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Certified Pediatric Nurse Exam

Subjects : certifications, health-sciences, nursing

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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. Viral Croup
Rinse mouth and brush teeth
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
Swelling or obstruction of the Larynx
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure

2. Teaching for Croup
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
trunk
Cool mist therapy - encourage oral intake - s/sx of resp. distress
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

3. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
An Acute inflamation of the meninges and CSF often caused by Enterovirus

4. Diet for a child with glumerlonephritis
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
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
Regular diet with low sodium an no added salt
Group B Streptococcus

5. What is used to diagnose GER?
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
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
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
Sterile-caused by blockage of thick mucous at the vas deferens

6. How many days after birth do bilirubin levels return to normal limits?
12-24 days
maternal nutrition and genetics
lethargy - irritability - decrease feedings - fever - seizures
Mid puberty

7. Peak flow meter
measures the largest velocity which occurs during a forced exhale
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
fecal soiling

8. Diagnose Intussusception by
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
Group B Streptococcus
Barium enema

9. Pathophysiology related to Head Trauma
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.
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Liver Biopsy

10. Head circumference should be assessed until what age
Between 6-12 months
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
3 years
gum hypertrophy

11. S/SX of Hirschsprungs
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Group B Streptococcus

12. What is epiglottitis?
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Foreskin is used during the surgical repair
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
A typical lymphocytosis - mono-spot - EBV serology

13. Pathophysiology of Chronic Asthma
inflammation located in the middle ear
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
inflammation and hypersensitivity to triggers
Enteropathy caused by an insensitivity to the gluten found in wheat

14. S/sx of GERD
Time and discription of seizure
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
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

15. 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
A narrowing within the Aorta resulting in collateral circulation
Length Chart
head

16. Signs and Symptoms of Asthma
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Sterile-caused by blockage of thick mucous at the vas deferens
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing

17. Linear growth event happens in Adolescents
Growth spurt
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium

18. Signs and Symptoms of Bilirubin Kernicterus (encephalopathy)
2 snacks
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
lethargy - irritability - decrease feedings - fever - seizures
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine

19. What confirms a positive TB infection?
chest x-ray following a Positive PPD skin test
Mechanical Ventalation - high inhaled o2 concentration
5ml/dl
maternal nutrition and genetics

20. What level does the bilirubin need to be at in order for jaundice to occur?
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
5ml/dl
2.5 inches
2 years

21. Pathophysiology of celiac disease
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Brain damage - hearing loss and learning disabilities
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Regular diet with low sodium an no added salt

22. RSV contagious for ...
up to 14 days
10 years
Repeated involuntary urination in a child who should already by toilet trained at night
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

23. Temp of home water heater to avoid burns
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
5 inches
5ml/dl
Less than 120 f.

24. 2 factors that determine birth weight
poor feeding - wt loss - fatigue - develop. delays - edema
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
maternal nutrition and genetics

25. What is Pyloric stenosis?
MVA - bike accidents and falls
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Urethral opening is positioned below the glans penis

26. Complications of acute otitis media
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
hearing loss - scarring - mastoiditis - meningitis
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Kawasaki disease - w/o treatment 25% will have permanent heart damage

27. Complications of meningitis
Brain damage - hearing loss and learning disabilities
Liver Biopsy
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)

28. What is Hemolytic Disease of the Newborn
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
MVA - bike accidents and falls
12-24 days

29. Prevention of infection in Sickle Cell Disease
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Penicillin Prophylaxis (BID)
head
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds

30. What are development considerations for hemophilia?
10 years
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support

31. BMI-@ risk for overweight
85-95%
Time and discription of seizure
Dental procedures - gum disease and urinary tract infections
Milk - Ice cream - Malts - Grains

32. Signs and symptoms of neonatal meningitis
birth-36 months
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

33. Where does the adolescent experience rapid growth?
Liver Biopsy
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
trunk - gonads and associative tissue
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth

34. What Pharmalogical measures can be used to treat GERD?
Brain damage - hearing loss and learning disabilities
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

35. Precaustions needed for pt's with varicella
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
A typical lymphocytosis - mono-spot - EBV serology
Airborne and contact
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations

36. Viral Meningitis
measures the largest velocity which occurs during a forced exhale
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing
high protien and calorie - multivitamins - extra enzymes for high fat food

37. Signs of increased ICP
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
trunk - gonads and associative tissue
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Foreskin is used during the surgical repair

38. Varicella communicable
BMI chart
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
Small bowel biopsy
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks

39. S/Sx of pyloric stenosis
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
Length Chart

40. Most cases of Reye's Syndrome follows what type of illness?
Viral---Varicella or influenza
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia

41. What has the HIB vaccine been successful in reducing?
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
up to 14 days
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis

42. first tooth
<25 yrs old
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
6 months
fever and infection

43. Can Asthma be cured?
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
none
Hepatoxicity - pancreatitis
No - it can only be controlled

44. Screening for overweight or underweight child on chart
BMI chart
Foreskin is used during the surgical repair
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
13 years

45. treatment of hemolytic disease of the newborn
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Foreskin is used during the surgical repair
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Phototherapy - exchange transfusion

46. Characteristics of the RBC's in sickle cell

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47. Treatment of Meningitis

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48. Which growth chart is appropriate for use - Growth for the young child who is measured laying down?
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Length Chart
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
4 years

49. Two examples of benzodiazepines
diazepam - lorazapam
5ml/dl
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
Between 6-12 months

50. Pathophysiology of cystic fibrosis
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen

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Certified Pediatric Nurse Exam

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