Chapter 4

A nurse is preparing to calculate a medication dose for a toddler who requires antibiotic therapy. In addition to knowing the child's weight, what other data should the nurse assess for? • body mass index (BMI) • ethnicity • developmental stage • Height

Height

Differences between the effects of a drug in children and the effects of the same drug in adults reflect what aspect of pharmacotherapy? • drug administration • drug absorption • drug adherence • Pharmacodynamics

• Pharmacodynamics

An infant is to receive a hepatitis B vaccine within a few hours after birth. Which is the bestapproach for the nurse to take when giving this medication? • Administer the medication in the vastus lateralis with a 20-gauge needle. • Administer the medication in the deltoid muscle with a 20-gauge needle. • Administer the medication in the dorsogluteal with a 25-gauge needle. • Administer the medication in the infant's vastus lateralis with a 25-gauge needle.

Administer the medication in the infant's vastus lateralis with a 25-gauge needle.

When preparing to administer a tablet by mouth to a hospitalized 4-year-old child, what can the nurse do to enlist cooperation of the child to take the medication while supporting autonomy? • Tell the child that the child can sit on the parent's lap. • Ask the child if the child would prefer the liquid form of the medication. • Tell the child that the medication is candy. • Tell the child that the medication has to be taken so that the child can leave the hospital.

Ask the child if the child would prefer the liquid form of the medication.

What topics are important for the nurse to share with an adolescent related to self-care and medication administration? (Select all that apply.) • Safe use of alcohol • Birth control pills and other drug interactions • Use of acne medications • Adverse effects of prescribed medications • How to get a sun tan

Birth control pills and other drug interactions Use of acne medications Adverse effects of prescribed medications

The nurse is caring for a 7-year-old hospitalized client who is taking several different medications. The nurse educates the family about all of the medications being administered in order to best achieve which safety related nursing goal? • Families need to understand the importance of the different classifications and actions of the drugs administered. • Families should be aware of medications that the child is taking so that they can administer them if necessary • Families become active partners with the rest of the health care team in preventing medication errors. • Families should be aware of all the medications given so that they can check their bill when the child is discharged.

Families become active partners with the rest of the health care team in preventing medication errors.

A 14-year-old child has been diagnosed with a seizure disorder necessitating long-term treatment with an oral anticonvulsant. What principle should guide this child's medication management in the home? • The child's parents should pour and administer each dose of the anticonvulsant. • The child should be encouraged to manage medications with oversight from the parents. • The child should manage the medications regimen independently. • The child should liaise with a community health nurse to ensure safe medication administration.

The child should be encouraged to manage medications with oversight from the parents.

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. • The dose should be increased to achieve and maintain therapeutic drug levels. • Only medications not excreted through the urine should be administered to this child. • The medication should be used in a half-dose so that the child will not become nephrotoxic.

The dose should be adjusted to achieve and maintain therapeutic drug levels.

A neonate's highly immature liver and resulting low levels of the enzyme cytochrome P-450 (CYP450) affects what aspect of pharmacokinetics? • distribution • metabolism • elimination • Absorption

metabolism

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. • age in years. • age in months. • weight.

body surface area.

A pediatric nurse is caring for several clients. Which client has reached the developmental milestone that will maximize the chances of the medication therapy being pharmacokinetically effective? • the 22-month-old who has been walking independently for 2 months • the 5-year-old who can print their name • the 12-year-old showing signs of puberty • the 8-year-old who plays the piano

the 12-year-old showing signs of puberty

The nurse is preparing to administer an intramuscular injection to an 8-month-old infant. Which site would the nurse select? • rectus femoris • vastus lateralis • deltoid • dorsogluteal muscle

vastus lateralis

The nurse is administering an injection to a toddler who is screaming, kicking, and trying to bite the nurse. After the injection is over, what is the best statement by the nurse? • "Your behavior was inappropriate and I hope that the next time you come to get your shots, you behave better." • "You cannot get a prize today because of your behavior, but next time, when you are better, you can get one." • "I know that was not very comfortable for you. Let's go to the prize drawer and get something." • "You were a bad boy today. You were so good the last time you had your shots."

• "I know that was not very comfortable for you. Let's go to the prize drawer and get something."

The nurse teaches a parent the importance of administering appropriate dosages of acetaminophen when the client's infant has a fever. What information should the nurse provide to this client? Select all that apply. • "In most cases, infants cannot be given medications because of their immature organs." • "Infant's and children's doses should be based on their weight or age." • "It is important to give the right dose to prevent toxic effects of the medication." • "An infant's dose of acetaminophen is about ½ of an adult dose." • "Children's dosages will change with time as they grow."

• "Infant's and children's doses should be based on their weight or age." • "It is important to give the right dose to prevent toxic effects of the medication." • "Children's dosages will change with time as they grow."

A toddler has been prescribed a liquid anti-epileptic medication. Following discharge from the hospital, the toddler has experienced an increase in seizure activity. The question the nurse asks that provides the most information is • "Were you able to get the prescription filled?" • "Are you giving the prescribed dose of the medication to your child?" • "Does your child spit out the medication?" • "What difficulties have you experienced giving the medication to your child?"

• "What difficulties have you experienced giving the medication to your child?"

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 • Information provided by the manufacturer • A pediatric drug reference • The Food and Drug Administration Web site • The Physician's Desk Reference

• A pediatric drug reference

The nurse is aware that CNS adverse effects of medications given to infants are higher because of what immature function? • Blood-brain barrier • Renal function • Liver function • Peripheral nervous system function

• Blood-brain barrier

Which statements regarding pharmacokinetic responses are true when considering the pediatric client? Select all that apply. • Pediatric clients have faster renal clearance. • Children have more total body of water than adults. • Drug absorption is affect by gastric motility. • After age 5, the liver is more mature and metabolism of drugs is more efficient. • By age 12, children have grown and matured to mimic responses similar to adults.

• Children have more total body of water than adults. • Drug absorption is affect by gastric motility. • By age 12, children have grown and matured to mimic responses similar to adults.

Suppositories are a very appropriate method of medication delivery in what age group? • Toddler • Infant • Preschooler • School age

• Infant

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 cost of the drugs prescribed • The drugs' potential side effects • References to books on teaching children about medicines • Schedule and duration of administration • Description of the intended therapeutic drug effect

• The drugs' potential side effects • Schedule and duration of administration • Description of the intended therapeutic drug effect

Which child would the nurse categorize as being an infant? • a child who is 15 months old • a child who is 18 months old • a child who is 3 weeks old • a child who is 9 months old

• a child who is 9 months old

To gain a preschooler's cooperation to swallow an oral medication, the nurse's best approach would be to: • offer to play a game with the child if the preschooler takes the medicine. • compare the taste of the medicine to a chocolate bar. • leave the medicine on the stand so the child can take it independently. • ask if the child would like to take the medicine in a cup or through an oral syringe.

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

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? • past experience • adult dosage • age • body surface area

• body surface area

To promote a positive outcome when administering drug therapy to a child, what type of knowledge should the nurse have? • potential type of reaction the child may have to the medication being administered • previous administrators of medication to the child and method • normal growth and development • type of medication the child has taken in the past

• normal growth and development

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. • health care prescriber. • computer system. • hospital pharmacist.

• nurse with verification by a second nurse.

A child who has been hospitalized with pneumonia is being discharged with two new medications. What information does the nurse need to educate the family about? (Select all that apply.) • what the medication is being taken for • how the drug works • the name of the drug • adverse effects • when the child feels better, the child can stop the medication

• what the medication is being taken for • how the drug works • the name of the drug • adverse effects

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? • the mother and grandmother's understanding about the drugs • how clean the home's environment is • where the medications will be stored • the health status of the other children

• where the medications will be stored