Certified Pediatric Nurse Exam 61 Questions with Verified Answers
3 month Key Milestones - CORRECT ANSWER Brings hands to mouth
Grasps and hold
... [Show More] object- actively holds rattle but not reaching for it
Takes swipes at objects
Watches faces intently
Smiles at sound of your voice
begins to imitate some sounds
4 to 6 Months - CORRECT ANSWER Demands and enjoys attention
Chuckles and laughs
Attachment begins discovers hands
6 Months - CORRECT ANSWER Peak time of development
Good head support - no head lag
Rolling in both directions
Bares weight on legs
Sitting with support - tripod position
6 Months Red Flags - CORRECT ANSWER Stiff of floppy tone
No affections or cuddling behavior
Does not track objects with eyes
Does not respond to sounds
Lack of social smile by 5 months
12 Month Red Flags - CORRECT ANSWER Not crawling
Not standing with support
Not using consonant sounds (dada mama)
Not using gestures
Anterior fontanel closure - CORRECT ANSWER 18mo
First steps - CORRECT ANSWER 12-15 mo
Red Flag Toddler - CORRECT ANSWER Not walking at 15mo
Toe walking
Not using words
Car Seats - CORRECT ANSWER Under 2- rear facing
2-3yrs forward facing
4-8yrs booster seat in rear
5 types of play - CORRECT ANSWER solitary, onlooker, parallel, associative, cooperative
solitary play - CORRECT ANSWER playing alone
Begins in infancy and common in toddlers
Toys are dissimilar if there are other children in room
Parallel play - CORRECT ANSWER Children play side by side
Especially common in toddlers
Similar toys but lack interaction
Associative play - CORRECT ANSWER Group play without group goals
Preschool period
Lack of formal organization
Cooperative Play - CORRECT ANSWER Organized with group goals
Begins late in preschool years
Children are either in or out of group
Onlooker Play - CORRECT ANSWER Observer
Toddler years
Lead Poisoning Blood Sample - CORRECT ANSWER (Blood lead level)
BLL >10mcg/dl needs to be rescreened in 1yr
BLL >20mcg/dl requires clinical management
BLL>45mcg/dl chelation therapy
Otitis Media - CORRECT ANSWER inflammation of MIDDLE EAR without reference to etiology
Acute Otitis Media - CORRECT ANSWER inflammation with RAPID ONSET of FEVER and ear pain (OTALGIA)
Otitis Media with Effusion - CORRECT ANSWER FLUID in middle ear space without symptoms of infection
Otitis Externa - CORRECT ANSWER infections of external ear due to EXCESSIVE wetness or dryness
AKA "Swimmer's Ear"
Otitis Media Signs and Symptoms - CORRECT ANSWER Purulent fluid accumulating in middle ear
Bulging red tympanic membrane
Pain from pressure
Irritable, pulling or holding ears
Rolling head side to side
Febrile
Rhinorrhea, V, D, S&S respiratory infection
Loss of appetite
Otitis Media Treatment - CORRECT ANSWER Antibiotics (amoxicillin 10-14 days)
Antipyretics, analgesic
Myringotomy (excision of ear drum, allows fluid to drain)
PE tubes (Pressure Equalizing tubes), ventilation of middle ear
Otitis Media Prevention - CORRECT ANSWER Breastfeeding until 6mo
Feed in upright position
D/c pacifier after 6mo
Pneumococcal vaccine
Avoid passive smoking
Acute Laryngotracheobronchitis (Croup) - CORRECT ANSWER Hoarseness
Barking and Brassy cough
inflammation of mucosa lining larynx and trachea
Narrowing of airway
Inspiratory stridor
Croup S&S - CORRECT ANSWER Inspiratory stridor (confirm not foreign body)
SUPRAsternal retractions
Nasal flaring
Tachypnea
Grandual onset of fever
Barky/Brassy cought
Worse at night during cold weather
Acute Epiglottitis - CORRECT ANSWER Obstruction of supraglottitis
2-5yrs old
Prevention: Hib vaccine
Acute Epiglottitis S&S - CORRECT ANSWER Abrupt onset, night
Pain on swallowing
Fever
Tripod position
Drooling, excess secretions
Voice muffled
Restless/irrtatble
Froglike croaking on INSPIRATION
Cherry red edematous epiglottis
RSV x-ray - CORRECT ANSWER Patchy atelectasis
Infiltration
Hyperinflation
RSV S&S - CORRECT ANSWER Begins with URI
Bronchiolar mucosa swells, fill wit mucous and exudates
Rhinorrhea
Low grade temp
Otitis media
Conjunctivitis
Cough
Wheezing
Retractions
Crackles
Dyspnea and Tachypnea
Synagis - CORRECT ANSWER Vaccine for RSV
High risk infants
<2 yrs with BPD
<32 wks gestation at birth
<2yrs with heart disorders
RSV treatment - CORRECT ANSWER Cool humidified O2
Fluid hydration
Airway maintenance
Chest PPD
Albuterol or RACEMIC EPI
Asthma - CORRECT ANSWER Chronic inflammatory disorder of airways
Episodes of progressive worsening of SOB, CO, wheeze, chest tightness
Primary cause of school absence, 3rd leading cause for hospitalization - CORRECT ANSWER Asthma
Asthma S&S - CORRECT ANSWER Spasm attacks of bronchi and bronchioles
Inflammation of edema of mucous membrane
Accumulation of tenacious secretions
Episodes of progressive worsening of SOB, CO, wheeze, chest tightness
Decreased EXPIRATORY airflow due to resistance
Older pts "abd pain"
Tripod position
Restless/Apprehensive
Asthma Diagnosis - CORRECT ANSWER PFT
Spirometry
Peak Expiratory flow rate (PEFR)
Asthma treatment long term - CORRECT ANSWER Maintains control of inflammation
Inhaled corticosteroids
Cromolyn sodium
long activng B antagonists
leukotriene modifiers
Singular
Nebulizer or metered inhaler with spacer
Asthma treatment quick relief - CORRECT ANSWER Short acting be atagonists
anticholinergics
systemic corticosteroids
B Adrenergic Agents
Albuterol
Terbutaline (broncho spasm)
Atropine
Ipratropium
Mag sulfate
Status Asthmaticus - CORRECT ANSWER Continued RDS despite measures
Gradual or rapid
Medical emergency
Respiratory ACIDOSIS
Dehydration
O2
Pyloric Stenosis - CORRECT ANSWER Metabolic Alkalosis (decreased NA, K, Cl)
Pyloric Stenosis - CORRECT ANSWER Olive shaped mass
projectile vomiting
Metabolic ALKalosis
FTT
visible peristaltic waves
Intussusception Triad - CORRECT ANSWER Sudden on-set of pain
palpable sausage shaped abd mass
currant jelly like stool
Hirschsprung disease (congenital aganglionic megacolon) - CORRECT ANSWER Congenital anomaly that results in mechanical obstruction from inadequate motility of part of the intestine
Hirschprung Disease - CORRECT ANSWER Autosomal DOMINANT
contraction of bowl
lack of peristalsis
Diarrhea - CORRECT ANSWER Metabolic Acidosis
Fluid Replacement - CORRECT ANSWER 1-10kg 4ml/hr
10-20kg 2ml/hr
+kg 1ml/hr
Vomiting - CORRECT ANSWER metabolic alkalosis
Hirsprung's disease pre-op diet - CORRECT ANSWER Low fiber (decrease bulk)
High Calorie & High Protein (prep for surgical healing)
Positioning for peritonitis post-op - CORRECT ANSWER Right side lying
allows peritoneal cavity to drain and decreases risk of abscess formation
Misshapen newborn ears - CORRECT ANSWER Evaluate for kidney malformations
(developing at the same time in utero)
Normal Hgb - CORRECT ANSWER 11.5-14.5mg/dl
Normal RBC lifespan - CORRECT ANSWER 90-120 days
Acute Anemia - CORRECT ANSWER Increased CV output
Heart Murmur
Tachy
HA
Acute tissue hypoxia
Chronic Anemia - CORRECT ANSWER Growth retardation
Delayed sexual maturation
Tachy
Increased CV output
Heart Murmur
Iron Deficiency Anemia - CORRECT ANSWER Inadequate supply
Impaired absorption
Bld loss
Excessive growth demands
At risk:
prematurity
multiple pregnancy
low income
Aplastic Anemia - CORRECT ANSWER Bone marrow fails to produce blood components
Congenital or Acquired
Thrombocytopenia
Leukopenia
Tx: BMA, immunosuppressives, BMT, Transfusions
SCD genetics - CORRECT ANSWER Autosomal recessive disease
Both parents with trait: 25% chance
Newborn screen
SCD Complication - CORRECT ANSWER Infection/Sepsis
VasoOcculusive Crisis
Acute Chest Syndrome
Aplastic Crisis
ITP - CORRECT ANSWER URI or viral illness precedes
Platelets <20,000
IVIG if <20,000
ANC - CORRECT ANSWER (Bands + Segs) x true WBC/100
(Bands + Segs) x (Abr. WBC x10)
Protective Isolation ANC - CORRECT ANSWER ANC <500
Wilm's Tumor - CORRECT ANSWER Firm
Nontender
Unilateral mass- deep flank
No mvmt with respiration
Do not palpate- keep encapsulated
loosen clothingA [Show Less]