CPEN Practice exam-with 100% verified solutions-2024-2025.docx, Exams of Nursing

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CPEN Practice exam-with 100% verified solutions-2024-

Difference between bacterial and viral conjunctivitis. Bacterial will cause purulent eye drainage, a viral infection will not. What class of medication is Diltiazem? Calcium channel blocker. infections usually begin in the oral mucosa and are very contagious. Variola/Small Pox Infection in which the accompanying rash progresses centrally, then outward to the limbs. Chicken Pox The size or gauge of the needle used contributes directly to which side effect post LP? Post Spinal Headachce Sickle cell disease may present with which other disease processes? Pneumonia or Acute Chest Syndrome Which medication is often used to enhance elimination of acidic drugs such as Salicylate in the case of overdose or poisoning? Sodium bi-carb What is the name of a rectal form of benzodiazepine? Diastat Treatment of which virus may cause a rash without a true penicillin allergy? EBV w Mononucliousis What is a common cause of multiple brain abscesses in children?

Cyanotic Heart Disease A newborn shows signs of lethargy, hypotension, ash colored skin, and abdominal distention. What medication was the mother most likely taking? Chloramphenicol. This medication may cause "gray baby syndrome." Which mechanical cardiac function is occurring during the P wave? Atrial contraction Which embryonic layer gives rise to the tooth enamel? Ectoderm What can happen upon administration of a beta blocker to a patient with any type of heart block? A complete heart block Children make up which portion of ED visits each year? 20% or 119 million What is the leading cause of injury in children? Falls What percentage of children had no healthcare visits to the office or clinic in the past 12 months? 14.4% What is the leading cause of death for African Americans aged 10-24 years? Homicide What is the most common illness that children are admitted for? Asthma What is the leading cause of death for infants 28 days to 11 months?

SIDS and congenital anomalies. What is the leading cause of death after the age of 1 year? Injury Children are at increased risk for what during intubation? Right stem intubation Children with a respiratory rate of or greater are at risk for respiratory arrest. 60 breaths per minute. A slow or irregular rate is an ominous sign. What do children heavily rely on for respirations? Their diaphragm. Attempt to maintain children in a sitting position. Children may remain normotensive until what percent of their circulatory volume is lost? 25% Le Fort I fracture involves? Mouth or teeth bridge only Le Fort II fracture involves? Mouth and teeth, and nasal bridge. Le Fort III fracture involves? Mouth and teeth, nasal bridge, and orbit floor. Croup is a viral upper airway infection and can show what sign on an XRAY? Steeple Sign Epiglottitis is bacterial upper airway infection and can show what sign on an XRAY? Thumb Sign

Respiratory Acidosis Low pH (<7.35) and high CO2 (>35)- Asthma Respiratory Alkalosis High pH (>7.45) and low CO2 (<35) Hyperventilating Teenager Metabolic Acidosis Low pH (<7.35) and low bi-carb (<22) DKA, Shock, excessive diarrhea. Metabolic Alkalosis High pH (>7.45) and high bi-carb (>26) Excessive Vomiting. 5 H's Hypothermia, hypovolemia, hypoxia, hydrogen ion, hyper/hypo electrolytes. 5 T's Tension pneumothorax, pericardial tamponade, toxins, trauma, thromboembolism, Kawasaki's kills your Koronaries Strawberry like tongue, and skin on hands and feet may begin peeling. What is the normal pediatric urinary output? 1-2ml/kg/hr In what child would a Babinski reflex be abnormal? A walking child What is an infants circulating blood volume? Approximately 90ml/kg In an unresponsive pediatric patient the most common cause of airway obstruction in what?

The tongue What is first noticed in the mouth of a pediatric patient and is a late sign of respiratory compromise? Cyanosis Estimating ET Tube size: Uncuffed Uncuffed (Age in years/4)+ Estimating ET Tube Size: Cuffed Cuffed (Age in years/4)+3. Age related pain scale for child less that 3 years of age Cries, Nips, FLACC Age related pain scale for child greater than 3 years of age FACES, Wong-Baker, Standard Pediatric milestones "Head, Shoulders, Knees, and Toes" 2 months: Holds head up 4 months: Rolls 6 months: Sits unsupported 1 year: Walking Which type chemical burns may cause more damage to the eyes? Alkali What is Beck's Triad? Cardiac Tamponade Signs -JVD -Muffled heart sounds -Narrowed pulse pressure Differences with Cardiomyopathy. Left vs Right

-Left heart failure backs up to the lungs -Right sided the rest of the body What is Waddell's Triad? Child vs Car (Child Waddell's away from the car) -Femur fracture -Belly or chest injuries -Head injuries What would raccoon eyes, and battle's sign indicate? A basilar skull fracture Glasgow Coma Scale Eye (4) Verbal (5) Motor (6) Describe decorticate posturing Abnormal flexion (bad) Describe decerebrate posturing Abnormal extension (worst) Kernig's Sign Meningitis Sign-Pain with flexion of knees Brudzinski's Sign Meningitis Sign-"B"ends knees after you "B"end their neck In the case of suspected bacterial meningitis consider administering antibiotics when? Prior to lumber puncture In which cases would you hyperventilate a patient with increased ICP. -A single blown pupil -Unilateral paralysis

-GCS drops by 3 or more points -Keep them alive long enough for a CT and neurosurgery Signs of Bacterial Meningitis -Flu like symptoms -Rapidly spreading, purple, non-blanching rash -Most feared is Meningococcal Febrile Seizures 5,5, -Less than 5 minutes -Most kids under 5 years -Occur with temps 102F-105F Another name for Spina Bifida Myelomeningocele Latex allergy may come up on exam Reye's Symdrome Think Aspirin Guillain-Barre -Viral Syndrome with Ascending weakness -Also flu-like symptoms Botulism Think honey Rule of 9's for Burns in Adults 9% Head and each arm, 18% for each of chest+abdomen, back, and each leg Rule of 9's for Burns in Children 9%for each arm, 18% for each of the head, chest/belly, and back 14% for each leg Parkland Burn Formula

(4cc x kg x BSA for amount in 24 hours)/2 for admin in the first 8 hours. Pediatric IV Fluid Maintenance Formula mL/hr = (4ml x first 10kg) + (2ml x second 10kg) + (1ml x every 1kg after) Kehr's Sign For possible Spleen injury -Shoulder pain w/ no shoulder trauma "Kehr's occurs with no trauma to the shoulder." Cullen's Sign If you "C" bruising around the umbilicus then thats Cullen's Sign. Grey-Turner's Sign Turn on your flank. If you see bruising thats Grey-Turner's Sign Intussuseption -Currant jelly stools -Treated with air or barium enema What is a volvulus? Twisting of the bowel on itself -A true surgical emergency A fever in Celcius? 39 C=102 F One of the considerations in the administration of blood products It can cause hypocalcemia due to the preservatives/additives in blood banked products.

A nurse should prepare for a possible septic work up for a child less than what age presenting to the ED with a fever? 3 months or 90 days with a temp greater than 100.4 F or 38 C. Difference between moderate and severe dehydration in a child -Moderate 5-10% weight loss and normal to pale skin color, decreased skin turgor, decreased urine output, and sunken fontanel. -Severe 10-15% weight loss and pale and mottled skin color, tenting skin turgor, decreased to anuric output, and sunken fontanel. -Mild is less than 5% weight loss Intussusception is most common in which group? Male infants aged 3-12 months