CPN Study Questions with Accurate Answers

A 6-month-old male is diagnosed with an intussusception of the colon. What diagnostic test is often therapeutic in reducing the invagination of one part of the intestine into another? A. Barium enema. B. Ultrasound. C. CT. D. MRI Correct AnswerA: The pressure of a barium enema against the intussusception is often enough to reduce it, returning the intestine to its normal position, although the intussusception can recur and may require surgical repair New red blood cells are made by the bone marrow and transport oxygen and carbon dioxide. What is the life span of a red blood cell? A. 30 days. B. 60 days. C. 90 days. D. 120 days Correct AnswerD: The typical life span of a red blood cell is 120 days. Red blood cells contain hemoglobin, which carries oxygen to cells and carbon dioxide back to the lungs. Typical symptoms of anemia in a pediatric patient would include all of the following EXCEPT: A. Fatigue. B. Easy bruising tendency. C. Pink oral mucosa. D. Conjunctival pallor. Correct AnswerC: Pale, not pink oral mucosa would be present with anemia. Fatigue, bruising, and conjunctival pallor all indicate anemia. The red blood cell index that measures the size of the red blood cells and is useful in classifying anemia is: A. Hemoglobin. B. Hematocrit. C. Mean corpuscular volume. D. Platelets. Correct AnswerC: The mean corpuscular volume (MCV) measures the average size of the red blood cells. This helps to classify anemia as microcytic, normocytic, or macrocytic. A 2-year-old female is evaluated for iron deficiency anemia. Which of the following would NOT likely be found? A. Larger RBC size. B. Decreased hemoglobin level. C. Decreased RBC mass. D. Decreased oxygen carrying capacity of the blood. Correct AnswerA: A smaller RBC size (decreased MCV) rather than larger would be found in iron-deficiency anemia. Other indicators include decreased hemoglobin, decreased RBC mass, and decreased oxygen carrying capacity, as iron is necessary for the formation of hemoglobin, which carries oxygen. An African-American newborn is evaluated for a possible hemoglobinopathy. What is the most common hemoglobinopathy in this population, occurring in 1 in 375 live births? A. Thalassemia. B. Sickle cell disease. C. Babesiosis. D. Malaria. Correct AnswerB: Sickle cell disease is a genetic hemolytic disease and is the most common hemoglobinopathy in African-Americans. It causes sickling of the red blood cells because of abnormal strands in the hemoglobin. Idiopathic thrombocytopenic purpura (ITP) is an acquired disease causing hemorrhage. What circulating blood component is reduced with ITP? A. Platelets. B. Red blood cells. C. White blood cells. D. Iron. Correct AnswerA: ITP represents an acquired deficiency of platelets (thrombocytes) leading to increased risk of bleeding. ITP is believed caused by an autoimmune process. Normal minimal platelet count is 140,000 for newborns and 150, 000 for older children. If the platelet count drops below 50,000, the child is at high risk for hemorrhage Discharge instructions are being given to the parents of a child with iron deficiency anemia. Which of the following food choices would NOT be a good source of iron in the diet? A. Lean beef. B. Spinach. C. Chicken. D. Potatoes. Correct AnswerD: Potatoes do not provide a good source of iron in the diet. Green leafy vegetables, such as spinach, and all meats, including lean beef and chicken, are good iron sources. At which age would a blood pressure reading of 80/40 be considered normal? A. 16 years. B. 7 years. C. 12 years. D. 3 months Correct AnswerD: A blood pressure reading of 80/40 is considered in the normal range for infants of 3 months old. Blood pressure in older children varies according to height and weight. In analysis of an ECG, what component of the heart's function does the P-wave represent? A. Ventricular repolarization. B. Atrial depolarization. C. Ventricular depolarization. D. Resting period of the heart. Correct AnswerB: The P-wave represents atrial depolarization and is used to mark the starting point of a new PQRS wave, which represents right and left ventricular depolarization. The T-wave represents ventricular repolarization (a resting period). . Diuretic medications are used to manage edema in pediatric patients with heart failure. Which of the following medications is NOT a diuretic medication? A. Furosemide (Lasix). B. Enalapril (Vasotec). C. Spironolactone (Aldactone). D. Bumetanide (Bumex). Correct AnswerB: Enalapril is an angiotensin-converting enzyme inhibitor and is not a diuretic. Furosemide, spironolactone, and bumetanide are commonly-used diuretics A patent ductus arteriosus (PDA) results when the fetal ductus arteriosus fails to close and blood flows from the aorta back into the pulmonary circulation. In neonates this can often be closed without surgery using certain medications. What class of medications is often used to close this congenital heart defect non-surgically? A. Antibiotics. B. Adrenergic steroids. C. Prostaglandin synthetase inhibitors. D. Beta blockers. Correct AnswerC: Prostaglandin synthetase inhibitors, such as indomethacin, can be used in neonates to close PDA's non-surgically. They are 80% effective if given within 10 days of birth. Some children require surgical repair. The most common congenital heart defect is: A. Patent foramen ovale. B. Atrial septal defect. C. Ventricular septal defect (VSD). D. Patent ductus arteriosus (PDA). Correct AnswerC: Ventricular septal defect, the most common congenital heart defect, is an abnormal opening in the septum between the right and left ventricles. Depending on the size of the defect, some may close spontaneously and others may require surgical closure using a graft. Which of the following congenital heart defects would lead to right ventricular hypertrophy and right heart failure if not treated? A. Aortic stenosis. B. Pulmonic stenosis. C. Coarctation of the aorta. D. Tricuspid atresia. Correct AnswerB: Pulmonic stenosis can lead to right heart failure if not treated. Pulmonic stenosis is a stricture of the pulmonary blood vessel that controls the flow of blood from the right ventricle to the lungs, resulting in right ventricular hypertrophy, as the pressure increases in the right ventricle, and decreased pulmonary blood flow. Aortic stenosis, coarctation of the aorta, and tricuspid atresia would lead to left heart failure. The most common cause for heart failure in children is congenital heart defects. Numerous medications can be used to improve functioning in addition to surgical procedures. Which of the following medications used in heart failure has a narrow therapeutic window requiring blood draws to monitor the blood level? A. Digoxin (Lanoxin). B. Propranolol (Inderal). C. Hydrochlorothiazide (HCTZ). D. Aspirin. Correct AnswerA: Digoxin has a narrow therapeutic window and requires monitoring for the blood level to prevent toxicity in children. Rheumatic fever is a systemic inflammatory autoimmune disease that occurs after an untreated infection with bacteria. What is the causative bacterium in rheumatic fever? A. Haemophilus influenza. B. Bacillus anthracis. C. Mycobacterium avis. D. Group A beta-hemolytic Streptococcus. Correct AnswerD: Rheumatic fever is an autoimmune disease that results from a response after an untreated infection with group A betA:hemolytic Streptococcus. RF can result in damage to the heart valves and to the joints. Rheumatic fever is assessed using the Jones criteria that divide the signs and symptoms of the disease into major and minor criteria. Which of the following characteristics is considered a minor and NOT a major criterion? A. Polyarthritis. B. Fever. C. Carditis. D. Chorea. Correct AnswerB: Fever, along with arthralgias and lab findings, such as elevated erythrocyte sedimentation rate and C:reactive protein, are considered minor Jones criteria. Polyarthritis, carditis, and chorea are major criteria. Rheumatic fever is diagnosed when 2 major criteria or one major and 2 minor criteria are met. Following a diagnosis of a urinary tract infection, an adolescent is counseled to maintain acidic urine to help speed healing of the infection. Which of the following liquids would NOT be a good choice? A. Cranberry juice. B. Prune juice. C. Carbonated sodas. D. Apple juice. Correct AnswerC: Carbonated sodas actually alkalinize the urine and are a poor choice in the treatment of a bladder infection. Cranberry juice apple juice, and prune juice are good choices to acidify urine. Citrus juices, such as lemonade and orange juice, alkalinize the urine. The most common genetic bone disease is osteogenesis imperfecta (OI). This is an inherited disorder that results from an abnormality in which of the following aspects of bone formation? A. Collagen synthesis. B. Calcium deposition. C. Phosphorus deposition. D. Iron deposition. Correct AnswerA: OI is a genetic disorder that results from the reduction in the synthesis of collagen, causing connective tissue and bone defects, such as "brittle bones," that lead to multiple fractures. A 14-year-old sustained a blow to the medial forearm. He has a fracture that is incomplete and does not extend all the way through the ulna. What is this type of fracture? A. Buckle fracture. B. Greenstick fracture. C. Bend fracture. D. Open fracture. Correct AnswerB: An incomplete fracture that does not fully extend through a bone is a greenstick fracture. A buckle fracture is common in children and involves an incomplete fracture with buckling of bone on one side only. Bend fractures involve bending of the soft bone without breaking. Open fractures break through the skin Duchenne's muscular dystrophy is the most common form of muscular dystrophy and causes progressive degeneration and weakness of the skeletal muscles. At what age is Duchenne's muscular dystrophy usually first evident? A. 6 months to 1 year. B. 12 to 15 years. C. 9 to 12 years. D. 3 to 5 years. Correct AnswerD: Muscular dystrophy is usually first evident at age 3 to 5 and observed with delays in motor development and weakness in the pelvic girdle. Children may have trouble standing and may fall easily. Calf muscles may begin to enlarge Which type of seizure is characterized by a sudden loss of muscle tone and then a postictal period of confusion? A. Tonic seizures. B. Clonic seizures. C. Atonic seizures. D. Absence seizures. Correct AnswerC: Atonic seizures are characterized by a loss of muscle tone and often a fall and then a period of confusion from a postictal state. Tonic seizures include muscle twitching and changes in consciousness. Clonic seizures are generalized seizures often accompanied by loss of consciousness. Absence seizures cause a lack of consciousness What should women of childbearing age consume in the preconceptual period to decrease their risk of neural tube defects in their children? A. Iron. B. Vitamin B12. C. Magnesium. D. Folic acid. Correct AnswerD: Additional folic acid (0.4 mg per day) is recommended to decrease the risk of neural tube defects during pregnancy. All women of childbearing age should have counseling regarding the importance of folic acid.