Deck 19: Medication Administration

Question 1

Infants and children are especially at risk for adverse reactions to medications, including age-specific adverse reactions and ineffective treatment, for which of the following reasons?

A) Drug companies make less money on pediatric clients than on other ages, so they do less research on drugs for this age group.
B) Ethical constraints related to informed consent severely limit the amount of testing of most drugs used with the pediatric population.
C) Mothers are a powerful lobbying group in Congress, the Department of Health and Human Services, and the Food and Drug Administration.
D) The response to medications varies significantly among children of similar weights and heights.

Answer 1

Ethical constraints related to informed consent severely limit the amount of testing of most drugs used with the pediatric population.

Question 2

Which of the following groups have the most sensitivity to medications and increased risk of adverse medication reactions?

A) clients with psychiatric diagnoses
B) the elderly population
C) infants and children
D) clients with a diagnosis of cancer

Answer 2

infants and children

Question 3

Which of the following factors makes children more sensitive to medications and have an increased risk of adverse medication reactions as compared to adults?

A) Physiological differences exist between children and adults.
B) They have not been exposed to all the drugs that adults have.
C) Their intestinal tract is more sensitive to medications.
D) Caregivers do not tend to measure medicines correctly, thus often overmedicating the child.

Answer 3

Physiological differences exist between children and adults.

Question 4

Which of the following factors influence the absorption of orally administered medications?

A) gastric emptying time and pH
B) time of day administered
C) condition of the kidneys
D) iron content of the blood

Question 5

The gastric emptying time in neonates is how many hours?

A) 1/2 hour
B) 1-2 hours
C) 3-5 hours
D) 6-8 hours

Question 6

The study or concern with movement of medications throughout the body by the processes of absorption, distribution, biotransformation, and excretion is called by which of the following terms?

A) absorption-related field
B) bioavailability
C) pharmacokinetics
D) pharmacological motility

Question 7

The gastric pH of the newborn is:

A) more acidic than the adult
B) more alkaline than the adult
C) about the same pH as throughout the life cycle
D) in a state of constant change from alkaline to acidic

Question 8

The neonate will more readily absorb which of the following types of medications?

A) acidic drugs
B) neutral drugs
C) slightly alkaline
D) very alkaline

Question 9

The amount of medication absorbed in the small intestine of the neonate and the young infant may be unpredictable because:

A) the pH is unpredictable
B) peristalsis is irregular
C) growth of the small intestine is irregular
D) the diet is irregular

Question 10

During the first 6 months of life, the infant's absorption of orally administered medications will be:

A) slower and more erratic
B) about the same as later in life
C) somewhat faster
D) much faster

Question 11

Absorption of medications administered intramuscularly in neonates and infants is best described as:

A) much more rapid than by any other age group
B) more predictable than in adults
C) not influenced by perfusion to the area there administered
D) slow and unreliable

Question 12

Topical medication absorption in infants and children is:

A) greater due to thinner skin and greater surface-to-weight ratio
B) slower due to less vascularity in infants and children
C) about the same as in older children
D) not typically used in infants due to poor tolerance

Question 13

The nurse notices that the infant is wearing a plastic-coated diaper. If a topical medication were to be prescribed and it were to go on the stomach or buttocks, the nurse would teach the caregivers to:

A) put the diaper on as usual
B) apply an ice pack for 5 minutes to the outside of the diaper
C) avoid covering the area of the topical medication with the diaper
D) avoid the use of clothing on top of the diaper

Question 14

The percentage of body water in children under 2 years of age compared with that of older children and adults is:

A) lower in intra- and extracellular fluid
B) higher mostly in extracellular fluid
C) about the same
D) varies significantly between all children

Question 15

The medication nurse notices that a 12-year-old overweight boy with considerable adiposity is receiving a larger dose of a lipid-soluble medication than a 10-year-old, average-weight female peer. The nurse realizes that the major reason for this is that:

A) females require less medication than males
B) older children require more medication than younger peers
C) lipid-soluble medications have an affinity for fat and can be stored in body fat
D) boys have more muscle, which uses more lipid-soluble drug faster

Question 16

To achieve therapeutic blood levels of a lipid-soluble medication, which of the following must happen first to get medication blood levels to rise?

A) The body fat must get saturated.
B) The blood sodium content must be constant.
C) Fat-soluble vitamins must be out of the blood.
D) The body must be hydrated.

Question 17

Distribution is concerned with which of the following activities of medications?

A) movement of a medication from blood to interstitial spaces and then into cells, and the amount of medication in various areas
B) speed at which medications move through the body and out of the body
C) route of administration of the medications and the area of the body there metabolism of the medication mainly takes place
D) which children the medication has been given to in order to facilitate studies of untoward effects and allergic reactions

Question 18

In neonates, the number of protein-binding sites is limited. What is the danger of competitive medication binding?

A) kernicterus or bilirubin encephalopathy
B) Wernicke-Korsakoff syndrome
C) bilirubinuria
D) xanthoendothelioma or pantanencephaly

Question 19

During the first month to 24 months of age, the liver of the neonate is immature. While the liver is immature, medications metabolized by the liver have:

A) a shorter half-life
B) no half-life
C) a longer half-life
D) about the same half-life

Question 20

Biotransformation is also called:

A) metabolism
B) absorption
C) excretion
D) anabolism

Question 21

Most biotransformation of medications occurs in the:

A) liver
B) kidneys
C) stomach
D) small intestine

Question 22

Which of the following conditions in the newborn causes a longer half-life and increased risk of toxicity to medications excreted primarily by the renal system?

A) fetal alcohol syndrome
B) immature kidneys
C) unstable urine filtration
D) small bladder capacity

Question 23

The nurse is preparing to administer oral medication to an infant. Based on knowledge of the developmental stage of infants, the nurse would:

A) give the medication quickly
B) have a parent give the medication
C) play a game with the baby, then give medication
D) let the baby hold the medicine and take it

Question 24

Based upon the toddler's developmental stage, the nurse giving medications to a toddler would most likely say:

A) "You must take this medicine right now."
B) "Would you like me to give you your medicine, or would you like your mommy to give it to you?"
C) "I have to give you this medicine on time because the health care practitioner ordered it."
D) "Be a good child and take your medicine, as it will make your mommy and daddy very happy."

Question 25

The nurse is preparing to give a bitter liquid medication to a child. Which of the following statements by the nurse would be best?

A) "This medicine will probably taste worse than anything you have ever tasted before."
B) "This medicine may taste different from anything you have tasted before."
C) "Sometimes medicines are awful, but they help you more than good-tasting medicines."
D) "This is a magic medicine with a special taste, and it will make you get better."

Question 26

The nurse is preparing to give a medication to an adolescent client. The nurse prepares to check the wristband, but it is missing. The nurse needs to:

A) ask the adolescent to self-identify
B) have a nearby peer identify the client
C) compare the adolescent to a picture ID
D) wait for the parents to identify the adolescent

Question 27

At what age can a child be trusted to self-identify for medication administration?

A) preschool
B) school-aged
C) adolescent
D) none

Question 28

The nurse is trying to give oral medication to an uncooperative child. The nurse's best course of action is to:

A) tell the child that you don't think the child dares to take the medication
B) tell the child that he will get a prize if he takes the medication
C) let the child know he will become sicker if he doesn't take the medicine
D) allow the child to pretend he is giving medicine to a stuffed animal first

Question 29

Nurses today would use which of the following methods to calculate a medication dosage for a child?

A) Clark's rule, using the child's weight in the calculation
B) Young's rule
C) Fried's rule
D) unit of drug per kilogram of body weight or body surface area

Question 30

The nurse is teaching caregivers about the administration of phenobarbital in suspension form. The most important thing the nurse will say to the caregivers to ensure an accurate dose is:

A) "Hold the medicine cup or syringe at eye level to read the amount to be given."
B) "Use a syringe to measure the medicine instead of a medicine cup or teaspoon."
C) "Shake the suspension before measuring and administering this medication."
D) "Always buy the medicine from the same drug company."

Question 31

The nurse is preparing to give a medicine that comes in tablet form to a 10-month-old child. The nurse checks with the pharmacy and it can be crushed. After the tablet is crushed, which of the following liquids or soft foods would be best to mix the tablet with?

A) honey
B) formula
C) whole milk
D) pudding

Question 32

The nurse administering liquid medication to children would teach the caregivers to give the medicine at home using which of the following utensils?

A) an ordinary teaspoon from the family kitchen
B) kitchen measuring spoons
C) a kitchen tablespoon
D) a calibrated medication spoon, dropper, or syringe

Question 33

The pediatric nurse is working with a hospitalized child and his family. The child is preparing to go home and back to school. The child is to take medication three times a day for 1 week. The nurse will advise the family to:

A) give the medication before school, after school, and at bedtime
B) check with the school about policies regarding medicine taken at school and talk with the school nurse about the medication
C) have the child stay home until the medication is completely finished
D) take the medicine as ordered until school starts and then change the medication to a dosage able to be given twice daily

Question 34

You are the nurse working with the caregivers of a child who is being discharged from the pediatric unit of the hospital. You have been teaching the caregivers about safe storage, use, and disposal of medicines. Which of the following statements by one of the caregivers would indicate he or she had understood your teachings?

A) "When we get home, we are going to give our baby her candy (medicine) just like you told us: every day at the same times."
B) "We will give her the antibiotic every day until it is finished and not save any of it."
C) "My brother's boy is coming down with something similar to what our girl had, so I told him he should try some of our medicine."
D) "I think I have this same prescription at home already from my sickness, so I understand I can use it, as long as it's the correct dosage for a child."

Question 35

The nurse is preparing to give an intravenous medication to a child. Which of the following actions by the nurse would most help avoid unnecessary anxiety?

A) Have the medication prepared and ready to administer before entering the child's room.
B) Have the health care practitioner talk to the caregivers about the intravenous medication.
C) Tell the child about the needle stick, the hurt, the medication, and why the child needs it.
D) Give the caregivers the medication insert or the drug guide so they can read about the medicine firsthand.

Question 36

You are the nurse preparing to give an injection to an infant. Which of the following sites is preferred for giving an intramuscular injection?

A) vastus lateralis
B) rectus femoris
C) ventrogluteal
D) deltoid

Question 37

You are the nurse assigned to care for several children of varying ages from newborn to toddler. All of these children are to get intramuscular injections. What is the most important criterion you will assess prior to using the dorsogluteal site for the intramuscular injection?

A) how tall the child is
B) degree of fear that the child has
C) whether the child has been walking for at least 1 full year
D) location of veins and arteries

Question 38

The nurse is selecting an injection site for a child. The nurse knows that muscle sites in children are determined primarily by muscle development and which of the following other criteria?

A) vascularity of area
B) size of the syringe
C) amount of fluid to be given
D) amount of adipose tissue the child has

Question 39

The nurse is preparing to give an injection to a preschooler. The nurse has selected the deltoid muscle. What is the maximum amount of solution that the nurse can give in the deltoid of a preschooler?

A) 0.25 cc
B) 0.05 cc
C) 0.5 cc
D) 1 cc

Question 40

What is the maximum amount of solution a nurse can give an adolescent in the deltoid muscle?

A) 0.5 cc
B) 1 cc
C) 1.5 cc
D) 2 cc

Question 41

When providing pharmacologic interventions for children, it is important for the nurse to consider which of the following differences between adults and children? Select all that apply.

A) anatomical
B) physiological
C) psychological
D) cognitive

Question 42

A nurse is preparing to administer an intramuscular injection to a 9-month-old child. Which of the following injection sites would be appropriate for the nurse to consider using? Select all that apply.

A) vastus lateralis
B) dorsogluteal
C) rectus femoris
D) ventro gluteal