PEDS CH 13
The nurse is administering a crushed tablet to an 18-month-old infant. What is a recommended guideline for this intervention? A) Mix the crushed tablet with a small amount of applesauce. B) Place the crushed tablet in the infant's formula. C) Mix the crushed tablet with the infant's cereal. D) Crushed tablets should only be mixed with water.
A
The nurse will be administering a medication to a child that is primarily excreted by the kidney. The nurse is aware that this action is especially dangerous until the child reaches what age? Record your answer in years.
2
The nurse is caring for a 6-year-old child who has multisystem trauma due to a motor vehicle accident. The child is receiving total parenteral nutrition (TPN). What is a recommended nursing intervention for children on TPN? A) Initially, check blood glucose levels frequently, such as every 4 to 6 hours, to evaluate for hyperglycemia. B) Be vigilant in monitoring the infusion rate, change the rate as necessary, and report any changes to the physician or nurse practitioner. C) If for any reason the TPN infusion is interrupted or stops, begin an infusion of a 10% saline at the same infusion rate as the TPN. D) Administer TPN continuously over an 8-hour period, or after initiation it may be given on a cyclic basis, such as over a 12-hour period during the night
A
The nurse is preparing to administer insulin to a diabetic child. Which would be the recommended route for this administration? A) Subcutaneous B) Intradermal C) Intramuscular D) Oral
A
The nurse is teaching the student nurse the factors that affect the pharmacodynamics of the drugs they are administering. What is a factor affecting this property of drugs? A) Immature body systems B) Weight C) Body surface D) Body composition
A
The nurse is preparing to administer oral ampicillin to a child who weighs 40 kg. The safe dose for children is 50 to 100 mg/kg/day divided in doses administered every 6 hours. What would be the low single safe dose and high single safe dose per day for this child? A) 50 to 100 mg per dose B) 100 to 500 mg per dose C) 500 to 1,000 mg per dose D) 1,000 to 5,000 mg per dose
C
The nurse is preparing to administer medication to a child with a gastrostomy tube in place. What is a recommended guideline for this procedure? Select all that apply. A) Verify proper tube placement prior to instilling medication. B) Mix liquid medications with a small amount of water and add directly into the tube. C) Mix powdered medications well with cold water first. D) Crush tablets and mix with warm water to prevent tube occlusion. E) Open up capsules and mix the contents with warm water. F) Flush the tube with water after administering medications.
A,D,E,F
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? A) "I can encourage her to place it on the back of her tongue." B) "I can pinch her nose to make it easier to swallow." C) "We cannot crush this type of pill as it will affect the delivery of the medication." D) "We can place the tablet in a spoonful of applesauce.
B
The nurse is caring for children who are receiving IV therapy in the hospital setting. For which children would a central venous device be indicated? A) A child who is receiving an IV push B) A child who is receiving chemotherapy for leukemia C) A child who is receiving IV fluids for dehydration D) A child who is receiving a one-time dose of a medicatio
B
The nurse is preparing to administer a medication to a 5-year-old who weighs 35 pounds. The prescribed single dose is 1 to 2 mg/kg/day. Which is the appropriate dose range for this child? A) 8 to 16 mg B) 16 to 32 mg C) 35 to 70 mg D) 70 to 140 mg
B
The nurse is preparing to administer an intramuscular injection to an 8-month-old infant. Which site would the nurse select? A) Rectus femoris B) Vastus lateralis C) Dorsogluteal muscle D) Deltoid
B
The nurse is providing teaching for the mother of an infant who receives all of his nutrition through a tube. The nurse is reviewing interventions to promote growth and development. Which response from the mother indicates a need for further teaching? A) "I will give him a pacifier during feeding time." B) "We need to keep feeding time very quiet." C) "We need to make sure he doesn't lose the desire to eat by mouth." D) "Sucking produces saliva, which aids in digestion."
B
The nurse is monitoring the output for a 10-year-old child. The medical record indicates the child weighs 78 pounds. How much urine can be anticipated for this child for a 12-hour period? 1. 78 pounds = 35kg 2. 1 mL X 35kg = 35 mL/hr and 2 mL X 35 = 70 mL/hr 3. 35 mL X 12 hours = 420 mL 4. 70 mL X 12 hours = 840 mL A) 300 to 1200 mL B) 360 to 900 mL C) 420 to 840 mL D) 600 to 1200 mL
C
When describing the differences affecting the pharmacokinetics of drugs administered to children, which would the nurse include? A) Oral drugs are absorbed more quickly in children than adults. B) Absorption of intramuscularly administered drugs is fairly constant. C) Topical drugs are absorbed more quickly in young children than adults. D) Absorption of drugs administered by subcutaneous injection is increased
C
The nurse is administering acetaminophen PRN to a 9-year-old child on the pediatric ward of the hospital. Which answers reflect nursing actions that follow the rules of the 'eight rights' of pediatric medication administration? Select all that apply. A) The nurse identifies the child by checking the name on the child's chart. B) The nurse makes sure the medication is given within the hour of the ordered time. C) The nurse checks the documented time of the last dosage administered. D) The nurse calculates the dosage according to the child's weight. E) The nurse explains the therapeutic effects of the medication to the child and parents. F) The nurse administers the medication even though the child is adamant about not taking it.
C,D,E
The nurse caring for a 6-year-old patient enters the room to administer an oral medication in the form of a pill. The dad at the bedside looks at the pill and tells the nurse that his daughter has a hard time swallowing pills. Which of the following is the best response by the nurse? A) Ask the child to try swallowing the pill and offer a choice of drinks to take with it. B) Crush the pill and add it to applesauce. C) Request that the physician prescribe the medication in liquid form. D) Call the pharmacy and ask if the pill can be crushed.
D
The nurse is administering a liquid medication to a 3-year-old using an oral syringe. Which action would be most appropriate? A) Direct the liquid toward the anterior side of the mouth. B) Keep the child's hand away from the oral syringe when squirting the medication. C) Give all of the drug in the syringe at one time with one squirt. D) Allow the child time to swallow the medication in between amounts
D
The nurse is caring for a child who is receiving total parenteral nutrition (TPN) for failure to thrive. Which nursing action might the nurse take to prevent complications from this therapy? A) Adhere to clean technique when caring for the catheter and administering TPN. B) Ensure that the system remains an open system at all times. C) Secure all connections and open the catheter during tubing and cap changes. D) Use occlusive dressings and chlorhexidine-impregnated sponge dressings.
D
The nurse is determining the amount of IV fluids to administer in a 24-hour period to a child who weighs 40 kg. How many milliliters should the nurse administer? A) 1,000 mL B) 1,500 mL C) 1,750 mL D) 1,900 ml
D
A physician orders a medication dosage that is above the normal dosage. The nurse administers the medication without questioning the dosage. What error did the nurse make? A) The nurse violated one of the "rights" of medication administration. B) The nurse performed an act outside the scope of practice for nursing. C) The nurse has not made an error, but the physician did by ordering the wrong dosage of medication. D) The nurse has committed an act of maleficence by administering the medication.
A
The parents of a child receiving total parenteral nutrition ask the nurse why their child must have their blood glucose monitored so frequently since they are not diabetic. What is the best response by the nurse? A) "We like to keep a close check on the blood glucose for all children receiving total parenteral nutrition." B) "It is important to monitor the blood glucose level because the solution has a high concentration of carbohydrates that convert to glucose." C) "This is a good time for us to monitor your child in case they start developing signs of diabetes related to receiving total parenteral nutrition." D) "I would suggest you ask the physician why blood glucose checks have been ordered so frequently."
B
The nurse notes that a child with swallowing difficulty is receiving a continuous tube feeding. The child is very active and the feeding frequently gets interrupted because the tube becomes disconnected. What should the nurse discuss with the physician about the tube feeding? A) The nurse should ask the physician if the patient could receive total parenteral nutrition. B) The nurse should ask the physician if the patient could receive bolus rather than continuous tube feedings. C) The nurse should ask the physician if the patient could receive the tube feedings during the night rather than continuously during all hours. D) The nurse should ask the physician if the patient could be given oral rather than tube feedings. E) The nurse should ask the physician if the patient could be given a sedative in order to prevent disruption of the tube feedings.
B,C
The student nurse is preparing to administer eye drops to a 2-year-old child. Which actions indicate the need for additional instruction? Select all that apply. A) The student nurse explains the medication regimen to the child's parents. B) The nurse holds the medication bottle 3 inches from the child's nurse during administration. C) The child is instructed to look down during the instillation of the medication in the eyes. D) The student nurse seeks assistance to hold the child during the medication administration. E) The child is turned so the medication flows toward the outer corner of the eye
B,C,E
A nurse has just administered medication via an orogastric tube. What is the priority nursing action following administration? A) Check tube placement. B) Retape the tube. C) Flush the tube. D) Remove the tube.
C
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? A) To promote dispersion over the cornea B) To enhance systemic absorption C) To ensure the medication stays in the eye D) To stabilize the eyelid
C
The nurse if checking placement on a child's feeding tube. When the pH is checked, it is 5.3. What action by the nurse is indicated? A) Remove the tube. B) Document the findings as normal. C) Contact the health care provider. D) Re-evaluate the pH again in 2 hours
C
The nurse is administering immunizations to children in a neighborhood clinic. What is the most frequent route of administration? A) Oral B) Intradermal C) Intramuscular D) Topical
C
The nurse is explaining to the student nurse the therapeutic effects of total parenteral nutrition (TPN). What accurately describes the use of TPN? A) It is used short term to supply additional calories and nutrients as needed. B) It is delivered via the peripheral vein to allow rapid dilution of hypertonic solution. C) It is a highly concentrated solution of carbohydrates, electrolytes, vitamins, and minerals. D) It is usually used when the child's nutritional status is within acceptable parameters
C
A nurse is caring for a 14-year-old with a gastrostomy tube. The girl has skin breakdown and irritation at the insertion site. Which would be the most appropriate method to clean and secure the gastrostomy tube? A) Make sure the tube cannot be moved in and out of the child's stomach. B) Use adhesive tape to tape the tube in place and prevent movement. C) Place a transparent dressing over the site whether there is drainage or not. D) If any drainage is present, use a presplit 2 × 2 and place it loosely around the site.
D
The nurse is providing teaching on how to administer nasal drops. Which response by the parents indicates a need for further teaching? A) "We need to be careful not to stimulate a sneeze." B) "She needs to remain still for at least 10 minutes after administration." C) "Our daughter should lie on her back with her head hyperextended." D) "We must not let the dropper make contact with the nasal membranes."
B
