NUR 405 - Chapter 38

The nurse administering an IV piggyback medication to a preschool child should a. Use a "Smart" pump if available. b. Flush the IV tubing before and after the infusion with normal saline solution. c. Inject the medication into the IV catheter using the port closest to the child. d. Inject the medication into the IV tubing in the direction away from the child.

A. use a "smart" pump if available

What is the appropriate nursing response to a parent who asks, "What should I do if my child cannot take a tablet?" a. "You can crush the tablet and put it in some food." b. "Find out if the medication is available in a liquid form." c. "If the child can't swallow the tablet, tell the child to chew it." d. "Let me show you how to get your child to swallow tablets."

B. "Find out if the medication is available in liquid form."

What is the maximum safe volume that a neonate can receive in an intramuscular injection? a. 0.5 mL b. 1.0 mL c. 1.5 mL d. 2 mL

B. 1.0 mL

What is the main purpose for using a volume-control device, such as a Buretrol or an infusion pump, to administer intravenous fluids to children? a. To avoid fluid overload b. To aid in measuring intake c. To administer antibiotics d. To ensure adequate intravenous fluid intake

A. to avoid fluid overload

When teaching a mother how to administer eye drops, where should the nurse tell her to place them? a. In the conjunctival sac that is formed when the lower lid is pulled down b. Carefully under the eye lid while it is gently pulled upward c. On the sclera while the child looks to the side d. Anywhere as long as drops contact the eye's surface

A. in the conjunctival sac that is formed when the lower lid is pulled down

When liquid medication is given to a crying 10-month-old infant, which approach minimizes the possibility of aspiration? a. Administer the medication with a syringe (without needle) placed along the side of the infant's tongue. b. Administer the medication as rapidly as possible with the infant securely restrained. c. Mix the medication with the infant's regular formula or juice and administer by bottle. d. Keep the child upright with the nasal passages blocked for a minute after administration.

A. administer the medication with a syringe (without needle) placed along the side of the infant's tongue

What should the nurse use to prepare liquid medication in volumes less than 5 mL? a. Calibrated syringe b. Paper measuring cup c. Plastic measuring cup d. Household teaspoon

A. calibrated syringe

What parameter should guide the nurse when administering a subcutaneous injection to a school-age child with cellulitis? a. Do not to give injections in edematous areas. b. Attach a clean 1-inch needle to the syringe. c. The maximum volume injected into one site is 2 mL. d. Do not pinch up tissue before inserting the needle.

A. do not give injections in edematous areas

A child is receiving intravenous fluids. How frequently should the nurse assess and document the condition of the child's intravenous site? a. Every hour b. Every 2 hours c. Every 4 hours d. Every shift

A. every hour

What nursing actions are correct when administering heparin subcutaneously? Select all that apply. a. Insert the needle with the bevel up at a 15-degree angle. b. Insert the needle at a 45- to 90-degree angle. c. Insert the needle into the tissue on the upper back. d. Insert the needle into the abdominal tissue. e. Massage the injection site when the injection is complete.

B, D

A nurse should routinely ask a colleague to double-check a medication calculation and the actual medication before administering which medications? Select all that apply. a. Antibiotics b. Insulin c. Anticonvulsants d. Anticoagulants e. Narcotics

B, D, E The nurse should ask another nurse to check the dosage calculation and the medication before administering the following: insulin, narcotics, chemotherapy, digoxin or other inotropic drugs, anticoagulants, and K+ and Ca++ salts. Institutions may require two nurses to check other medications also to prevent medication error.

What is the hourly maintenance fluid rate for an intravenous infusion in a child weighing 19.5 kg? a. 19 mL b. 61 mL c. 195 mL d. 1475 mL

B. 61 mL The formula for calculating daily fluid requirements is 0 to 10 kg: 100 mL/kg/day; 10 to 20 kg: 1000 mL for the first 10 kg of body weight plus 50 mL/kg/day for each kilogram between 10 and 20. To determine an hourly rate, divide the total milliliters per day by 24. Calculations: Child weighs 19.5 kg. Therefore the child requires 1000 mL; plus 50 mL ´ 9.5 kg = 475 mL. Next add calculated amounts: 1000 + 475 = 1475 mL, and divide by 24 hours to equal 61.45 mL per hour. This rounds down to 61 mL/hr.

Which food is appropriate to mix with medication? a. Formula or milk b. Applesauce c. Syrup d. Orange juice

B. applesauce

Which factor should the nurse remember when administering topical medication to an infant as compared with an adolescent? a. Infants require a larger dosage because of a greater body surface area. b. Infants have a thinner stratum corneum that absorbs more medication. c. Infants have a smaller percentage of muscle mass. d. The skin of infants is less sensitive to allergic reactions

B. infants have a thinner stratum corneum that absorbs more medication

Guidelines for intramuscular administration of medication in school-age children include a. Inject medication as rapidly as possible. b. Insert needle quickly, using a dart-like motion. c. Penetrate skin immediately after cleansing site, before skin has dried. d. Have child stand, if possible, and if child is cooperative.

B. insert the needle quickly, using a dart-like motion

What action is correct when administering eardrops to a 2-year-old child? a. Administer the eardrops straight from the refrigerator. b. Pull the pinna of the ear back and down. c. Massage the pinna after administering the medication. d. Pull the pinna of the ear back and up.

B. pull the pinna of the ear back and down

What nursing action is indicated when a child receiving a unit of packed red blood cells complains of chills, headache, and nausea? a. Continue the infusion and take the child's vital signs. b. Stop the infusion immediately and notify the physician. c. Slow the infusion and assess for cessation of symptoms. d. Start a dextrose solution and stay with the child.

B. stop the infusion immediately and notify the physician

What is the best action for the nurse to take when giving medications to a 3-year-old child? a. Tell the child to take the medication "right now." b. Tell the child to take the medication or he will have to get a shot. c. Allow the child to choose fruit punch or apple juice when giving the medication. d. Tell the child that another child his age just took his medication like a "good boy."

C. allow the child to choose fruit punch or apple juice when giving the medication

What action is appropriate when using an EMLA cream before intravenous catheter insertion? a. Rub a liberal amount of cream into the skin thoroughly. b. Cover the skin with a gauze dressing after applying the cream. c. Leave the cream on the skin for 1 to 2 hours before the procedure. d. Use the smallest amount of cream necessary to numb the skin surface.

C. leave the cream on the skin for 1 to 2 hours before the procedure

What is the most important nursing action before discharge for a mother who is apprehensive about giving her child insulin? a. Review the side effects of insulin with the mother. b. Have the mother verbalize that she knows the importance of follow-up care. c. Observe the mother while she administers an insulin injection. d. Help the mother devise a rotation schedule for injections.

C. observe the mother while she administers an insulin injection

What action indicates that a school-age child is using a metered-dose inhaler correctly? a. The child uses his inhaled steroid before the bronchodilator. b. The child exhales forcefully as he squeezes the inhaler. c. The child holds his breath for 10 seconds after the first puff. d. The child waits 10 minutes before taking a second puff.

C. the child holds his breath for 10 seconds arfter the first puff

Which physiologic difference affects the absorption of oral medications administered to a 3-month-old infant? a. More rapid peristaltic activity b. More acidic gastric secretions c. Usually more rapid gastric emptying d. Variable pancreatic enzyme activity

D. variable pancreatic enzyme activity

In which muscle should the nurse select to give a 6-month-old infant an intramuscular injection? a. Deltoid b. Ventrogluteal c. Dorsogluteal d. Vastus lateralis

D. vastus lateralis