Question 1

A 2-year-old child will receive several doses of an intramuscular medication. The nurse caring for this child will use which intervention to help the child cope with this regimen?

Accepted Answer

Allowing the child to give "pretend" shots to a doll with an empty syringe helps the child understand and cope with the procedure by making it a familiar and less threatening activity.

Question 2

The nurse assumes care for an infant who is showing signs of toxicity in response to a drug given several hours prior. The nurse checks the dose and confirms that the dose is consistent with standard dosing guidelines. Which characteristic of the drug could explain this response in an infant?

Accepted Answer

Infants have lower levels of plasma proteins to which drugs can bind, leading to a higher concentration of the free, active form of the drug in the bloodstream. If a drug is highly protein-bound, this can result in increased effects or toxicity in populations with lower protein levels, such as infants.

Question 3

What is NOT a challenge associated with over-the-counter (OTC) medication and the pediatric client?

Accepted Answer

This statement is not true as not all OTC drugs are contraindicated in children under the age of 2. Some medications may have specific age restrictions, but this is not a universal rule for all OTC drugs. A, B, and C are all challenges associated with OTC medication and the pediatric client.

Question 4

The nurse will administer an intravenous (IV) medication to an adolescent patient. When preparing the adolescent for the IV insertion, which is an appropriate action by the nurse?

Accepted Answer

Allowing the patient to verbalize concerns about the procedure is an appropriate action by the nurse as it helps alleviate anxiety and build trust between the nurse and the patient.

Question 5

The nurse reviews information about a drug and learns that it is best absorbed in an acidic environment. When giving this drug to a 1-year-old patient, the nurse will expect:

Accepted Answer

The stomach of a 1-year-old is more acidic than that of an adult, so the drug will be absorbed more efficiently in the child's stomach.

Question 6

The nurse is caring for a 5-year-old child. The child is taking a drug that has a known therapeutic range in adults, and the nurse checks that the ordered dose is correct and notes that the child's serum drug level is within normal limits. The child complains of a headache, which is a common sign of toxicity for this drug. Which action will the nurse take?

Accepted Answer

The nurse should hold the next dose of the drug and contact the healthcare provider. Although the child's serum drug level is within normal limits, the headache may be a sign of toxicity in the child. The nurse should not administer the medication or attribute the headache to nondrug causes without further assessment and guidance from the healthcare provider. Requesting an order for an analgesic is not appropriate until the cause of the headache is determined.

Question 7

The nurse is preparing to administer an intramuscular medication to a 4-year-old child who starts to cry and screams, "I don't want a shot!" What is the nurse's next action?

Accepted Answer

Engaging the child in conversation about non-threatening topics can help distract them from the pain and anxiety of the injection, making the experience less traumatic. This can establish trust with the child, which is important for future interactions with healthcare providers. Option A may make the child feel like their feelings are not validated, while option C may traumatize the child further. Option D may not be effective with a young child who may not understand the concept of time.

Question 8

The nurse is preparing to give a 7-year-old child a bitter-tasting oral medication. The child asks the nurse if the medicine tastes bad. To help the child take this medication, which action will the nurse take?

Accepted Answer

It is important to be honest with the child and let them know the medication will taste bad. However, offering a choice of beverages to drink afterward may help make the taste more tolerable for the child. Delaying the medication or restraining the child should be avoided if possible.

Question 9

The parent is concerned about giving a child a medication that carries an indication for use in children because of the lack of knowledge about the effects of drugs on children. The nurse discusses legislation passed in 2012 about pediatric pharmacology. Which is true about this law?

Accepted Answer

The Best Pharmaceuticals for Children Act (BPCA) and the Pediatric Research Equity Act (PREA), both passed in 2012, require drug manufacturers to study pediatric medication use and provide incentives for conducting pediatric clinical trials. However, they do not forbid providers from prescribing medications unless they have FDA approval for use in children, mandate consistent dosing guidelines, or provide federal grants for pediatric pharmaceutical research.

Question 10

The nurse is teaching a 15-year-old female patient and her parents about an antibiotic the adolescent will begin taking. The drug is known to decrease the effectiveness of oral contraceptive pills (OCPs). The nurse will:

Accepted Answer

The nurse should inform the adolescent privately that the medication may decrease the effectiveness of OCPs to respect her privacy and confidentiality. It is also important to provide the patient with alternative methods of birth control and encourage her to discuss with her physician which method is appropriate for her. The nurse should not disclose the patient's medical information to her parents without the patient's consent.

Question 11

The nurse is preparing to administer a medication to a 6-month-old infant. The nurse will monitor closely for signs of drug toxicity based on the knowledge that, compared to adults, infants have:

Accepted Answer

Infants have immature hepatic and renal function, which means that they are less able to metabolize and excrete drugs. This can lead to drug toxicity, as drugs can accumulate in the infant's system. Therefore, it is important to closely monitor for signs of toxicity when administering medications to infants.

Question 12

The nurse is preparing to administer an oral liquid medication to an 11-month-old child who is fussy and uncooperative. Which action will the nurse take to facilitate giving this medication?

Accepted Answer

Using a syringe and allowing the parent to give the medication is a noninvasive method of administering oral medication to an uncooperative infant. Adding honey to improve the taste or putting the medication in the infant's formula may alter the medication's effectiveness and is not recommended. Requesting an injectable form of the medication may be unnecessary and cause discomfort to the infant.

Question 13

A 14-year-old female who has type 1 diabetes mellitus that has been well controlled for several years is admitted to the hospital for treatment of severe hyperglycemia. The patient's lab values indicate poor glycemic control for the past 3 months. The nurse caring for this patient will suspect which cause for the change in diabetes control?

Accepted Answer

Hormonal fluctuations during adolescence can affect blood glucose control in individuals with diabetes. This is due to changes in hormonal levels during puberty, which can lead to insulin resistance and changes in insulin requirements.

Question 14

A preschool-age child has moderate dehydration and needs a rapid bolus of fluids. To provide atraumatic care and administer fluids most effectively, what action will the nurse take?

Accepted Answer

Using a lidocaine preparation prior to insertion of the IV needle can help to reduce the pain and discomfort the child may experience during the procedure. This can provide atraumatic care and help the child feel more comfortable and relaxed during administration of the fluids. Options A, B, and C do not provide atraumatic care and can actually cause more trauma and distress for the child. Waiting until the child is sleeping is not a safe or appropriate option, asking parents to restrain the child can be traumatic and can undermine the parent-child relationship, and nasogastric fluids may not be appropriate for all types of dehydration and can also be traumatic for some children.

Question 15

Which of the following actions is NOT consistent with the concept of "atraumatic care"?:

Accepted Answer

Atraumatic care emphasizes on minimizing pain and trauma to the patient during care. Recognizing that interventions to decrease pain are not feasible goes against this concept. The other options are consistent with atraumatic care.

Question 16

The parent of a school-age child tells the nurse that the child often misses the midday dose of a medication because the child forgets to take it to school. What will the nurse suggest?

Accepted Answer

Asking the pharmacist to divide the prescription into two labeled packages can help ensure that one package can be kept at home and the other can be left at school, reducing the likelihood of forgetting the medication.

Question 17

The provider has ordered that vitamin D drops be given to a newborn. Based on the knowledge of drug distribution in infants, the nurse understands that the infant may need:

Accepted Answer

Infants have a higher percentage of body fat which can cause the drug to be distributed more extensively, resulting in a lower concentration of the drug in the blood. Therefore, infants may need a lower dose of vitamin D drops compared to older children or adults.

Quiz 6: Pediatric Considerations