CPN STUDY QUESTIONS WITH
COMPLETE AND ACCURATE
SOLUTIONS.
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. -- Answer ✔✔ 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 -- Answer ✔✔ 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. -- Answer ✔✔ 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 -- Answer ✔✔ 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. -- Answer ✔✔ 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. -- Answer ✔✔ 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. -- Answer ✔✔ 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. -- Answer ✔✔ 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 -- Answer ✔✔ 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. -- Answer ✔✔ 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.
COMPLETE AND ACCURATE
SOLUTIONS.
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. -- Answer ✔✔ 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 -- Answer ✔✔ 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. -- Answer ✔✔ 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 -- Answer ✔✔ 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. -- Answer ✔✔ 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. -- Answer ✔✔ 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. -- Answer ✔✔ 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. -- Answer ✔✔ 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 -- Answer ✔✔ 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. -- Answer ✔✔ 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.
