Chapter 5 NIP103
A 15-year-old has been diagnosed with bone cancer after several months of fatigue and pain. What question should the nurse include in an assessment when trying to minimize the potential for adverse drug reactions?
"Do you ever use alcohol or drugs?"
The nursing student is learning about the metric system and how it is the most commonly used system of measurement in medicine. The student demonstrates an understanding of the metric system when stating which?
"In the metric system, the liter is a unit of volume."
The nurse is calculating the body surface area (BSA) of a neonate. The neonate is 22 inches long and weighs 3 kg. The BSA is:
0.2 m^2.
A client with insomnia was put on eszopiclone (Lunesta) 2 mg orally before bedtime. The nurse was ordered to increase the dose by 250 mg weekly at 2- to 4-week intervals. How many milligrams more will the nurse give to increase the dose by 250 mg?
0.25 mg
The health care provider has ordered 250 micrograms of a cardiac medication. The nurse knows through conversions of the metric system that this is equal to how many milligrams?
0.25 mg
The nurse is to administer 25 mg of meperidine (Demerol). The vial states that it contains meperidine 50mg/1 mL. How much medication should the nurse draw up for the ordered dosage?
0.5 mL
A client has been prescribed 15 mL of an oral liquid potassium supplement. The nurse should administer how many ounces?
0.5 oz
What represents correct placement of a zero in a decimal?
0.75
A nurse is to administer 30 mg of furosemide (Lasix) to a client with congestive heart failure (CHF). The vial contains 40 mg/mL. Which is the correct dose to administer?
0.75 mL
A drug label reads 1 tablet equals 60 milligrams. How many grains would this be?
1 grain
Medication doses given to children are usually smaller than those given to adults. Doses for children can also be calculated based on the child's weight. Which would be correct when calculating a dose based on weight?
1 kg equals 2.2 pounds
The nurse is ordered to administer 1.5 L of saline for a dehydrated client via an IV line. What is the equivalent of this amount of saline in milliliters?
1,500 mL
An antineoplastic medication is prescribed for a child. The nurse is verifying the dose is the recommended dose for a child with a certain body surface area (BSA). The child's BSA is 0.43 m2. The average adult BSA is 1.7 m2, and the usual adult dose of this medication is 40 mg. What is the recommended child's dose? (Round to the nearest whole number.)
10
A child is to receive 500 mg of an antibiotic suspension. The label on the bottle reads 250 mg/5 mL. The nurse should administer how much of the suspension in one dose?
10 mL
A child with a urinary tract infection who is prescribed cephalexin 25 mg/kg/day in 3 divided doses. Knowing that the child weighs 15 kilograms, the nurse should administer how many mg with each dose?
125
A newly admitted client has orders to receive 1,000 mL of normal saline IV over 8 hours. If the IV infusion set is a microdrip set that delivers 60 drops per mL, how many drops per minute should the nurse administer to the client?
125
The nurse is to infuse 1,000 mL over the next 8 hours. Calculate the mL/hour that the nurse should set the infusion pump.
125 mL
Delatsone (prednisone) has been prescribed to a client with sarcoidosis. The client is to take 20 mg/day for 1 week and then taper the dose. The medication is available in 10-mg tablets. If the client follows the drug regimen, how many tablets would be taken in the first week?
14
At 0700 (7 AM) the health care provider has ordered the nurse to begin an IV infusion and has ordered the client to receive 125 mL/hr of IV fluid. At what time will the nurse be prepared to hang the next liter of IV fluid?
1500 (3 PM)
In preparation for the delivery of anesthesia for surgery, an adult client's weight is measured and documented as 75.7 kg. This measurement is equivalent to how many pounds?
166.5 lb
A client consumed the 6-ounce cup of orange juice that was on the breakfast tray. The nurse should document what volume of fluid intake on the client's fluid balance sheet.
180 mL
A client is to receive 0.5 g of an analgesic. The client has 250 mg tablets on hand. The nurse should instruct the client to take how many tablets?
2
A client with Paget disease who weighs 110 lbs is prescribed 8 mg/kg PO of etidronate disodium. The nurse should administer how many 200 mg tablets?
2
A drug label reads "1 tablet equals 120 milligrams". How many grains would this be?
2
A health care provider orders "aspirin gr x." The label on the bottle states that one tablet contains 5 grains. How many tablets would the nurse administer?
2
A client is being treated for congestive heart failure (CHF) and is to receive 0.5 milligrams of digoxin, which is available in 250-microgram tablets. The nurse would correctly administer how many tablets?
2 tablets
The nurse determines that a newborn weighs 6 lb 7 oz. What would be the equivalent of this weight in grams?
2,920 g
A child weighs 11 kilograms. The physician orders a drug as follows: 0.2 mg/kg intravenously. What dose should the nurse administer?
2.2
How many pounds are in 1 kilogram?
2.2
A child weighs 11 kilograms. The physician orders a drug as follows: 0.2 mg/kg intravenously. The nurse determines the proper dose as:
2.2 mg
A client is to receive 150 mL of intravenous solution over the next hour using a microdrip delivery system. How much fluid would the client receive in 1 minute?
2.5 mL
Remicade 3 mg/kg IV infusion monthly has been prescribed for a client diagnosed with rheumatoid arthritis. The client weighs 150 pounds. How many mg of Remicade will be infused? Round your answer to the nearest whole number.
205
A child weighs 22 kilograms. The physician orders a drug as follows: "1.1 mg/kg by intramuscular injection." The nurse determines the proper dose as:
24 mg
A postmenopausal client has been prescribed Ibandronate (Boniva) 3 mg intravenously every 3 months. Boniva is available 1 mg/mL. How many mL should the nurse administer?
3
In the household measurement system, how many teaspoons are in 1 tablespoon?
3
Methocarbamol (Robaxin) 1.5 g orally four times a day has been prescribed for a client to treat neck pain. Robaxin is available in 500-mg tablets. How many tablets will the nurse administer for each dose?
3
The nurse is converting grams to milligrams. How would the nurse move the decimal point?
3 places to the right
A client states sometimes taking 1 ounce of an oral liquid laxative. The nurse should document that the client takes how many mL of the laxative?
30
The physician orders a client to receive 1000 mL of intravenous fluid over the next 8 hours. The intravenous delivery set is a macrodrip system. The nurse would set the infusion to run at which rate?
32 gtts/min
The client is to be given ascorbic acid 1 g daily by mouth. The medication comes in a container labeled, "Ascorbic Acid 250 mg tablets." How much will the nurse give?
4 tablets
The nurse is to administer 200 mg of Bactrim suspension. The suspension must be shaken well as suspensions settle to the bottom of the bottle. The medication available is Bactrim 250 mg in 5 mL. Which is the correct dosage required for administration?
4mL
The nursing student is studying drug dosing with liquids. The student knows that a specific amount of drug will be in a given volume. A particular drug label reads "Augmentin 125 mg/5 mL." Which is the correct volume?
5 mL
A client has been prescribed an IV antibiotic that must be mixed with 100 mL of normal saline and given over 30 minutes. The infusion set delivers 15 drops/mL. How many drops per minute should the nurse administer?
50
A client with mild postoperative pain has been prescribed 650 mg acetaminophen q6h PO PRN. The medication is available in 325 mg tablets. How many tablets can the client safely take in any 24-hour period?
8
The physician orders a client to receive 1000 mL of intravenous fluid over the next 12 hours. The intravenous delivery system is a microdrip system. The nurse would set the infusion to run at which rate?
83 gtts/minute
A nurse needs to convert 3 fluid ounces to the metric system equivalent. The nurse performs the calculation to find which result?
90 mL
According to protocol, a nursing student is required to complete metric conversions to ensure accurate administration of medication dosage. What does this indicate?
A nurse must possess a basic understanding of mathematics.
The nurse is to administer an off-label medication to a premature infant. To check for an appropriate dose for this client, the nurse refers to
A pediatric drug reference
A 2-year-old has been prescribed an antibiotic as part of treatment. What should the nurse consider to minimize the adverse effects?
Altering the dosage of the drug according to the child's age
A nurse needs to calculate a safe dose of medication for a child. Which would be most appropriate for the nurse to use?
Body surface area
What type of pediatric drug calculation is expressed in square meters?
Body surface area
A group of students are practicing pediatric dosage calculation using Clark's rule. Which information would the students need?
Child's weight in pounds
Many drugs prescribed to pediatric clients are used off label. What is the main reason that this occurs?
Drug studies do not typically involve children.
The nurse is administering a drug metabolized in the liver to an infant. Because of the immaturity of the infant liver, what does the nurse determine should be done for dosing of this drug?
Ensure that lower drug dosages or an increased interval between doses is scheduled
Clark's rule is commonly used today to calculate pediatric drug dosages, but Young's rule is rarely used.
False
One tablespoon is equivalent to 30 milliliters.
False
A nurse is using the metric system for solid measure. Which unit would the nurse expect to use?
Gram
The nurse is performing an assessment on a 7-year-old child in the clinic. The nurse observes the child's teeth are darkly stained. What information should the nurse obtain from the parent?
Has the child taken tetracycline for treatment?
The clinical nurse educator who oversees the emergency department in a children's hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children?
Have nurses check their math calculations with a colleague before administering a drug.
The charge nurse is retiring from work after 25 years of service. The staff are bringing potluck for all to enjoy. When planning to make brownies for the party, which measurement system would a nurse use?
Household system
After teaching a group of students about measuring systems and drug calculations, the instructor determines that the teaching was successful when the students identify which system as most widely used?
Metric system
The nurse is preparing to administer a client's scheduled medication. What measuring system should the nurse utilize?
Metric system
The health care provider has ordered a client to receive 0.75 g of amoxicillin (Amoxil). The medication is available as 250 mg/tablet. The nurse uses ratio and proportion to perform the drug calculation and sets up the formula to look like this: 1000 mg:1 g =X mg:0.75 g. What does the X represent in this formula?
The dosage to be delivered to the client
The nurse is administering medications to a 2-year-old child with impaired renal function. What does the nurse understand about the dosage of medication for this child?
The dose should be adjusted to achieve and maintain therapeutic drug levels.
An 8-year-old is going home on medication for a chronic condition. The nurse preparing to review the discharge instructions with the mother should include what basic information and/or instructions to help minimize the child's risk for injury? (Select all that apply.)
The drugs' potential side effects, Schedule and duration of administration, Description of the intended therapeutic drug effect
All prescriptions are required to list the metric measure for quantity and strength of the drug.
True
Pharmacokinetics involves the study of how medications are absorbed, distributed, metabolized, and eliminated. What are the two key factors that influence pharmacokinetics in children?
age and size
Which system of measurement uses the minim as the basic unit of liquid measure?
apothecary
The nursing student is studying drug dosage and has learned that there are three systems of measurement associated with drug dosing. What are these systems? (Select all that apply.)
apothecary system, household measurement system, metric system
The nurse is preparing to administer a medication to a pediatric client but does not see a child dose specified. How can a correct dose be determined from the adult dose?
based on the body surface area
A 2-year-old client 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
A nurse working in a cancer center is preparing to administer medication to a 5-year-old child. The nurse will calculate the drug dosage using:
body surface area.
An emergency department nurse is confirming that a child's ordered dose of IV analgesia is congruent with the body surface area (BSA). In order to calculate the child's BSA, the nurse must know which variables? (Select all that apply.)
child's weight, child's height
A nurse has viewed a bulletin from the FDA that has been posted in a children's hospital. The bulletin includes a warning about potentially adverse effects of a drug that has been used safely in adults. Differences between the effects of a drug in children and the effects of the same drug in adults reflect what aspect of pharmacotherapy?
differences in pharmacodynamics in children
Which units of measure would a nurse expect to find when using the apothecary system?
drams
Which laboratory test relates most directly with the impaired drug elimination that is expected in neonates?
glomerular filtration rate
Parents of a 10-year-old child with asthma are concerned about their child's lack of growth. The parents say that the child is much shorter than anyone in the class and want to know what could have caused the problem. What medication may this child have taken that contributed to the growth suppression?
glucocorticoid
An antibiotic has been ordered for a toddler who is showing signs and symptoms of sepsis. The dose will be determined based on the child's body surface area (BSA). In addition to knowing the child's weight, the care team will also have to consider the child's:
height
A nurse who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to:
immature liver and kidney function in infants and children.
A nurse should recognize what as a metric system unit? (Select all that apply.)
kilogram, gram, milliliter
A nurse is preparing to administer a parenteral medication. Which form of the medication will be used?
liquid
A nurse is aware that a neonate is born with a highly immature liver and has low levels of the enzyme cytochrome P450 (CYP450). This physiological characteristic affects what aspect of pharmacokinetics in neonates?
metabolism
The nurse knows that there are three systems of measurement used when working with drug dosing. The most frequently used system in medication administration is which?
metric system.
A nurse in a nutrition clinic is to give 2 cups of organic prune juice to a client every night. The nurse is to document this on the nursing chart. What unit will the nurse use to document the amount of juice according to the metric system of measurement?
milliliter
The nurse administering pediatric medications understands that it is important to double check each calculated dose for accuracy. Who is responsible for ensuring the accuracy of a prescribed drug dose before it is administered?
nurse administering the drug
The nurse is administering regular insulin (Novolog) using a weight-based protocol. The nurse administers the insulin by using calculations performed by the:
nurse with verification by a second nurse.
A 4-year-old boy is postoperative day one following surgery for trauma suffered in a motor vehicle accident. The boy is in pain, and the nurse is preparing to administer a dose of hydromorphone syrup as ordered. To administer this drug, the nurse should use a(n):
oral syringe
What are the units of the apothecary system?
ounces
A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause
staining of permanent teeth.
An instructor is describing the units of measure associated with household system. Which would the nurse include? (Select all that apply.)
teaspoon, quart, ounce, cup
A 2-year-old is about to receive treatment for an ear infection by intramuscular injection. To assure effective, safe treatment, what factors must the nurse consider? (Select all that apply.)
the child's weight, the child's body surface area
The student nurse is studying common fractions as they apply to the healthcare setting. What is true about common fractions?
the numerator is part of the whole number and is the top number
The nurse is to administer an intramuscular medication to a 2-year-old toddler. The nurse uses:
the vastus lateralis muscle as the site for administration.
The nurse, when using the method of dispensing drugs in which each tablet or capsule is packaged separately. Which dispensing method is this?
unit-dose method
A nurse is preparing to administer a nebulized bronchodilator to a young child with asthma. The nurse should be aware that this child's dosage is based primarily on what characteristic of the child?
weight
A 2-year-old child is diagnosed with a minor ailment and is to be administered medications at home for 2 weeks. The child lives with the mother, grandmother, and four other children between the ages of 14 months and 7 years. The home health nurse is asked to assess the home environment to determine if it is appropriate and safe for the child to take his medication at home. What will have the greatest impact on the nurse's assessment?
where the medications will be stored
