Deck 9: Pharmacotherapy of the Pediatric Patient

Question 1

The nurse is calculating the medication dose for a 4-year-old child by plotting the child's height and weight on a nomogram,then drawing a line between the two points.The point at which the line intersects the surface area line is the child's BSA.The dose is calculated using the BSA.What does this calculation represent?

A)Body weight method
B)Age-weight method
C)Pharmacokinetic method
D)Body surface area method

Answer 1

Body surface area method

Question 2

The pediatric nurse is aware that a child might experience the same adverse effects to a medication as an adult.For what class of medication could this reaction occur,and what reaction would the nurse anticipate?

A)Antianxiety; diarrhea
B)Antidepressants; diarrhea
C)Antipsychotics; CNS depression
D)Antibiotics; CNS depression

Answer 2

Antipsychotics; CNS depression

Question 3

An infant recently prescribed the anti-infective gentamicin is brought to the emergency department with oliguria,hematuria,cloudy urine,and fever.Which diagnosis would the nurse anticipate for this infant based on the assessment findings?

A)Respiratory distress syndrome
B)Gasping syndrome
C)Nephrotoxicity
D)Neurotoxicity

Answer 3

Nephrotoxicity

Question 4

The nurse in a pediatric clinic is preparing to give a toddler and a preschooler intramuscular (IM)antibiotics.The nurse chooses the injection sites for each child based on which considerations? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)The vastus lateralis muscle is the preferred site for IM injections in toddlers.
B)After the child has been walking for a year,the ventrogluteal site is used for IM injections.
C)Use of the dorsogluteal site should be avoided.
D)The vastus lateralis muscle is the preferred site for IM injections in preschoolers.
E)The dorsogluteal site is the preferred site for IM injections.

Question 5

The nurse is teaching the mother of an infant how to properly administer medication.Which teaching points are important for this age group? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Cuddle the infant while administering medications.
B)Deposit oral medication into the cheek area of the infant's mouth.
C)Hold the buttocks closed for 5 to 10 minutes after administering a rectal suppository.
D)Administer oral medications as quickly as possible before the infant can resist.
E)Use a household teaspoon for oral medications.

Question 6

The nurse is providing discharge instructions to an adolescent and the family.To increase the likelihood of adherence,which questions would the nurse ask? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"This particular prescription has to be taken three times a day.Will that be difficult for you to do?"
B)"Are you worried about the fact that you will need to take this medication while you are at school?"
C)"This medication may give you dry mouth.Will you be allowed to suck on hard candy in school to help with the dry mouth?"
D)"Because you will be on the medication for such a long time,can you make an appointment for one year?"
E)"Do you think your parents should watch you take the medication every day to make sure you take it as prescribed?"

Question 7

The nurse is teaching a toddler's mother strategies for administering prescribed oral antibiotics.Which strategies will be discussed? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Mix unpleasant-tasting medications in appetizing food such as jam or syrup.
B)Ask the pharmacist to put the medication into sweet syrup,if possible.
C)Physically comfort or praise the toddler following medication administration.
D)Put any liquid medication into the toddler's milk bottle to ensure it will be completely consumed.
E)Give the child a detailed explanation regarding the need for the medication.

Question 8

The nurse is following the guidelines established by American Academy of Pediatrics (2007)when administering mediations to pediatric patients.Which nursing action is included in the guidelines?

A)Confirm the client's identity before administering the first dose of the shift.
B)Remember that all medication ordering and dispensing systems are the same in all facilities.
C)Check medication calculations with another professional.
D)Verify drug orders after medication administration.

Question 9

The nurse is providing discharge instruction to a child and the family.To promote medication adherence,the nurse facilitates which conditions?

A)Minimal nursing guidance
B)Minimal adverse effects from the medications
C)A complex,expensive medication regimen
D)Low expectations for a successful outcome

Question 10

It is important that the nurse understand that the safety and effectiveness of a medication regimen depend on which factors? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Proper procurement
B)Proper administration of the drug
C)Protection of the health care provider from liability
D)Proper storage of the medication
E)Protection of the nurse from liability

Question 11

In 1997,the Food and Drug Administration Modernization Act was passed.What was the rationale for this legislation?

A)To prove that all adult medications are safe for children
B)To improve testing and labeling of pediatric drugs
C)To encourage the production of more pediatric drugs
D)To generate higher profits for pharmaceutical companies marketing pediatric drugs

Question 12

The nurse has been assigned to the pediatric floor.Which nursing interventions indicate this nurse understands pharmacokinetic variables in children? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Monitoring diagnostic lab work for therapeutic levels of phenobarbital in a premature infant
B)Monitoring blood sugars for hyperglycemia in an infant with eczema requiring frequent applications of topical corticosteroid cream
C)Monitoring a 5-month-old infant taking propranolol (Inderal)for a heart defect for symptoms of toxicity
D)Monitoring a 6-year-old taking salicylates for pain for hepatic toxicity
E)Monitoring a 2-week-old infant taking gentamicin for severe infection for decreased blood urea nitrogen (BUN)

Question 13

The nurse plans to administer medication to a preschool-age child.Which approach indicates the nurse has an understanding of growth and development?

A)The child will be more cooperative if the parent is not in the room.
B)A brief explanation,followed by quick administration of the medication,is best.
C)There should be no need to restrain a child this age.
D)The child will do better with verbal instruction than play instruction.

Question 14

A clinic nurse is discussing an acne medication regimen with an adolescent client.Which statements by the adolescent represent common problems with adherence? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"I was taking the medicine for a while,but it didn't seem to be working."
B)"I took it the first month but my mom got busy and kept forgetting to get my refill."
C)"I felt nauseous whenever I took the medicine."
D)"The nurse explained everything to me so that I could understand."
E)"I only have to take the medication once a day."

Question 15

The nurse plans to teach a safety class to parents of toddlers about household exposure to medications.Which information would be included in an effective teaching plan? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Poisoning is extremely common during the toddler years.
B)Vitamins are not medications,and therefore are not toxic.
C)All medications should be locked up or stored out of reach of the toddler.
D)Prescription drugs for children come in flavored elixirs and can be mistaken for candy.
E)Toddlers put everything in their mouths,including topical medications.

Question 16

Which factor would lead to the dilution of the drug furosemide (Lasix)in the newborn?

A)The higher proportion of fat to water dilutes water-soluble drugs.
B)There is no dilution of the drug in pediatric clients.
C)The lower proportion of water to fat dilutes water-soluble drugs.
D)The higher proportion of water to fat dilutes water-soluble drugs.

Question 17

Which classification(s)of drugs is/are more commonly prescribed for children due to their high incidence of infectious diseases? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Respiratory drugs
B)Systemic antibiotics
C)Dermatologic drugs
D)Cardiovascular drugs
E)Musculoskeletal system drugs

Question 18

The nurse plans to administer medication to a 6-month-old infant based on which understanding?

A)The gluteal site is the preferred site for intramuscular (IM)administration of medication.
B)The dosage should be based on milligrams per kilogram weight per day.
C)Oral medications are the preferred route due to fewer side effects.
D)Medications should be calculated based on the infant's age.

Question 19

The nurse would determine that which pediatric client is experiencing an adverse effect from a medication? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)A child taking ibuprofen (Advil)for a sports injury who has frequent upset stomach
B)A child taking an ototoxic antibiotic who does not respond when spoken to
C)A child taking amoxicillin for an ear infection who has diarrhea
D)A pregnant teen taking ferrous sulfate (Feosol)who experiences headaches
E)A teenager taking minocycline (Minocin)for acne who has a rash

Question 20

The emergency department nurse is preparing for the arrival of a 3-year-old with suspected drug overdose.Which medications are most likely to be the cause of the overdose? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Analgesics
B)Cough syrup
C)Topical ointments
D)Vitamins
E)Oral antibiotics

Question 21

Which factors does the nurse recognize potentially influence oral absorption of drugs in the pediatric client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Increased gastric pH
B)Delayed gastric emptying
C)Immature hepatic cytochrome P450 enzyme system
D)Immaturity of the kidneys
E)High water-to-fat proportion