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PNP AC Pediatric Nurse Practitioner - Acute Care 2024 Exam Quiz Study Guide, Exams of Pediatrics

Vanderbilt University (Vandy)Pediatrics

A comprehensive study guide for the pnp ac (pediatric nurse practitioner - acute care) 2024 exam. It covers a wide range of topics relevant to pediatric acute care, including symptoms, diagnoses, and treatments for various pediatric conditions such as postpericardiotomy syndrome, hirschsprung disease, intussusception, pyloric stenosis, appendicitis, bowel obstruction, meckel's diverticulum, volvulus, toxic megacolon, skin conditions like erythema multiforme and stevens-johnson syndrome, as well as information on pneumoperitoneum, staph scalded skin syndrome, botulism, delirium risk factors, heart murmurs, and medication management. The guide also includes details on laboratory values, growth and development milestones, and emergency management of poisonings and overdoses. This extensive resource would be highly valuable for nursing students or practitioners preparing for the pnp ac exam, providing a thorough review of the key concepts and clinical scenarios they may encounter.

Typology: Exams

2024/2025

Available from 09/21/2024

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PNP AC Pediatric Nurse Practitioner -
Acute Care 2024 Exam Quiz Study Guide
100% Pass
Postpericardiotomy Syndrome Symptoms - Answer>> fever,
pericardial effusion, fatigue, chest pain, irritability, poor PO intake.
May lead to cardiac tamponade.
postpericardiotomy syndrome treatment - Answer>> NSAIDS
(5-7 days) or systemic steroids
Hirschsprung disease - Answer>> - aganglionic megacolon
-rectal biopsy
- palpable fecal mass in LLQ, but no stool in rectal vault
-surgery: bowel resection
intussusception - Answer>> -telescoping of bowel
-Intermittent colicky abdominal pain, vomiting, currant jelly stools,
sausage‐shaped mass in RUQ
-Diagnosis: US
-surgical consult: barium air enema
pyloric stenosis - Answer>> - narrowing of the pylorus
- hunger after vomiting
- metabolic alkalosis
- 2 cm olive‐shaped mass in mid‐epigastriarea beneath liver edge;
+ gastric peristaltic waves
- Diagnosis: Ultrasound
- surgical intervention after stabilization of electrolytes
appendicitis - Answer>> - acute inflammation of the appendix,
potential for rupture
- abdominal CT
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PNP AC Pediatric Nurse Practitioner -

Acute Care 2024 Exam Quiz Study Guide

100% Pass

Postpericardiotomy Syndrome Symptoms - Answer>> fever, pericardial effusion, fatigue, chest pain, irritability, poor PO intake. May lead to cardiac tamponade. postpericardiotomy syndrome treatment - Answer>> NSAIDS (5-7 days) or systemic steroids Hirschsprung disease - Answer>> - aganglionic megacolon -rectal biopsy

  • palpable fecal mass in LLQ, but no stool in rectal vault -surgery: bowel resection intussusception - Answer>> -telescoping of bowel -Intermittent colicky abdominal pain, vomiting, currant jelly stools, sausage‐shaped mass in RUQ -Diagnosis: US -surgical consult: barium air enema pyloric stenosis - Answer>> - narrowing of the pylorus
  • hunger after vomiting
  • metabolic alkalosis
  • 2 cm olive‐shaped mass in mid‐epigastriarea beneath liver edge;
  • gastric peristaltic waves
  • Diagnosis: Ultrasound
  • surgical intervention after stabilization of electrolytes appendicitis - Answer>> - acute inflammation of the appendix, potential for rupture
  • abdominal CT
  • Focal right lower quadrant pain, to periumbilical pain, fever, testicular pain, flank and back pain, nausea, vomiting and anorexia.
  • Mcburney point tenderness, rebound tenderness, + psoas sign, obturator sign bowel obstruction - Answer>> -bile colored emesis -crampy pain in the abdomen, usually diffuse often has abdominal distention anorexia, nausea and or vomiting fever
  • Gold standard: CT
  • Surgery: Lad procedure Meckel's diverticulum - Answer>> - Painless rectal bleeding in pediatrics. Slight bulge in small intestine most commonly at distal ileum.
  • Ages 2-
  • Meckel's nuclear medicine scan volvulus - Answer>> - Bilious emesis, abdominal pain
  • CT, CBC, electrolytes
  • Surgery toxic megacolon - Answer>> - fever, abdominal distention, tenderness, Shock leukocytosis, hypokalemia, hypoalbuminemia.
  • Diagnostics: Abdominal x‐ray, CBC, electrolytes
  • Tx: Antibiotics, fluid and electrolyte management
  • Surgery: Colectomy Erythema Multiforme - Answer>> ‐low mortality, target lesions on extremities, face, trunk and legs spared, little mucosal involvement. Lesions are symmetrical, fixed, round and macular.
  • Pre‐existing emotional and/or behavioral problems
  • Cyanotic heart disease
  • Longer mechanical ventilation time Hemangiomas of Infancy - Answer>> may increase in size until 6 months Still's murmur - Answer>> Low frequency (use bell side), heard best at mid-left sternal border when the patient is supine. Midsystolic, grade 2-3-no thrill or click. Vibratory or twangy in sound • Becomes quieter or disappears with upright positioning and when bell pressed firmly down or with valsalva Pulmonary ejection murmur - Answer>> commonly heard in adolescents - harsh midsystolic murmur head at the left second intercostal space VSD murmur - Answer>> Holosystolic, harsh-sounding murmur Loudest at tricuspid area, LLSB ASD murmur - Answer>> Hallmark-widely split fixed S2 grade 2-3 at LUSB. S1 - Answer>> the first heart sound, heard when the atrioventricular (mitral and tricuspid) valves close S2 - Answer>> the second heart sound, closing of the aortic and pulmonic valve Succinylcholine contraindications - Answer>> Succinylcholine --

life-threatening hyperkalemia --> very high risk in Myasthenia Gravis or other neuromuscular diseases

  • Spinal cord injuries, burns, crush injuries --> takes hours/days for upregulation to occur

Refeeding syndrome - Answer>> hypophosphatemia, hypomagnesemia, hypokalemia, hypomagnesemia -> muscular weakness, respiratory weakness Supplement needed for prolonged steroid use - Answer>> calcium Supplements needed for breastfed babies of vegetarian mothers - Answer>> Iron, Vitamin B12, and Zinc Bilirubin levels - Answer>> Should be less than 10 by 24 hours of age VACTERL syndrome - Answer>> Vertebral anomalies Anal atresia Cardiovascular anomalies Tracheoesophageal fistula Esophageal atresia Renal anomalies Limb anomalies Main cause for FTT in VACTERL syndrome - Answer>> Cardiovascular anomalies (VSD) Slipped Capital Femoral Epiphyses - Answer>> - Separation of the growth plate in the proximal femoral head.

  • acute hip pain and inability to walk even with support of crutches ESR (erythrocyte sedimentation rate) - Answer>> - Non-specific test for inflammation or infection
  • can take days to weeks

Serum sodium > 150 Urine sodium < 30 Syndrome of Inappropriate Antidiuretic Hormone (SIADH) - Answer>> UOP: <1 mL/kg/hr Serum sodium < 135 Urine sodium > 30 Cerebral salt wasting - Answer>> UOP: 2-3 mL/kg/h Serum sodium < 135 Urine sodium > 80 Disseminated Intravascular Coagulation (DIC) - Answer>> Thrombocytopenia, prolonged PT, PTT, *+D‐dimer idiopathic thrombocytopenia - Answer>> - May spontaneously go into permanent remission. If condition continues long term

  • may perform a Splenectomy
  • Can be detected with direct Coomb's test. Kawasaki disease - Answer>> - (inflammation of blood vessles, hence the strawberry tongue) causes coronary artery aneurysms.
  • fever for 5 days + 4-5 criteria
  • Changes in peripheral extremities or perineal area (e.g. palms of hands and/or soles of feet)
  • Treat with IVIG and aspirin Tylenol overdose - Answer>> - N‐acetyl cysteine (NAC) is the antidote
  • activated charcoal
  • Obtain level 4 hours after ingestion
  • Monitor LFTs and coags

Alcohol ingestion (methanol, ethanol, ethylene glycol) - Answer>> - Gastric decontamination is not recommended

  • Methanol ‐> treatment with ethanol
  • Ethylene glycol ‐> treatment with ethanol
  • Ethanol: monitor for profound hypoglycemia Calcium Channel Blocker ingestion - Answer>> - Gastric decontamination
  • Calcium administration
  • Volume administration or vasoactives for hypotension
  • Glucagon • Increases cyclic AMP, resulting in increased blood pressure and heart rate
  • IV lipid administration; may absorb lipophilic drugs
  • Obtain ECG for potential heart block Iron ingestion - Answer>> - bowel irrigation
  • polyethylene glycol
  • Deferoxamine IV to Bind absorbed iron Salicylate ingestion - Answer>> - Gastrointestinal decontamination
  • Correction of hypoglycemia
  • Treat seizures; benzodiazepines
  • Emergent hemodialysis; levels approaching 100 mg/dL or severe clinical manifestations Anticholinergic overdose (benadryl) - Answer>> - physostigmine
  • Sodium bicarb for prolonged QRS intervals
  • "Red as a beet" - Cutaneous vasodilation
  • "Dry as a bone" (anhidrosis)
  • "Hot as a hare" (anhydrotic hyperthermia)
  • "Blind as a bat" (nonreactive mydriasis) - Muscarinic input contributes to both pupillary constriction and effective accommodation.