NCLEX Pediatric Drugs

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.

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

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

D. 85%

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

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

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

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

C. FluMist

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

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 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

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

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

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

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."

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

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."

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.

In what ways can a nurse prevent medication errors? Select all that apply. 1 Avoid using abbreviations and acronyms 2 Minimize the use of verbal and telephone orders 3 Try to guess what the client is saying if the language is not understood 4 Document each dose of the drug using trailing zeros when recording the dose 5 Check three times before giving a drug by comparing the drug order and medication profile

1 Avoid using abbreviations and acronyms 2 Minimize the use of verbal and telephone orders 5 Check three times before giving a drug by comparing the drug order and medication profile The use of abbreviations is avoided because this action may cause confusion and increase the risk of error. The use of verbal and telephone orders should be minimized to avoid confusion over drugs that have similar names. Before a drug is administered, the dosage order should be checked three times to verify the five rights: right drug, right dose, right time, right route, and right client. The use of trailing zeros should be avoided because it increases the risk of overdose. If the client's language is not understood, a translator's help should be enlisted.

An infant with congenital heart disease is to be discharged with prescriptions for digoxin and furosemide. The nurse discusses the danger signs of digoxin toxicity with the parents. What danger sign requires a call to the healthcare provider? 1 Difficulty feeding with vomiting 2 Cyanosis during periods of crying 3 Daily naps lasting more than 3 hours 4 A pulse rate faster than 100 beats/min

1 Difficulty feeding with vomiting Vomiting and feeding issues are early signs of digoxin toxicity. Cyanosis is expected in a crying infant with heart disease because the energy expenditure exceeds the body's ability to meet the oxygen demand. Long naps are expected; infants routinely require several naps, and an infant with heart disease requires long rest periods. The pulse rate of an infant receiving digoxin should remain faster than 100 beats/min.

Which statement regarding anesthetic drugs in pediatric clients requires correction? 1 During general anesthesia, the upper air obstruction risk is less in pediatrics. 2 Pediatric clients are more affected by anesthesia than adults. 3 Cardiac abnormalities are more common in pediatric clients receiving anesthesia. 4 The central nervous system of pediatric clients is more sensitive to the effects of anesthetics.

1 During general anesthesia, the upper air obstruction risk is less in pediatrics. Neonates have a respiratory structure that is small in diameter, and they have a high metabolic rate. Because of this, the chance of upper air obstruction during general anesthesia is quite high. In pediatric clients, drug accumulation and toxicity also increases because the child's liver and kidney functions are immature. Thus children are more affected by anesthesia than adults. A child's cardiac system is not fully developed, which causes problems with the excretion and metabolism of anesthetics and leads to cardiac abnormalities. Because the blood brain barrier is underdeveloped in pediatric clients, the central nervous system becomes more affected by anesthetics.

A school-aged child is admitted to the pediatric unit with hypertensive acute glomerulonephritis. In addition to hydralazine, what medication does the nurse anticipate will be prescribed initially? 1 Digoxin 2 Furosemide 3 Alprazolam 4 Phenytoin

2 Furosemide Furosemide is a loop diuretic that is recommended for the treatment of acute glomerulonephritis; it promotes the excretion of fluid and thus limits fluid retention. Digoxin is not used because there is no cardiac involvement. An anxiolytic is unnecessary. Phenytoin may be used only if hypertensive encephalopathy causes seizures. Test-Taking Tip: Being emotionally prepared for an examination is key to your success. Proper use of resources over an extended period of time ensures your understanding and increases your confidence about your nursing knowledge. Your lifelong dream of becoming a nurse is now within your reach! You are excited, yet anxious. This feeling is normal. A little anxiety can be good because it increases awareness of reality; but excessive anxiety has the opposite effect, acting as a barrier and keeping you from reaching your goal. Your attitude about yourself and your goals will help keep you focused, adding to your strength and inner conviction to achieve success.

A child is diagnosed with classic hemophilia. A nurse teaches the child's parents how to administer the plasma component factor VIII through a venous port. It is to be given three times a week. When should the parents administer this therapy? 1 Whenever a bleed is suspected 2 In the morning on scheduled days 3 At bedtime while the child is lying quietly in bed 4 On a regular schedule at the parents' convenience

3 At bedtime while the child is lying quietly in bed Factor VIII has a short half-life; therefore prophylactic treatment involves administering the factor on the scheduled days in the morning so the child will get the most benefit during the day, while he is most active. Prophylactic treatment is administered on a scheduled basis to prevent bleeds from occurring. Administering the drug at bedtime will limit its effectiveness because bleeds are more common when the child is active. Administering the medicine on a regular schedule at the parents' convenience does not take into consideration the properties of the drug.

Which vaccine is used to prevent a human papilloma virus infection? 1 Varivax 2 RotaTeq 3 Gardasil 4 Hepatitis A vaccine

3 Gardasil Gardasil is a quadrivalent vaccine used to prevent genital cancers and warts caused by human papilloma virus. Varivax is associated with protection from the varicella virus; this vaccine is sometimes given in combination with the MMR vaccine. The RotaTeq vaccine is used to vaccinate against a rotavirus infection. The hepatitis A vaccine is used to protect against the hepatitis A virus.

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

A 3-year-old child is to receive a liquid iron preparation. What will the nurse teach the mother regarding this medication? 1 Monitor the stools for diarrhea. 2 Administer with meals to improve absorption. 3 Avoid giving the child orange juice with the iron preparation. 4 Have the child drink the diluted iron preparation through a straw.

4 Have the child drink the diluted iron preparation through a straw. 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.

An intravenous (IV) antibiotic is prescribed for a child with fever of unknown origin. Within 10 minutes of the antibiotic infusion, the child's face and neck are flushed but the remainder of the body is unchanged. The nurse checks the child's record. In light of this information, what will the nurse do? 1 Administer acetaminophen. 2 Place the child on protective isolation. 3 Increase the rate of the vancomycin infusion. 4 Notify the primary healthcare provider after stopping the infusion.

4 Notify the primary healthcare provider after stopping the infusion. The child is exhibiting a common vancomycin reaction called red man syndrome or red neck syndrome. Flushing usually begins in the chest area and spreads upward to the neck and face, usually during the first 15 minutes of administration. This reaction is caused by a release of histamine, which results in vasodilation. If not treated, the syndrome can lead to circulatory collapse. The appropriate response is to stop the infusion and notify the primary healthcare provider. The provider will usually prescribe diphenhydramine hydrochloride (Benadryl) and then resume the vancomycin infusion. Diphenhydramine will be administered before each vancomycin dose, and the infusion will be set at a slower rate. Normal temperature is 98.6° F (37° C). It is not necessary to administer acetaminophen for a temperature below 100.4° F (38° C). The child's laboratory results indicate a bacterial infection. Protective (or reverse) isolation is not necessary. Increasing the vancomycin infusion rate will exacerbate the reaction and lead to circulatory collapse.

A nurse is planning an evening snack for a child receiving NPH insulin. What is the reason for this nursing action? 1 It encourages the child to stay on the diet. 2 Energy is needed for immediate utilization. 3 Extra calories will help the child gain weight. 4 Nourishment helps counteract late insulin activity.

4 Nourishment helps counteract late insulin activity. 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. Test-Taking Tip: Make educated guesses when necessary.

An infant with a diagnosis of heart failure is being given furosemide twice a day. Which laboratory value will the nurse report to the healthcare provider? 1 Sodium of 140 mEq/L (140 mmol/L) 2 Ionized calcium of 2.35 mEq/L (1.2 mmol/L) 3 Chloride of 102 mEq/L (102 mmol/L) 4 Potassium of 3.0 mEq/L (3.0 mmol/L)

4 Potassium of 3.0 mEq/L (3.0 mmol/L) Because furosemide is a potassium-losing diuretic, the potassium should be frequently checked. Normal potassium concentration in infants is 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L). A potassium concentration of 3.0 mEq/L (3.0 mmol/L) should be reported to the healthcare provider. The normal range for sodium is 139 to 146 mEq/L (139 to 146 mmol/L), ionized calcium is normally 2.24 to 2.46 mEq/L (1.12 to 1.23 mmol/L), and chloride is normally 98 to 106 mEq/L (98 to 106 mmol/L). The sodium, calcium, and chloride readings are normal.

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."

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

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. A side effect of methylphenidate is anorexia; it should be given during or immediately after breakfast. The absorption rate is not affected by the timing of when it is given. Oral mucous membrane irritation is not a side effect of methylphenidate. In a child of this age the parents are responsible for administering medications. Test-Taking Tip: Do not read too much into the question or worry that it is a "trick." If you have nursing experience, ask yourself how a classmate who is inexperienced would answer this question from only the information provided in the textbooks or given in the lectures.

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 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

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." 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.

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.

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 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.

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

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

C. Phenothiazines

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.)

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 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 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.

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

Pharmacokinetic factors determine the concentration of a drug at its site of action. These are different in neonates and infants than they are in small children or adults. Arrange the factors in the order in which they occur. 1. Excretion 2. Absorption 3. Distribution 4. Metabolism

1.Absorption 2.Distribution 3.Metabolism 4.Excretion The first step after administering the drug through any route is absorption. For instance, orally administered drugs are generally absorbed in the gastrointestinal tract. After absorption, drugs may be distributed through protein binding, or some may enter the central nervous system through the blood-brain barrier. Most drugs are then metabolized in the liver; this capacity is low in newborns. Drugs do not remain in the body indefinitely; rather they are excreted by the kidneys.

A toddler with cystic fibrosis has been hospitalized with bacterial pneumonia. The nurse determines that the child has no known allergies. What does the nurse conclude is the reason that the healthcare provider selected a specific antibiotic? 1 Tolerance of the child 2 Sensitivity of the bacteria 3 Selectivity of the bacteria 4 Preference of the healthcare provider

2 Sensitivity of the bacteria When the causative organism is isolated, it is tested for antimicrobial susceptibility (sensitivity) to various antimicrobial agents. When a microorganism is sensitive to a medication, the medication is capable of destroying the microorganism. The tolerance of the child of the particular antibiotic is unknown because up to this time the child has not exhibited any allergies. Bacteria are not selective. Although the healthcare provider may have a preference for a particular antibiotic, it first must be determined whether the bacteria are sensitive to it.Test-Taking Tip: Pace yourself while taking a quiz or exam. Read the entire question and all choices before answering the question. Do not assume that you know what the question is asking without reading it entirely.

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

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

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."

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

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

A. Fentanyl

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.

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

A. Rotavirus

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

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 Rotavirus vaccines are generally administered orally because these live viruses should replicate in the gut of the infant. MMR vaccines are generally administered subcutaneously in the upper region of the arm. Live influenza vaccines are administered nasally. Meningococcal conjugate vaccines (MCV4) are administered intramuscularly in the deltoid region.

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 Kidney function must be adequate to excrete the lead; if it is not adequate, nephrotoxicity or kidney damage may result. Skin breakdown is not associated with chelation therapy. A high-protein diet is not necessary. Liver damage does not occur with chelation therapy.

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

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

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

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."

Correct 3 "Aspirin may cause more bleeding. Give him acetaminophen instead."

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

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 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. Test-Taking Tip: Read the question carefully before looking at the answers: (1) Determine what the question is really asking; look for key words; (2) Read each answer thoroughly and see if it completely covers the material asked by the question; (3) Narrow the choices by immediately eliminating answers you know are incorrect.