CPN Study Questions 1-100 with Answers 2023/2024 New Guide.

CPN Study Questions 1-100 with Answers 2023/2024 New Guide. A 6-week-old male infant is brought into the ED by his mother. He has a weeklong history of progressively worsening emesis that is projectile in nature. What is his most likely diagnosis? A. Intussusception. B. Appendicitis. C. Pyloric stenosis. D. Pancreatitis. - C: Projectile vomiting in a 6 week-old male is the classic presentation for pyloric stenosis, obstruction of the pyloric sphincter between the gastric pylorus and the small intestine, caused by hypertrophy and hyperplasia of the circular muscle of the pylorus, which obstructs the sphincter. An 8-year-old male has contracted chicken pox (varicella virus). With which of the following family members can the child have contact? A. 20-year-old aunt on chemotherapy. B. 35-year-old uncle with HIV. C. 95-year-old grandfather on long-term steroid therapy. D. 2-year-old brother who has never had varicella but has had the vaccine - D: The 2-year-old brother, who has had the vaccine, is likely immune to varicella, so contact is safe. All of the other relatives have some form of immunosuppression from infection (HIV) or medications (chemotherapy and steroids) and should avoid contact with the patient A 5-year-old girl has a fever, headache, and complaints of a stiff neck. The physician suspects bacterial meningitis. What is the best test culture site to detect the bacteria? A. Lumbar puncture. B. Clean catch urine. C. Blood culture. D. Nasal swab. - A: Lumbar puncture is the method of choice for detecting the bacteria causing bacterial meningitis and sending a sample for culture, as meningitis infects the meninges and bacteria is present in the cerebrospinal fluid. A 2-year-old child has severe dental caries in the upper and lower front teeth, posterior aspects. What is the most likely cause for this type of caries? A. Lack of fluoridation in the water. B. Sleeping with water in a nighttime bottle. C. Low carbohydrate diet. D. Sleeping with sugared liquid in nighttime bottle - D: Caries in the posterior front teeth is a sign of sleeping with sugared drinks in the nighttime bottle (such as juice) because fluid pools in the mouth when the child falls to sleep. ***Which of the following patients will likely need surgical correction of his/her fracture?*** A. 10-year-old with humeral head fracture. B. 5-year-old with tuft fracture of the distal phalanx. C. 4-year-old with tuft fracture of the toe. D. 16-year-old with radial head fracture. - A: Humeral head fractures usually need open reduction and internal fixation to maintain proper future functioning. Distal phalanx and toe fractures are treated with splints and fracture of the radial head with a sling. An infant with a chronic respiratory condition should be offered all of the following vaccines EXCEPT: A. Hepatitis A. B. Hepatitis B. C. Hepatitis C. D. Influenza. - C: A vaccine for Hepatitis C does not currently exist. Hepatitis A, hepatitis B and influenza vaccines are all recommended for the infant A 14-year-old boy with leukemia is receiving an IV infusion of packed red blood cells. The client reports that he is feeling anxious and short of breath even though his respiratory rate is 24. What should the nurse do in this situation? A. Give a dose of ibuprofen (Motrin). B. Give a dose of acetaminophen (Tylenol). C. Give a dose of diphenhydramine (Benadryl). D. Stop infusion and notify physician. - D: Anxiety and the sensation of breathlessness are signs of possible anaphylactic shock, a reaction to the packed red blood cells, so the nurse should stop the infusion immediately and notify the physician. As part of counseling for a 7-year-old child with mild persistent asthma, the nurse tells the client's family that the most reliable indicator of worsening asthma is: A. Coughing. B. Fever. C. Decreased peak flow. D. Fatigue. - C: A decreased peak flow is the most reliable indicator that asthma may be worsening. It is therefore vital that the client's family know what the baseline is so that any deviation can be quickly addressed. Coughing and fever may trigger asthma, so peak flows should be monitored. Fatigue may result from poor oxygenation but alone it is not a reliable indicator of worsening asthma. ***A patient is experiencing dizziness, shortness of breath, lightheadedness, and nausea caused by encephalitis. Which of the following descriptions most accurately describes the patient's condition?*** A. metabolic acidosis B. respiratory alkalosis C. metabolic alkalosis D. respiratory acidosis - B: Respiratory alkalosis results from hyperventilation, during which extra CO2 is excreted, causing a decrease in carbonic acid (H2CO3) concentration in the plasma. Symptoms include tachycardia, arrhythmias, lightheadedness, nausea, and vomiting. 10-year-old male with sickle cell disease comes into the ED complaining of pain in his legs due to a vaso-occlusive crisis. In addition to IV fluids, what is the other initial treatment for this client? A. Elevate legs. B. Ace wrap to legs. C. Nitroglycerine paste. D. Pain medication. - D: In addition to IV fluids, the other primary initial treatment for sickle cell crisis resulting in vascular occlusion is pain medication because pain is often severe. Other treatments include oxygen, hydroxyurea (anti-sickling medication), blood transfusions if anemia is pronounced, and antibiotics if the crisis was triggered by an infection. 14-year-old male with renal failure is given an arteriovenous fistula (shunt) for future dialysis. How does the nurse assess the shunt post-operatively for patency? A. Assess for bruit and thrill. B. Monitor blood pressure on that arm. C. Ease of venipuncture at shunt site. D. Rate of flow during dialysis. - A: The patency of an AV shunt is assured by assessing for bruit and thrill. Continuous wave Doppler ultrasound can also assess patency. Venipuncture and blood pressure measurements should never be done on the arm with an AV shunt.