis media
hearing loss - scarring - mastoiditis - meningitis
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
up to 14 days
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

7. Pathophysiology of a fever and infection with sickle cell disease
Mid puberty
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth

8. Rheumatic Fever
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
12 years
1-6 months

9. Complications of meningitis
measures the largest velocity which occurs during a forced exhale
Brain damage - hearing loss and learning disabilities
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
inflammation located in the middle ear

10. Non-pharmalogical measures to treat GER
larger
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
chest x-ray following a Positive PPD skin test
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting

11. Part of body that grows the fastest in infancy
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
head
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old

12. Reyes Syndrome
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Phototherapy - exchange transfusion
Kawasaki disease - w/o treatment 25% will have permanent heart damage

13. Hourly maintenance Fluid Requirements
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
Phototherapy - exchange transfusion

14. treatment of hemolytic disease of the newborn
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Phototherapy - exchange transfusion
Hepatoxicity - pancreatitis
Give freedom and choices - save battles for the important things

15. Define Magical thinking

16. What Component of Aspirin cause's Reye's Syndrome?
Brain damage - hearing loss and learning disabilities
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Salicylates

17. Signs and Symptoms of Celiac Disease
lethargy - irritability - decrease feedings - fever - seizures
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op

18. Treatment and nursing care for pertussis
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Hepatoxicity - pancreatitis
lethargy - irritability - decrease feedings - fever - seizures
from trunk to extremities

19. Cause of bronchiolitis
Sterile-caused by blockage of thick mucous at the vas deferens
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
complete physical and psychosocial assessment to rule out underlying disorders
Day 3 of life

20. Nursing care for Cystic Fibrosis
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
trunk
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

21. Diet for a child with glumerlonephritis
They are people - need a balance of limits and independence
MVA - bike accidents and falls
Vaso-occulisive crisis - infection and sepsis
Regular diet with low sodium an no added salt

22. Term infant --Bilirubin peaks at what day of life
2.5 inches
none
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Day 3 of life

23. Diagnose Reye's Syndrome
diazepam - lorazapam
Dust - mold - animal dander - viral infections
Liver Biopsy
They are people - need a balance of limits and independence

24. Normal presentation of cystic fibrosis
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
drooling
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

25. Signs and Symptoms of Bilirubin Kernicterus (encephalopathy)
lethargy - irritability - decrease feedings - fever - seizures
12-24 days
measures the largest velocity which occurs during a forced exhale
inflammation located in the middle ear

26. Asthma
Between 6-12 months
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
measures the largest velocity which occurs during a forced exhale

27. Temp of home water heater to avoid burns
1-6 months
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
Less than 120 f.
drooling

28. Screening for overweight or underweight child on chart
BMI chart
drooling
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
inflammation located in the middle ear

29. What are development considerations for hemophilia?
1-6 months
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Cool mist therapy - encourage oral intake - s/sx of resp. distress
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support

30. How is Celiac Disease diagnosed?
Small bowel biopsy
5 inches
Length Chart
9 months

31. Side effects of benzodiazepines
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
drooling
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
GERD is the complications and symptoms that happen because of GER

32. Where does the adolescent experience rapid growth?
trunk - gonads and associative tissue
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

33. Focus of adolescent discipline
Equal to
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
gum hypertrophy
Give freedom and choices - save battles for the important things

34. BMI-@ risk for overweight
Viral---Varicella or influenza
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
85-95%

35. What level does the bilirubin need to be at in order for jaundice to occur?
5ml/dl
inflammation located in the middle ear
2.5 inches
20 inches

36. Define Proximodistal
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
from trunk to extremities
MVA - bike accidents and falls
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping

37. difference btwn GER and GERD
GERD is the complications and symptoms that happen because of GER
O2 status of blood - acid-base balance
head
birth-36 months

38. 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
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
fever and infection

39. Diastat rectal diazepam gel

40. Basic defect in coarctation of the aorta
trunk
fecal soiling
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
A narrowing within the Aorta resulting in collateral circulation

41. What should be observed in a case of a seizure?
Phototherapy - exchange transfusion
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
up to 14 days
Time and discription of seizure

42. Pertussis?
Length Chart
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
Mechanical Ventalation - high inhaled o2 concentration

43. Leading cause of head injury
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
2 snacks
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
MVA - bike accidents and falls

44. Kawasaki Disease
double birth weight
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
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

45. 2 key factors to consider when caring for a preschooler
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
They are people - need a balance of limits and independence
4 years
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks

46. What should be done to minimize the risks of Sudden infant death syndrome?
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
BMI chart
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
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant

47. What is enuresis?
passage of abdominal contents to the esophagus
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
>95%
Repeated involuntary urination in a child who should already by toilet trained at night

48. Common Asthma irritants
Dust - mold - animal dander - viral infections
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
maternal nutrition and genetics
3 years

49. Part of the body that grows the fastest in the toddler-preschool age
trunk
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection

50. Complications related to varicella
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
MVA - bike accidents and falls
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
13 years

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Certified Pediatric Nurse Exam

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