EXAM 5 chapter 31 PREP U

A nurse is preparing a dose of insulin to give the client. Which action takes priority when preparing and administering this medication?

Double-check the dose with another RN before giving.

The nurse is preparing to administer regular insulin to a child following lunch. Which finding will cause the nurse to question administering the medication?

The client received insulin aspart 2 hours ago.

The parent of a child with a central venous catheter expresses concern about whether the catheter could fall out when the child goes home. What is the nurse's best response?

There is a tiny cuff under the skin that secures the catheter.

A child with a seizure disorder is prescribed valproic acid and is refusing to swallow the capsule. What is the best way for the nurse to administer the medication?

Open the capsule and place in a small amount of applesauce.

The nurse is preparing to give a 4-month-old an oral medication. Which technique demonstrates the nurse's accurate knowledge of the infant's developmental level?

Position the infant upright, offer the infant a bottle of formula, remove the bottle and squirt the medication on the side of the tongue toward the cheek, then offer the infant the bottle again.

The nurse is caring for an 8-year-old girl who requires medication that is only available in an enteric tablet form. The nurse is teaching the mother how to help the girl swallow the medication. Which statement indicates a need for further teaching?

"I can pinch her nose to make it easier to swallow."

The nurse is teaching parents of a 12-year-old child how to administer otic medication. Which statement by the parent indicates a need for further education?

"I will pull the outer ear down and back before administering the medication."

A toddler is prescribed amoxicillin for bilateral otitis media. The parent reports that the toddler refuses to take the oral medication. The nurse knows that more education is needed when the parent makes which statement?

"I will shake the medication well, and draw up the medication to the top of the syringe. My spouse and I will hold our toddler down and force the medication down his throat."

A school-aged child will have an intravenous line inserted. His mother asks if he could have this placed in his left hand so that he can do homework. What is the nurse's best response

"Let's take a look at the left hand first."

The nurse is providing teaching on how to administer nasal drops. Which response by the parents indicates a need for further teaching?

"She needs to remain still for at least 10 minutes after administration."

A father believes his 2-year-old son is frightened by seeing an intramuscular (IM) medication injected into his thigh and requests that the child's "butt" be used. What will be the nurse's response?

"The muscle in his butt is not well enough developed to receive this injection until he has walked for 1 year."

The nurse is providing discharge education to the parents of a 2-year-old who will be taking amoxicillin orally at home. The nurse would include which statement in the teaching?

"Use a dosing cap to measure the dosage."

The nurse is providing teaching for parents on how to administer ointment to their son's eyes. Which response indicates a need for further teaching?

"We should stand or sit behind him as he lies down."

A health care provider has written several prescriptions for a 7-pound newborn with jaundice. Which prescription does the nurse need to question?

IV normal saline 20 ml/hour

The nurse is caring for a child who weighs 42 lb (19 kg). The medication prescribed for the child has a therapeutic dosage range of 33 mg/kg/day to 48 mg/kg/day. The medication prescribed is to be given 3 times per day. Which dosage would the nurse identify as being appropriate to administer to this child in one dose?

250 mg

A nurse is caring for a school-age child who is to receive long-term intravenous antibiotics at home for treatment of a bone infection. When discussing the options for intravenous access, which access route would the nurse include as being the likely choice? .

A peripherally inserted central catheter in an antecubital space

A 3-year-old child with asthma and a respiratory tract infection is prescribed an antibiotic and a bronchodilator. The nurse notes the following during assessment: oral temperature 100.2°F (37.9°C), respirations 52 breaths/minute, heart rate 90 beats/minute, O2 saturation 95% on room air. Which action will the nurse take first?

Administer the bronchodilator via a nebulizer.

The nurse is preparing to give an oral medication to an 11-year-old client. Which of the following is the best approach for the nurse to take?

Allow independence from the parent in the process of medication administration.

Which technique should the nurse use to administer ear drops to a 18-month-old child?

Lift the pinna of the ear down and back.

A child with gastroenteritis has been unable to keep oral medication down. What nursing intervention would be appropriate for this client?

Request an intravenous form of the medication.

A nurse is preparing to administer a prescribed medication to a hospitalized 4-year-old child. Which action would the nurse use to identify the child?

Scan the barcode on the child's armband.

An infant is to have a scalp-vein intravenous infusion begun. What is an advantage of this insertion site?

The scalp veins are easily visualized.

A mother of a newborn brings her child to the well-child clinic the week after birth. The mother asks the nurse if the child will get any "shots" at the next appointment. The best response from the nurse would be:

Yes, your child will get 3 shots next time. They will be the polio vaccine (called IPV), Haemophilus influenza B vaccine (called Hib), and hepatitis B vaccine. They will be given in the thigh."

When preparing an intravenous infusion for an infant, it would be important to:

add a calibrated fluid chamber to the line.

The charge nurse is assisting the new graduate nurse in administering eye drops to a child. The charge nurse would stop the new graduate if which action was observed?

holds the eyelids apart for about 30 seconds

A child is prescribed multiple intravenous medications. Which nursing action demonstrates the best practice to maintain medication safety?

Flush the intravenous line between each medication.

The nurse is caring for a young child in the hospital who is receiving IV therapy. Part of the routine care for this child will involve monitoring the IV site as frequently as every hour. The nurse will assess the IV for which of the following? Select all that apply.

induration at the IV site moisture at the IV site the IV flow rate swelling at the IV site

A 4-year-old child is admitted to the hospital for surgery. Before the nurse administers medicine, the best way to identify the child would be to:

read the child's armband.

What is the most important reason for administering a medication at the correct time?

to maintain the desired blood level of the medication

The nurse enters the room to give a subcutaneous injection of insulin to a 6-year-old female client with diabetes. Which of the following would be most appropriate for the nurse to do?

Ask the client where she would like to have the nurse give the injection.

The pediatric nurse is bringing the prescribed medication for a child but notes that the identification band is missing. The parents are at the bedside holding the child. What is the best method for identifying the child?

Ask the parents to tell you the child's name and date of birth.

The nurse is flushing a saline lock when the child cries out that it hurts. What is the nurse's next action?

Assess for signs of infiltration.

The nurse is identifying a diagnosis appropriate for a preschool-age child who began to cry after learning about needing intravenous fluid therapy. Which diagnosis should the nurse select to address this specific reaction?

fear related to intravenous infusion

Parents question the necessity of moving their preschooler from her room to another place to insert her IV line. The nurse explains:

the importance of avoiding unpleasant experiences in the child's room and bed in order for both to remain safe places.

Samuel, a 1-month-old baby, is severely ill and has been prescribed an injection as part of his drug therapy. What is the preferred injection site?

the vastus lateralis muscle

After administering eye drops to a child, the nurse applies gentle pressure to the inside corner of the eye at the nose for which reason?

to ensure the medication stays in the eye

Intravenous therapy is most commonly administered in the pediatric client for which reason? Select all that apply.

to maintain fluid and electrolyte balance to administer medications, antibiotics, and pain medication to administer blood or blood products to administer nutrients

The nurse is caring for a 12-year-old post-appendectomy client who weighs 86 pounds. The child has a temperature of 38.5ºC (101.3ºF). The nurse prepares to give the client a dose of oral acetaminophen. The order reads "Tylenol 15mg/kg/dose every 4 to 6 hours PO PRN for fever or pain." How many milligrams of Tylenol should the nurse give the client?

587 milligrams

A 5-year-old child is to receive long-term IV antibiotics. The mother is concerned about what type of administration method will be used. Which medication administration route may be the most easily accepted?

A peripherally inserted central catheter (PICC) line in an antecubital space

The nurse is giving discharge instructions to a mother of a 3-month-old infant who will be receiving oral medication at home. Which of the following would the nurse include in the teaching plan?

Give the medication with a syringe and squirt a small amount at a time beside the tongue while holding the infant upright.

The nurse is giving ophthalmic medication to a 7-year-old male client. Which of the following approaches is the best for the nurse to use?

Have the child hold his head back and close his eyes, drop the medication on the inner canthus, then have him open his eyes.

The nurse is preparing to administer an oral dose of antibiotics to a 10-year-old child who weighs 70 lb (31.75 kg). The prescription reads cephalexin 500 mg orally every 6 hours. The pediatric drug book dosing reads 25 to 100 mg/kg/day in 2 to 4 divided doses. What is the safe range per dose if administering every 6 hours for this client?

199 to 794 mg per dose

The nurse is administering a liquid medication to a 3-year-old using an oral syringe. Which action would be most appropriate?

Allow the child time to swallow the medication in between amounts.

The nurse is preparing to give a preschool-age client an oral medication. Which approach would be appropriate for the nurse use to gain the child's cooperation?

Ask the child if they want to take teh medication with juice or water.

The nurse enters the room to give a subcutaneous injection of insulin to a 6-year-old child with diabetes. What is the best method of medication administration?

Ask the child where the child would like to have the injection.

The nurse is caring for a 13-year-old client. The nurse prepares and verifies several medications and brings them and the medication administration record to the client's room. The nurse observes that the client is not wearing an identification band. Which action will the nurse take?

Ask the client to recall his or her name and date of birth.

A 5 year-old client is prescribed an oral antibiotic. What should the nurse do when preparing to give the child this medication?

Assess if the child is able to swallow pills.

The nursing is teaching parents how to administer a prescribed otic medication for a 2-year-old toddler with otitis media. Which statement will the nurse include in the teaching?

Be sure the ear drops are at room temperature before administering."

A child reports pain at the IV insertion site. The nurse suspects infiltration based on which assessment finding?

The area is cool to the touch.

The nurse teaches the mother of a 2-year-old child how to instill antibiotic otic drops. The mother indicates understanding of the skill when she takes which action?

She pulls down and backward on the earlobe before instilling the drops.

Which action should the nurse take to ensure an intravenous infusion will be administered safely to young child?

Use an infusion pump for administration.

The nurse is preparing to administer an IV antibiotic to a 10-year-old child. After calculating the recommended dose with the client's weight, the nurse discovers the ordered dose exceeds the safe dose range in a pediatric drug reference. The medication has been given to the child at this dose for three days. Which of the following should the nurse's next action be?

Verify the dose with the prescribing practitioner.

A mother is told that her child will receive total parenteral nutrition. She asks the nurse what this means. The nurse bases her response on knowledge that total parenteral nutrition is:

administration of fluids, electrolytes, amino acids, lipids, dextrose, and minerals through an IV.

The nurse is working to gain a preschooler's cooperation to swallow an oral medication. What would be the nurse's best approach?

ask if the child would like to take the medicine in a cup or through an oral syringe

A medical/surgical nurse has been floated to the pediatric unit. Which action by the float nurse would require the pediatric nurse to intervene?

asking the child his or her name prior to giving medications

The nurse is preparing to administer an oral dose of metoclopramide to a 5-year-old child who weighs 40 lb (18.2 kg). The prescription reads metoclopramide 0.8 mg/kg/day to be given in 4 oral doses. How many milligrams of metoclopramide would the nurse give per dose?

3.65 mg per dose

When considering the developmental pharmacokinetics of children, what accurately describes the factors that affect medication distribution in children?

Children have a higher proportion of total body water, a lower proportion of body fat, and an immature blood-brain barrier.

The nurse is preparing to administer a PO medication to a 6-year-old in the hospital for an exacerbation of asthma. The nurse notes that the child is due for an oral dose of lansoprazole in 1 hour. What is the most important action for the nurse to take before administering this medication to the client?

Clarify the order, since there is no apparent link between the client's diagnosis and the medication.

A child is receiving intravenous fluids for dehydration. The nurse notes coarse breath sounds and increased pulse and blood pressure. What does the nurse do first?

Discontinue the IV infusion.

While working in the emergency room, the nurse receives a call that a 3-year-old child sustained extensive burns in a house fire. Assuming all of the following actions are included in the standing burn-care protocol, which action should be the nurse perform first?

Obtain a weight.

The nurse is preparing a subcutaneous insulin injection for a preschooler. How and where should the nurse administer the insulin?

at a 45- to 90-degree angle into the elevated tissue of the upper arm

David, age 2, is diagnosed with stomach flu and is suffering from vomiting and diarrhea. What is the most important factor in determining the correct dosage for his infection?

body surface area

Mike, age 8, is going home on medication after surgery. The nurse is preparing to review the discharge instructions with the mother. What basic information and/or instructions should be given to her to continue the drug therapy at home? Select all that apply.schedule and duration of administration description of the intended therapeutic drug effect

schedule and duration of administration description of the intended therapeutic drug effectgeneric and trade names of drugs