NCLEX Pediatric Drugs

Which anesthetic drug is commonly used for short procedures on pediatric clients? A. Fentanyl B. Morphine C. Meperidine D. Hydromorphone

A. Fentanyl

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

1.6

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

4.5

Which diseases are caused by viruses? Select all that apply. A. Mumps B. Tetanus C. Measles D. Hepatitis B E. Diphtheria

A. Mumps C. Measles D. Hepatitis B

Which influenza vaccine is administered by way of the intranasal route? A. Fluarix B. Fluvirin C. FluMist D. Fluzone

C. FluMist

The healthcare provider prescribes mebendazole for a 4-year-old child with pinworms. For which expected response to the medication does the nurse teach the parents to be alert? A. Blood B. Constipation C. Yellow stools D. Passage of worms

D. Passage of worms

A 10-year-old child is prescribed tetracycline. Which possible drug-related reactions are associated with this drug? A. Kernicterus B. Gray syndrome C. Reye syndrome D. Staining of teeth

D. Staining of teeth

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? A. At bedtime B. After lunch C. Before dinner D. Upon awakening

D. Upon awakening

A nurse is teaching parents of toddlers about why children receiving specific medications should not receive varicella vaccines. Which medication will be included in the discussion? A. Insulin B. Steroids C. Antibiotics D. Anticonvulsants

B. Steroids

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.

1.5

A 6-year-old child who has undergone abdominal surgery complains of incisional pain. The nurse administers the prescribed acetaminophen. The mother asks the nurse why her child isn't being given ibuprofen. How will the nurse respond? A. "It could prolong bleeding time." B. "It's contraindicated for young children." C. "It can suppress the healing of the incision." D. "It becomes ineffective when given for long periods."

A. "It could prolong bleeding time."

Which statements are true regarding the pharmacokinetic changes observed in infants? Select all that apply. A. An infant's fat content is higher B. An infant's gastric pH is less acidic C. An infant's gastric emptying is slow D. An infant's first-pass metabolism is slow E. An infant's transdermal absorption is rapid

B. An infant's gastric pH is less acidic C. An infant's gastric emptying is slow D. An infant's first-pass metabolism is slow

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? A. Give the antibiotic between feedings. B. Ensure that the antibiotic is administered as prescribed. C. Shake the bottle thoroughly before giving the antibiotic. D. Keep the antibiotic in the refrigerator after the bottle has been opened.

B. Ensure that the antibiotic is administered as prescribed.

The parent of a child with hemophilia asks the nurse, "If my son hurts himself, is it all right if I give him two baby aspirins?" What is the best response by the nurse? A. "You seem concerned about giving drugs to your child." B. "It's all right to give him baby aspirin when he hurts himself." C. "Aspirin may cause more bleeding. Give him acetaminophen instead." D. "He should be given acetaminophen every day. It'll prevent bleeding."

C. "Aspirin may cause more bleeding. Give him acetaminophen instead."

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

A. The free levels of a drug will increase.

A broad-spectrum oral antibiotic is prescribed for an adolescent with a bacterial infection. The prescription reads, "Take three times a day." At which times should the nurse recommend that the medication be taken to maintain a therapeutic blood level? A. 8:00 AM, 2:00 PM, 8:00 PM B. 6:00 AM, 2:00 PM, 10:00 PM C. 6:00 AM, 12:00 PM, 8:00 PM D. 10:00 AM, 4:00 PM, 10:00 PM

B. 6:00 AM, 2:00 PM, 10:00 PM

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? A. Urticaria B. Lethargy C. Low-grade fever D. Generalized rash

C. Low-grade fever

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? A. Encouraging the adolescent to start exercising B. Asking the adolescent to obtain an immediate glucometer reading C. Informing the adolescent that a complex carbohydrate such as cheese should be eaten D. Telling the adolescent that the prescribed dose of rapid-acting insulin should be administered

D. Telling the adolescent that the prescribed dose of rapid-acting insulin should be administered

A 6-year-old child is experiencing tonic-clonic seizures, and carbamazepine 15 mg/kg/day divided equally into two doses is prescribed. The child weighs 44 lb (20 kg). The medication available is carbamazepine suspension 100 mg/5 mL. How many milliliters should the nurse administer in one dose? Record your answer using one decimal place. ___ mL

7.5

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

C. Valproic acid

Loratadine, 10 mg by mouth once a day in the morning, is prescribed for a 15-year-old girl with hay fever. The girl tells the school nurse that she is concerned that she will be sleepy for a quiz the next day. How should the nurse respond? A. By explaining that this medication rarely causes drowsiness B. By advising her to take half a tablet in the morning before school C. By suggesting that she skip the next day's dose if she can tolerate the hay fever D. By recommending that she call the allergist for a prescription containing a stimulant

A. By explaining that this medication rarely causes drowsiness

The medication prescribed for an infant is to be given intramuscularly. Which site will the nurse select for administration of the medication? A. Vastus lateralis B. Ventrogluteal C. Dorsogluteal D. Deltoid

A. Vastus lateralis

A school-aged child is receiving 45 units of intermediate-acting insulin at 7:00 AM and 7:00 PM. What will the nurse tell the parents regarding a bedtime snack? A. Offer a snack at bedtime if there are signs of hyperglycemia. B. Provide a bedtime snack to prevent hypoglycemia during the night. C. Withhold the snack after dinner to prevent hyperglycemia during sleep. D. Leave a snack at the bedside in case the child becomes hungry during the night.

B. Provide a bedtime snack to prevent hypoglycemia during the night.

Which vaccine is administered orally in children? A. MMR vaccine B. Rotavirus vaccine C. Live influenza vaccine D. Meningococcal conjugate vaccine (MCV4)

B. Rotavirus vaccine

A nurse is reviewing discharge instructions with the parent of an infant with cystic fibrosis. What statement indicates that the parent knows how to administer the pancreatic enzyme replacement? A. "We should give the medication with feedings." B. "We should put crushed enteric-coated pills in the formula." C. "We need to give the medication every 6 hours, even during the night." D. "We should feed the granules from the capsule in applesauce every morning."

A. "We should give the medication with feedings."

An 18-month-old toddler is to receive an intravenous infusion of 1000 mL 5% dextrose and 0.45% sodium chloride over 24 hours. At what rate will the nurse set the volume-control device? Record your answer as a whole number. ___ mL/hr

42

An adolescent with leukemia is to be given a chemotherapeutic agent that is known to cause nausea and vomiting. When is the best time for the nurse to administer the prescribed antiemetic? A. Before each dose of chemotherapy B. As nausea occurs C. 1 hour before meals D. Just before each meal is eaten

A. Before each dose of chemotherapy

The mother of a school-aged child with type 1 diabetes asks why it was recommended that her child use an insulin pump rather than insulin injections. What will the nurse tell the mother concerning the greatest advantage of the insulin pump? A. Independence is fostered. B. Fear of daily injections is allayed. C. Dietary restrictions are minimized. D. Blood glucose monitoring can be eliminated.

A. Independence is fostered.

An adolescent who has been prescribed prednisone and vincristine for leukemia tells the nurse that he is very constipated. What should the nurse cite as the probable cause of the constipation? A. It is a side effect of the vincristine. B. The spleen is compressing the bowel. C. It is a toxic effect from the prednisone. D. The leukemic mass is obstructing the bowel.

A. It is a side effect of the vincristine.

Mebendazole is prescribed for a 3-year-old child with a pinworm infestation. What information will the nurse include when teaching the parents about this medication? A. It may cause transient diarrhea. B. One dose is all that will be needed. C. Rectal itching will be relieved the next day. D. Other family members will not need to take it.

A. It may cause transient diarrhea.

Methylphenidate has been prescribed for a 7-year-old child with attention deficit-hyperactivity disorder (ADHD) and is to be taken with meals. What rationale does the nurse provide for the parents about the timing of medication administration? A. Ritalin depresses the appetite. B.This will ensure proper absorption. C. It is an oral mucous membrane irritant. D. Children tend to forget to take it before meals.

A. Ritalin depresses the appetite.

Which vaccine may cause intussusception in children? A. Rotavirus B. Hepatitis C. Measles, mumps, and rubella D. Diphtheria, tetanus, and pertussis

A. Rotavirus

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

A. Tachycardia

A 5-month-old infant is admitted with a diagnosis of respiratory syncytial virus (RSV) infection. The infant's condition suddenly deteriorates, and a dose of epinephrine is prescribed to relieve bronchospasm. For what side effect of the medication should the nurse assess the infant? A. Tachycardia B. Hypotension C. Respiratory arrest D. Central nervous system depression

A. Tachycardia

A 5-year-old child is given fluoroquinolones. Which potential adverse effect unique to pediatric clients should the nurse anticipate? A. Tendon rupture B. Cartilage erosion C. Staining of developing teeth D. Central nervous system toxicity

A. Tendon rupture

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? A. "I'll make sure that she pushes the PCA button every 6 minutes." B. "She needs to push the PCA button whenever she needs pain medication." C. "I'll have to wake her up on a regular basis so she can push the PCA button." D. "I'll press the PCA button every 6 minutes so she gets enough pain medication while she's sleeping."

B. "She needs to push the PCA button whenever she needs pain medication."

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

B. 6-12 weeks

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

B. DT

Which vaccine is administrated through the intranasal route? A. Rotavirus vaccine B. Influenza (live) vaccine C. Varicella virus vaccine D. Human papillomavirus vaccine

B. Influenza (live) vaccine

Which medication is prescribed to an infant with congenital syphilis? A. Vidarabine B. Intravenous (IV) penicillin C. Pyrimethamine D. Trimethoprim-sulfamethoxazole

B. Intravenous (IV) penicillin

A nurse is teaching the parents of an 8-year-old child who is taking a high dose of oral prednisone for asthma. What critical information about prednisone will be included? A. It protects against infection. B. It should be stopped gradually. C. An early growth spurt may occur. D. A moon-shaped face will develop.

B. It should be stopped gradually.

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? A. Blood pressure B. Abdominal girth C. Body temperature D. Serum glucose level

C. Body temperature

What is the priority nursing intervention for a school-aged child with lead poisoning who is undergoing chelation therapy? A. Scrupulous skin care B. Provision of a high-protein diet C. Careful monitoring of intake and output D. Daily blood sampling for liver function tests

C. Careful monitoring of intake and output

A 5-year-old child is being given dactinomycin and doxorubicin therapy after nephrectomy for Wilms tumor. What will the nursing care include? A. Administering aspirin for pain B. Offering citrus juices with meals C. Ensuring meticulous oral hygiene D. Eliminating spicy foods from the diet

C. Ensuring meticulous oral hygiene

Which drug may cause sudden infant death syndrome? A. Nalidixic acid B. Promethazine C. Phenothiazines D. Hexachlorophene

C. Phenothiazines

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

C. Preventing exposure of the child to infection

Which drug class may cause kernicterus in neonates? A. Salicylates B. Tetracyclines C. Sulfonamides D. Glucocorticoids

C. Sulfonamides

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? A. "You can try the wine, but be sure it's diluted." B. "Your aunt means well, but that's not a good idea." C. "The wine will help kill the pain, but don't use it too often." D. "An over-the-counter topical gel can be used, but make sure it's for teething."

D. "An over-the-counter topical gel can be used, but make sure it's for teething."

What is the percentage of total body water in a premature newborn? A. 55% B. 65% C. 75% D. 85%

D. 85%

Which adverse effect on pediatric clients is associated with nalidixic acid? A. Kernicterus B. Gray syndrome C. Tendon rupture D. Cartilage erosion

D. Cartilage erosion

A school nurse teaches a 13-year-old child with hay fever that the prescribed phenylephrine nasal spray must be used exactly as directed. What complication may occur if the nasal spray is used more frequently or longer than recommended? A. Tinnitus B. Nasal polyps C. Bleeding tendencies D. Increased nasal congestion

D. Increased nasal congestion

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

D. Maintaining patency of the intravenous catheter and tubing.

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

D. Measles, mumps, and rubella virus vaccine (MMR)

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

D. PEDIARIX E. DAPTACEL (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.)

Which type of immune preparation, made from donated blood, contains antibodies that provide passive immunity? A. Toxoid B. Killed vaccine C. Live attenuated vaccine D. Specific immune globulin

D. Specific immune globulin

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 Lactobacillus granules. What explanation does the nurse give to the infant's parents about the reason for giving lactobacilli? A. They diminish the inflammatory mucosal edema. B. The discomfort caused by gastric hyperacidity is lessened. C. They relieve the pain caused by gas in the gastrointestinal tract. D. The flora that inhabit a healthy gastrointestinal tract must be recolonized.

D. The flora that inhabit a healthy gastrointestinal tract must be recolonized.

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? A. Single initial dose and a booster dose 3 years later B. Single initial dose and a booster dose 5 years later C. Single initial dose and a booster dose 7 years later D. Two initial doses and a booster dose at 16 years old

D. Two initial doses and a booster dose at 16 years old