Peds Pharm Adaptive Quiz

An 11-year-old child with juvenile idiopathic arthritis will be receiving continued nonsteroidal antiinflammatory drug (NSAID) therapy at home. Which important toxic effect of NSAIDs must be included in the nurse's discharge instructions to the child and family? Diarrhea Hypothermia Blood in the urine Increased irritability

Blood in the urine Rationale: Hematuria may result from the use of NSAIDs because they may cause nephrotoxicity. Diarrhea can occur but is not a sign of toxicity. Hypothermia does not occur with NSAIDs. Drowsiness, not hyperactivity, may occur.

A 1-year-old infant is in the pediatric unit for management of AIDS. One of the medications that has been prescribed for the child is zidovudine. What clinical finding indicates to the nurse that the infant is experiencing life-threatening zidovudine toxicity? Fatigue and lethargy Increased urine output Progressive weight loss Bruises on the limbs and trunk

Bruises on the limbs and trunk Rationale: Zidovudine can cause life-threatening blood dyscrasias, including thrombocytopenia. With zidovudine toxicity the infant will demonstrate agitation, restlessness, and insomnia, not fatigue and lethargy. Urine output is unrelated to zidovudine toxicity; decreased urine output may be related to decreased fluid intake, vomiting, and diaphoresis associated with the illness. Weight loss is usually a response to the illness rather than to the therapy.

Which vaccine is administrated through the intranasal route? Rotavirus vaccine Influenza (live) vaccine Varicella virus vaccine Human papillomavirus vaccine

Influenza (live) vaccine is administered through the intranasal route. The rotavirus vaccine is administered orally. The varicella virus vaccine is given as a subcutaneous injection. The human papillomavirus vaccine is given as intramuscular injection.

A child has unknowingly swallowed a poisonous substance and has fallen unconscious. Which nursing intervention is advisable for the child?

Make arrangements so that the child is taken to a hospital. When the child has collapsed and is unconscious, an emergency call should be made to 911, and transport should be arranged for the child to be shifted to the hospital for treatment. Ipecac was once used as an emetic for poison, but it has since been banned from use by the American Academy of Pediatrics. If the child was still conscious, then a call to the national poison control hotline would not be advisable.

Acetaminophen 15 mg/kg is prescribed for a child with a temperature of 102° F (38.9° C). How much will the nurse tell the parent to administer if the child weighs 9.6 kg and the acetaminophen strength is 160 mg/5 mL? Record your answer using one decimal place. ___ mL

4.5mL 9.6kg*15mg=144mg 144mg/160mg=0.9 0.9*5mL=4.5mL

The nurse is teaching parents about the side effects of immunization vaccines. What expected side effect associated with the Haemophilus influenzae (Hib) vaccine will the nurse include in the teaching? Urticaria Lethargy Low-grade fever Generalized rash

The Hib vaccine may cause a low-grade fever as the body reacts to the vaccine. Urticaria is more likely to occur with the tetanus and pertussis vaccines. Lethargy is not expected. There may be a mild reaction at the injection site, but a generalized rash is not expected.

Which drug increases the risk of Reye syndrome in children? Aspirin Naloxone Ibuprofen Acetaminophen

Aspirin increases the risk of Reye syndrome in children. Naloxone, ibuprofen, and acetaminophen can be used, but the child should be assessed for renal and liver functioning before prescribing.

A teenage client has a prescription for oral solution levofloxacin to treat a sinus infection, and the nurse explains when the medication should be taken. The nurse concludes that the teaching has been effective when the client makes which statement? "I should take the medication at mealtime." "I should take the medication just before a meal." "I should take the medication 1 hour before a meal." "I should take the medication 30 minutes after a meal."

"I should take the medication 1 hour before a meal." Rationale: Absorption of the oral solution levofloxacin is enhanced when the stomach is empty, and it should be taken one hour before meals or two hours after meals. Tablets can be taken without regard to food. Food in the stomach will interfere with absorption. If the medication is taken just before a meal, food in the stomach shortly afterward will interfere with absorption. If the medication is taken 30 minutes after a meal, food remaining in the stomach will interfere with absorption.

Trimethoprim/sulfamethoxazole is prescribed for a child with a urinary tract infection. Which statement by the parent about the drug indicates that the nurse's instructions about administration have been understood? "Mealtime is a good time to give the medication." "I'll make sure to give each pill with 6 to 8 oz (180 to 240 mL) of fluid." "It must be taken with orange juice to ensure acidity of urine." "The drug has to be taken every 4 hours to maintain a blood level

"I'll make sure to give each pill with 6 to 8 oz (180 to 240 mL) of fluid." Rationale: This is a sulfa drug; water must be encouraged to prevent urine crystallization in the kidneys. This drug does not have to be given with meals; it is administered every 12 hours. Orange juice causes an alkaline urine; water is the best fluid to be administered with this drug. This drug maintains the blood level for 8 to 12 hours; it is an intermediate-acting drug.

he nurse is teaching a parent of a 2-year-old toddler how to administer ear drops. In what direction does the nurse teach the parent to gently pull the pinna? Forward Up and back Straight back Down and back

In children younger than 3 years of age the eustachian tube is shorter, wider, and more horizontal. Pulling the pinna down and back facilitates passage of fluid by way of gravity to the eardrum. Pulling the pinna forward does not help position the canal for passage of the drops to the eardrum. Pulling the pinna up and back is the technique used for administering ear drops to children older than 3 years of age and adults. Pulling the pinna straight back does not position the canal for passage of the drops to the eardrum.

A 4-year-old child develops thrombocytopenia after vaccination. Which vaccination may be responsible? Rotavirus vaccine Varicella virus vaccine Human papillomavirus vaccine Measles, mumps, and rubella virus vaccine (MMR

Measles, mumps, and rubella virus vaccine ( MMR) may cause transient thrombocytopenia. It is generally benign and occurs only rarely. Rotavirus vaccine carries a small risk for intussusception. Varicella virus vaccine and human papillomavirus vaccine may cause mild effects such as fever and fainting.

Which preparations use toxoids but not live viruses? Select all that apply. Rotarix Varivax M-M-R II PEDIARIX DAPTACEL

PEDIARIX DAPTACEL Rationale: PEDIARIX consists of diphtheria and tetanus toxoids plus inactivated bacterial components of pertussis, inactive viral antigen of hepatitis B, and inactivated poliovirus vaccine. DAPTACEL is a preparation consisting of toxoids plus inactive bacterial and viral components of diphtheria and tetanus toxoids and acellular pertussis vaccine. Rotarix, Varivax, and M-M-R II are preparations containing live viruses.

An infant with cardiopulmonary disease who displays signs and symptoms of bronchiolitis and pneumonia was admitted to the hospital. What condition is the infant likely to have? Poliomyelitis Pneumococcal infection Meningococcal infection Respiratory syncytial virus infection

Respiratory syncytial virus infections are the most common cause for hospitalization of infants younger than 1 year of age; this disease especially affects premature infants and infants with cardiopulmonary disease. Poliomyelitis is caused by the poliovirus. Streptococcus pneumonia infections cause meningitis, sepsis, pneumonia, and otitis media. Neisseria meningitidis causes meningitis.

A 12-year-old child has just received a dose of epinephrine. What is the priority assessment after this medication is administered? Tachycardia Hypoglycemia Constricted pupils Decreased blood pressure

Tachycardia Rationale: Epinephrine is a sympathetic nervous system stimulant that causes tachycardia. Hyperglycemia, not hypoglycemia, may result. The pupils will dilate, not constrict. Epinephrine is more likely to cause hypertension than hypotension because of its effect of peripheral vasoconstriction.

Which type of vaccines triggers the recipient's immune system to produce antitoxins? Live vaccines Killed vaccines Toxoid vaccines Specific immune globulins

Toxoids are a nontoxic form of bacterial toxins that induce the formation of antitoxins by the recipient's immune system. Examples of these types of vaccines include tetanus toxoid and diphtheria toxoid. Both live and killed vaccines induce the body's immune system to produce antibodies, making the individual actively immune to the microbes. Specific immune globulins are high concentration of antibodies prepared from donated blood directed against specific antigens.

According to the Healthcare Personnel Vaccination Recommendations, what meningococcal conjugate vaccine dose should a nurse administer to a 12-year-old with an HIV infection? Single initial dose and a booster dose 3 years later Single initial dose and a booster dose 5 years later Single initial dose and a booster dose 7 years later Two initial doses and a booster dose at 16 years old

Two initial doses and a booster dose at 16 years old Rationale: A 12-year-old with HIV would require two primary meningococcal conjugate vaccine delivered two months apart initially and a booster dose at the age of 16 years old. The client would require two initial doses, not a single initial dose, and a booster at 16 years old, not 3, 5, or 7 years later.

The medication prescribed for an infant is to be given intramuscularly. Which site will the nurse select for administration of the medication?

Vastus lateralis

Which vaccination is given to young children to provide protection against tetanus and diphtheria but not pertussis? Td DT DTaP Tdap

DT is given to children to provide protection from both tetanus and diphtheria. Td is used as a booster dose to protect adolescents and adults from tetanus and diphtheria. DTaP is given to children to provide protection from tetanus, diphtheria, and acellular pertussis. Tdap is used as a booster dose to protect adolescents and adults from tetanus, diphtheria, and acellular pertussis.

After surgery for a ruptured appendix, a 12-year-old child is receiving morphine for pain control by way of a patient-controlled analgesia (PCA) infusion. A bolus of morphine can be delivered every 6 minutes. A parent will be staying with the child during the immediate postoperative period. What statement indicates to the nurse that the instructions about the PCA pump have been understood? "I'll make sure that she pushes the PCA button every 6 minutes." "She needs to push the PCA button whenever she needs pain medication." "I'll have to wake her up on a regular basis so she can push the PCA button." "I'll press the PCA button every 6 minutes so she gets enough pain medication while she's sleeping."

"She needs to push the PCA button whenever she needs pain medication." Rationale: Morphine, an opioid analgesic, relieves pain; when control of pain is given to the child, anxiety and pain are usually diminished, resulting in a decreased need for the analgesic; only the child should press the PCA button. Having the child press the PCA button every 6 minutes is unnecessary. Although pain medication can be delivered as often as every 6 minutes, it should be used only if necessary. If the child is sleeping, the pain is under control; waking the child will interfere with rest. If the child is sleeping, the pain is under control; also, this will result in an unnecessary and excessive dosage of the opioid.

A healthcare provider prescribes 160 mg of acetaminophen (Tylenol) elixir for a child. The label on the bottle reads "100 mg/mL." How many milliliters of acetaminophen will the nurse instruct the mother to administer? Record your answer using one decimal place. _____ mL

1.6mL

The nurse administers an initial dose of Haemophilus influenzae type b (Hib) vaccine to a 2-month-old infant. When should the nurse administer the final dose of the vaccine to the infant? 6-8 months of age 8-10 months of age 12-15 months of age 16-18 months of age

12-15 months of age Rationale: The Haemophilus influenzae type b (Hib) vaccine is administered in four doses, finishing at the age of 12-15 months. Following the first dose at 2 months, the second is administered at 4 months, and the third at 6 months. For the final dose, 6-8 months and 8-10 months would be too soon; 16-18 months would be too late. https://www.cdc.gov/flu/about/viruses/types.htm

The healthcare provider has prescribed 700 mL of intravenous fluid to be infused over 24 hours. At what rate should the nurse set the volume-control device? Express your answer as a whole number. ___ mL/hr

29mL/hr

Permethrin 1% lotion is prescribed for a 5-year-old child with pediculosis capitis (head lice). What instruction does the nurse include while teaching the parents about treating the head lice? Personal belongings must be discarded. Side effects are nonexistent with the medicated shampoo. Other children should be kept away from the child for a week. The child's hair must be combed with a fine-toothed comb to remove nits.

A fine-toothed comb removes any nits that remain after the application of permethrin 1% lotion. Personal belongings do not need to be disposed of; clothing and linens should be laundered in hot water and dried in a hot dryer, and other personal items may be soaked in a pediculicidal solution. Excessive use of permethrin 1% lotion may cause the lice to develop resistance to the shampoo. Once the hair has been shampooed there is no reason to isolate the child.

A nurse is planning care for a toddler who has ingested aspirin. What assessment warrants close monitoring because an increase can result in further complications? Blood pressure Abdominal girth Body temperature Serum glucose level

Body temperature Rationale: Hyperpyrexia (increased temperature) is a manifestation of acute aspirin poisoning; this leads to increased oxygen consumption and heat loss. Blood pressure is not directly affected by aspirin ingestion. Ascites does not occur as a result of aspirin ingestion; it may occur if liver failure develops. Aspirin ingestion does not affect the serum glucose level.

A nurse is teaching dietary management to the parents of a toddler who is undergoing chelation therapy to treat lead poisoning. What will be included in the discussion of the dietary plan? Maintaining a low-salt diet Ensuring adequate fluid intake Avoiding refined sugar and flour Offering high-calorie, low-protein foods

Ensuring adequate fluid intake Rationale: Adequate hydration is needed because the lead complexes released during chelation therapy are excreted by the kidneys. There is no basis for restricting salt in the diet of a child with lead poisoning. There is no basis for restricting intake of refined sugar and flour except for improving the nutrition of every child, not just those with lead poisoning. There is no reason to increase caloric intake unless the child is underweight; it is unnecessary to restrict protein.

A 2-year-old boy with hemophilia A is to start receiving prophylactic intravenous infusions of the recombinant form of factor VIII three times a week. The nurse will instruct the parents to administer the factor at what time on the designated days? At bedtime After lunch Before dinner Upon awakening

Factor VIII is administered once in the morning on designated days. The half-life of factor VIII is short. If factor VIII is administered later in the day (i.e., at bedtime, after lunch, or before dinner), protection will not be adequate during the day, when the child is most active and more vulnerable to bleeding.

What is the priority nursing intervention for a young infant who has an intravenous (IV) line in place after undergoing abdominal surgery? Administering oral fluids Limiting handling by parents Weighing diapers after each voiding Maintaining patency of the intravenous catheter and tubing.

It is imperative that the nurse monitor the IV site and tubing for patency. Signs of obstruction or infiltration must be detected and, if needed, a new means of circulatory access must be obtained quickly. Oral fluids are not administered after abdominal surgery until peristalsis has returned. There is no reason to limit handling the infant as long as the IV site is not disturbed. Parent-infant contact should be encouraged. Although an accurate output record, which includes the number of voidings, is important, maintenance of the IV infusion is the priority.

A nurse is caring for a preschool child who is receiving prednisone. What is most important for the nurse to consider when administering adrenocorticosteroid therapy? It suppresses inflammation. It may produce hyperkalemia. Wound healing is accelerated. Antibody production increases.

It suppresses inflammation. Rationale: Because of suppression of the inflammatory manifestations of infection, such as increase in body temperature, the nurse must be alert to the subtle signs and symptoms of infection (e.g., changes in appetite, sleep patterns, and behavior). Adrenocorticosteroid therapy may cause hypokalemia, not hyperkalemia, because of the retention of sodium and fluid. Adrenocorticosteroid therapy delays, not accelerates, wound healing. Adrenocorticosteroid therapy decreases, not increases, the production of antibodies.

A nurse is planning an evening snack for a child receiving NPH insulin. What is the reason for this nursing action? It encourages the child to stay on the diet. Energy is needed for immediate utilization. Extra calories will help the child gain weight. Nourishment helps counteract late insulin activity.

Nourishment helps counteract late insulin activity Rationale: A bedtime snack is needed for the evening. NPH insulin is intermediate-acting insulin, which peaks 4 to 12 hours later and lasts for 18 to 24 hours. Protein and carbohydrate ingestion before sleep prevents hypoglycemia during the night when the NPH is still active. The snack is important for diet-insulin balance during the night, not encouragement. There are no data to indicate that extra calories are needed; a bedtime snack is routinely provided to help cover intermediate-acting insulin during sleep. The snack must contain mainly protein-rich foods, not simple carbohydrates, to help cover the intermediate-acting insulin during sleep.

The mother of a 7-month-old infant who becomes irritable when teething tells the nurse, "My aunt said to wipe my baby's gums with wine to ease the pain." What is the best response by the nurse? "You can try the wine, but be sure it's diluted." "Your aunt means well, but that's not a good idea." "The wine will help kill the pain, but don't use it too often." "An over-the-counter topical gel can be used, but make sure it's for teething."

Providing information is a nonjudgmental way to address unsafe child care practices. There are safe over-the-counter analgesic products specifically formulated to ease the discomfort of teething. Alcohol ingestion is contraindicated and illegal for all children. Being judgmental about the aunt's approach may close communication; the nurse should offer acceptable alternatives.

At 7:00 AM a nurse learns that an adolescent with diabetes had a 6:30 AM fasting blood glucose level of 180 mg/dL (10.0 mmol/L). What is the priority nursing action at this time? Encouraging the adolescent to start exercising Asking the adolescent to obtain an immediate glucometer reading Informing the adolescent that a complex carbohydrate such as cheese should be eaten Telling the adolescent that the prescribed dose of rapid-acting insulin should be administered

Telling the adolescent that the prescribed dose of rapid-acting insulin should be administered Rationale: A blood glucose level of 180 mg/dL (10.0 mmol/L) is above the average range, and the prescribed rapid-acting insulin is needed. Although exercise does decrease insulin requirements and does lower the blood glucose level, the immediate action of insulin is needed. Asking the adolescent to obtain an immediate glucometer reading is an action that will not correct the problem; the blood glucose level is already known. Food intake at this time will increase the level of blood glucose.

A nurse is caring for a 3-month-old infant with severe diarrhea following antibiotic therapy. After the effects of dehydration are stabilized, the healthcare provider prescribes Lactobacillusgranules. What explanation does the nurse give to the infant's parents about the reason for giving lactobacilli? They diminish the inflammatory mucosal edema. The discomfort caused by gastric hyperacidity is lessened. They relieve the pain caused by gas in the gastrointestinal tract. The flora that inhabit a healthy gastrointestinal tract must be recolonized.

The flora that inhabit a healthy gastrointestinal tract must be recolonized. Rationale: Lactobacilli are part of the flora in the healthy gastrointestinal tract. The purpose of administering lactobacilli granules is to help recolonize the normal gastrointestinal flora that were destroyed with antibiotic therapy. The other options are not the actions of lactobacilli granules.

The protein binding capacity of drugs in infants is low. Which is an implication of this physiologic process? The free levels of a drug will increase. The free levels of a drug will decrease. The free levels of a drug will remain constant. The free levels of a drug will disappear once administered.

The free levels of a drug will increase. Rationale: Drugs bind to serum albumin and endogenous compounds such as fatty acids and bilirubin. The levels of these compounds are relatively low in infants. Due to this availability of less binding sites, the free concentration of the drug molecules increases. In adults, the drugs undergo extensive binding, and free levelsof a drug will decrease. Levels of a drug cannot remain constant after drug absorption, nor will they immediately disappear.

What is the percentage of total body water in a premature newborn? 55% 65% 75% 85%

The total body water in a premature newborn is 85%. In full-term infants, body water ranges from 70% to 80%. The total body water in a child between the ages of 1 and 12 is approximately 64%.

Which antiepileptic drug is used as the first-line treatment for absence seizures? Phenytoin Diazepam Valproic acid Acetazolamide

Valproic acid is used as the first-line treatment for absence seizures. Phenytoin is used to treat partial, secondary, and generalized tonic-clonic seizures. Diazepam is used to treat status epilepticus. Acetazolamide is used as an adjunct drug for the treatment of absence seizures.

A school-aged child with newly diagnosed acute lymphocytic leukemia (ALL) is to undergo induction therapy with prednisone, vincristine, and asparaginase. After several days the child becomes constipated. What does the nurse suspect as the cause? Diet, which lacks bulk Inactivity, which results from illness Vincristine, which decreases peristalsis Prednisone, which causes gastric irritability

Vincristine, which decreases peristalsis Rationale: Constipation, which may progress to paralytic ileus, is a side effect of vincristine. Lack of bulk and inactivity each may contribute to constipation, but neither is the primary cause of this child's constipation. Prednisone may cause nausea and vomiting, but it does not cause constipation.

A parent calls the outpatient clinic requesting information about the appropriate dosage of acetaminophen for a 16-month-old child. The directions on the bottle of acetaminophen elixir are 120 mg every 4 hours when needed. At the toddler's 15-month visit, the healthcare provider prescribed 150 mg. What is the best response by the nurse? "The dose is close enough, and it doesn't really matter which one you give." "From your description, the medications aren't necessary. They should be avoided at this age." "It's appropriate to base dosages on age. Children typically have weights consistent for their age groups." "The prescribed dose of the drug was based on weight, and this is a more accurate way of determining a therapeutic dose."

"The prescribed dose of the drug was based on weight, and this is a more accurate way of determining a therapeutic dose." Rational: A specific dose per kilogram of body weight prevents overdose; there is a large range in weight for specific ages, and a uniform dosage based on age could be unsafe or ineffective. Stating that the dose is close enough may result in an inadequate dose. Medication is important; the child has a fever. Using dosages based on age is unsafe because of the wide range of weights for a specific age group.

Allopurinol is prescribed for a 6-year-old child undergoing chemotherapy for cancer of the bone. When given the medication, the child asks, "Why do I have to take this pill?" What is the best response by the nurse? "It protects your body from getting new problems after your treatment is over." "It stops your sick white cells from going to other parts of your body." "You know the healthcare provider wouldn't prescribe anything for you unless it was very important." "With the other medicines, it helps you get rid of the things that are making you sick."

"With the other medicines, it helps you get rid of the things that are making you sick." Rationale: Telling the child it helps get rid of the things making the child sick is the most accurate and age-appropriate response to the child's question. Telling the child that the medicine protects the body from new problems is inaccurate, and not being truthful will interfere with the development of the child's trust in the nurse. Telling the child that it stops sick white cells from spreading is inaccurate and may instill more fear. Telling the child that it is needed because the healthcare provider says so is insensitive to the question and does not provide an explanation.

A healthcare provider prescribes an initial loading dose of 75 mcg of oral digoxin for a school-aged child. The medication is supplied as an elixir, 50 mcg/mL. How many milliliters of solution will the nurse administer? Record your answer using one decimal place. ___ mL.

1.5mL

A 3-year-old child is to receive a liquid iron preparation. What will the nurse teach the mother regarding this medication?

A liquid iron preparation may stain tooth enamel; therefore it should be diluted and administered through a straw. Constipation, rather than loose stools, often results from the administration of iron. Iron absorption is improved when taken on an empty stomach. The exception is acidic foods, such as citrus juices, which improve absorption.

Corrective surgery for hypertrophic pyloric stenosis is completed, and the infant is returned to the pediatric unit with an intravenous (IV) infusion in progress. What is the priority nursing action? Applying adequate restraints Administering a mild sedative Removing the nasogastric tube Assessing the IV site for infiltration

Assessment of the IV site is a priority. The infant will need IV fluids until oral feedings are possible. Restraints are not needed. Administering a sedative is not necessary and should not be done until a full assessment is completed. If the infant has a nasogastric tube in place, it should not be removed until an assessment of bowel sounds and nausea and vomiting is done.

Which medication is prescribed to an infant with congenital syphilis?

IV penicillin destroys the cell wall of Treponema pallidum, the causative organism of syphilis.

A child recovering from a severe asthma attack is given oral prednisone 15 mg twice daily. What is the priority nursing intervention? Having the child rest as much as possible Checking the child's eosinophil count daily Preventing exposure of the child to infection Offering nothing by mouth to the child except oral medications

Prednisone reduces the child's resistance to certain infectious processes and, as an antiinflammatory drug, masks infection. The child will self-limit activity depending on respiratory status. The eosinophil count is often consistently increased in children with asthma. The child will need adequate hydration to help loosen and expel mucus.

Which vaccine may cause intussusception in children? Rotavirus Hepatitis Measles, mumps, and rubella Diphtheria, tetanus, and pertussis

Rotavirus vaccines very rarely cause intussusception, a form of bowel obstruction in which the bowel telescopes in on itself. Hepatitis vaccines can cause anaphylactic reactions. The measles, mumps, and rubella vaccine may cause thrombocytopenia. The diphtheria, tetanus, and pertussis vaccine carries a small risk of causing acute encephalopathy, convulsions, and a shock-like state.

A 14-year-old girl in whom scoliosis has been diagnosed undergoes spinal fusion. On the first postoperative day her face is red, she is rigid, and she is crying because she is in pain. She has prescriptions for morphine sulfate for severe pain and an acetaminophen-codeine compound for moderate pain. What information should influence the nurse's choice of analgesic? One dose of morphine may be given, but the drug should be restricted thereafter because it is addictive. Adolescents tend to exaggerate their discomfort, particularly when they are immobilized by surgery or injury. Spinal fusion causes considerable pain during the early postoperative days, and morphine is the more effective analgesic. The acetaminophen-codeine compound is preferred because morphine can cause respiratory depression or respiratory arrest.

Spinal fusion causes considerable pain during the early postoperative days, and morphine is the more effective analgesic. Rationale: Spinal fusion causes considerable pain for several days and requires a strong analgesic. The first postoperative day is too early to begin weaning the client from opiates. Adolescents are no more prone to exaggerating their discomfort than clients in any other age group. A more potent analgesic, such as morphine, is needed, and the prescribed dosage should not cause respiratory problems.

When is the first dose of Rotarix vaccine administered in infants? Birth to 6 weeks 6-12 weeks 12-18 weeks 18-24 weeks

The Rotarix vaccine prevents rotavirus gastroenteritis and diarrhea-related problems. The vaccination requires two doses. The first dose of Rotarix should be given between 6 and 12 weeks followed by the second dose, which is given four or more weeks after the first dose. Administering the vaccine before the age of 6 weeks is too early, and administering it at 12-18 weeks or 18-24 weeks is too late. https://www.cdc.gov/rotavirus/index.html

After 3 months of supplemental oral iron therapy, there is no significant increase in an adolescent's hemoglobin level. Iron dextran is prescribed. What is the best way for the nurse to administer this medication? With a transdermal needle By massaging the injection site With the use of the Z-track method By administering a local anesthetic first

The Z-track injection methodprevents seepage of iron dextran through the needle track, thereby limiting irritation of subcutaneous tissue and staining of the skin. The length of a transdermal needle is too short to reach a muscle; a 1.5-inch (3.8 centimeters) needle is required. Massage will force iron dextran into the subcutaneous tissue, causing irritation and staining. Although an injection may be uncomfortable, a local anesthetic is unnecessary.

An infant who has undergone cardiac surgery for a congenital defect is to be discharged. What should the nurse emphasize to the parents regarding administration of the prescribed antibiotic? Give the antibiotic between feedings. Ensure that the antibiotic is administered as prescribed. Shake the bottle thoroughly before giving the antibiotic. Keep the antibiotic in the refrigerator after the bottle has been opened.

Ensuring that the antibiotic is administered as prescribed is a priority because inadequate antibiotic therapy may predispose the infant to the development of bacterial endocarditis. Giving the antibiotic between feedings, shaking the bottle, and storing the medication in the refrigerator are not priority instructions because instructions often vary depending on the antibiotic.