Peds Practice Exam

What is a child's body surface area in square meters if the child weighs 7 kg and has a height of 25 inches? Record your answer to two decimal places.

Answer: 0.35m^2 Rationale: To calculate body surface area, both height and weight must be in metric units. To convert height from inches to centimeters, a nurse multiplies 25 in by 2.5 cm/1 in to yield 62.5 cm. A nurse then multiplies 62.5 cm by the patient's weight of 7 kg and divides the product by 3,600. The square root of the quotient is then taken to yield 0.349, which rounds to 0.35 m^2

How many grams per kilogram is a pediatric patient receiving if the patient weighs 9 kg and is prescribed 4.5 g/d of the medication? Include a leading zero if applicable. Record your answer using one decimal place. _____g/kg

Answer: 0.5 g/kg Rationale: The medication administered per kilogram equals 4.5 g divided by 9 kg, which is 0.5 g/kg.

What is a child's body surface area in square meters if the child weighs 22 kg and is 65 cm in height? Record your answer using two decimal places.

Answer: 0.63 m^2 Rationale: The formula to determine body surface area by the square root method is the square root of the product of the patient's weight (in kg) and height (in cm) divided by 3,600. Thus a nurse would plug in 22 for the weight and 65 for the height, divide by 3,600, and take the square root of that number to get 0.63 square meters.

How many milliliters will a nurse administer for each dose to a 13-lb pediatric client who is ordered phenytoin (Dilantin) oral suspension 5 mg/kg/day in two divided doses and the product available comes in a concentration of 125 mg per 5 mL? Use a leading zero if applicable. Record your answer using one decimal place.

Answer: 0.6mL Rationale: The nurse first converts the client's weight into kilograms by dividing 13 by 2.2 to get 5.9 kg. If the client is to receive 5 mg per kilogram of the drug daily, the nurse multiplies 5 times the weight, 5.9 kg, to get 29.5 mg total per day. If there are 125 mg in every 5 mL of solution, the nurse multiplies 5 times 29.5 to get 147.5, then divides it by 125 to determine that the client receives 1.2 mL per day. The nurse divides this by 2 (doses) to yield 0.6 mL per dose.

What is the 24-hour maintenance fluid requirement for a pediatric patient weighing 11 kg? Record answer using whole number. Use a comma if applicable.

Answer: 1,050mL Rationale: Fluid requirements for a pediatric patient who weighs between 10 and 20 kg is 1,000 mL + 50 mL/kg for every kg over 10 kg. For a patient weighing 11 kg, the 24-hour maintenance fluid requirement would be 1,000 mL for the first 10 kg and with an additional 50 mL added for the 11th kg. 1,000 mL + 50 mL = 1,050 mL in 24 hours.

How many grams of ceftriaxone will the nurse administer to a 66-lb pediatric client who is prescribed a one-time intramuscular dose of ceftriaxone at 50 mg/kg? Record your answer using one decimal place.

Answer: 1.5g Rationale: The nurse converts the client's weight of 66 lb to kilograms by dividing by 2.2 to yield 30 kg. A nurse then multiplies the client's weight of 30 kg by 50 mg/kg to yield a dose of 1,500 mg. To convert to grams, the nurse divides 1,500 by 1,000 to yield 1.5 g.

Calculate the drops per minute for 1,500 mL of an intravenous medication to be administered for 24 hours via burette to a pediatric patient. The drop factor is 10. Record your answer using a whole number. _____gtt/min

Answer: 10 gtt/min Rationale: Calculation of mL per hour: Total volume (TV) of the drug is 1,500 mL. Total time (TT) of infusion is 24 hours. Formula: TV/TT = 1,500/24 = 62.5 mL Calculation of drops per minute: Volume of drug to be infused per hour = 62.5 mL Drop factor of the drip = 10 Formula: drops per min = drop factor/time (minutes) x total volume 10/60 x 62.5 = 10.41 Drops can be timed only in whole numbers, so the drops per minute should be 10. 1,500 x 10/24 x 60 = 10.4, rounded to 10 (you cannot give a partial drop)

A nurse is preparing to administer a medication to a child weighing 30 pounds. Determine the patient's weight in kilograms. Record answer using one decimal place.

Answer: 13.6 kg Rationale: To determine weight in kg using the formula method, 2.2 lb : 1 kg 30 lb : x kg 2.2x : 30 x : 13.63 kg --> 13.6kg

What is the daily dose in milligrams per day for 20 mg/kg/d divided every 8 hours that can be administered to a child who weighs 6.5 kg?

Answer: 130mg/d Rationale: The usual minimum child dosage is 20 mg/kg/d in divided doses every 8 hours. The child's weight is 6.5 kg. Therefore the minimum daily dose is 20 mg/kg/d multiplied by 6.5 kg, which equals 130 mg/d.

How many drops per minute will a nurse set an intravenous infusion if a health care provider has ordered 90 mL of an intravenous fluid to be infused for a pediatric patient over 1 hour if the administration set has a drop factor of 10 gtt/mL? Record your answer using a whole number.

Answer: 15 gtt/min Rationale: Using dimensional analysis, a nurse will take 90 mL/1 h and multiply it by 1 h/60 min and 10 gtt/mL to yield 15 gtt/min

How many drops per minute will a nurse set an intravenous infusion if a health care provider ordered 1,800 mL of an intravenous fluid to be infused for a pediatric patient over 12 hours if the administration set has a drop factor of 60 gtt/mL? Record your answer using a whole number.

Answer: 150 gtt/min Rationale: Using dimensional analysis, a nurse will take 1,800 mL/12 h and multiply it by 1 h/60 min and 60 gtt/mL to yield 150 gtt/min.

What is the minimum safe dosage for an infant who weighs 4,048 g if the recommended dose for a medication is 8 to 12 mcg/kg/d divided q12h? Include a leading zero if applicable. Record your answer using one decimal place.

Answer: 16.2 mcg/dose Rationale: To figure out the safe and therapeutic minimum dose for this medication for an infant who weighs 4,048 g, a nurse converts the infant's weight from grams to kilograms by dividing by 1,000 to yield 4.048 kg. A nurse then multiplies the infant's weight by the lower end of the range: 4.048 kg × 8 mcg/kg/d to yield a daily dose of 32.38 mcg. Because the daily dose is given in divided doses every 12 hours, a nurse divides the daily dose by 2 to get 16.19 mcg per dose.

The nurse needs to give acetaminophen 12.5 mg/kg PO every 4 hours as needed for a child with a temperature of 100.5°F who weighs 65 lb. Acetaminophen is available as 100 mg/5 mL. How much medication will the nurse administer with each dose? Record your answer using one decimal place.

Answer: 18.4 mg/mL Rationale: 65 lb/2.2 kg = 29.5 kg 29.5 kg x 12.5 mg/kg = 368.75 mg 368.75 mg / 100 mg x 5 mL = 18.4 mL (recorded using one decimal place)

Cefdinir 14 mg/kg/day orally is ordered for a child weighing 50 lb. The medication is available as an oral suspension that provides 125 mg/5 mL. How many teaspoons will the nurse instruct the child's parents to administer? Record your answer using a mixed fraction.

Answer: 2.5 Rationale: Convert 50 lb x 2.2 lb/kg = 22.7 kg. Then take cefdinir 14 mg x 22.7 kg = 317.8 mg/day. The oral suspension provides 125 mg/5 mL. Hence, the nurse will take 317.8 mg/125 mg x 5 mL = 12.7 mL. There are 5 mL per teaspoon. 12.7 mL/5 mL = 2.54 tsp = 2½ tsp

How many milliliters per hour is the 24-hour fluid maintenance requirement for a patient receiving 750 mL over 24 hours? Record your answer using a whole number.

Answer: 31mL/hr Rationale: A nurse takes the fluid requirement of 750 mL and divides it by 24 hours to yield 31.25 mL/h. This appropriately rounds to 31 mL/h.

What is the dose in milligrams of a medication prescribed at 8 mg/kg for a patient weighing 4 kg? Record your answer using a whole number.

Answer: 32mg Rationale: If a patient weighs 4 kg and the rate is 8 mg/kg, a nurse will multiply 4 kg by 8 mg/kg to get 32 mg as the dose.

The body surface area of a pediatric patient is 0.2 m^2 . If the dose ordered is 15 mg/m^2, calculate the dose to be given to the patient.

Answer: 3mg Rationale: To determine the dose, the nurse multiplies 0.2 by 15 to get 3 mg

Calculate the dosage required for a pediatric patient with a height of 120 cm and weight of 24 kg for a medication whose recommended dose is 5 mg/m^2 . Include a leading zero if applicable. Record your answer using one decimal place.

Answer: 4.5 Rationale: The nurse determines the patient's body surface area using the square root formula. In this case, the nurse multiplies 24 by 120 and then divides the product by 3,600. The nurse then takes the squareroot of this number. The result is 0.89. After this, 0.89 is multiplied by 5 to get 4.45 mg; 4.45 rounds up to 4.5 mg.

A patient weighing 134 lb is prescribed heparin using the protocol below. How many units does a nurse deliver for the bolus of heparin? Round to the nearest hundred. Bolus dose of 70 units/kg rounded to the nearest 100 units

Answer: 4300 units Rationale: 134lbs/2.2 = 60.90kg x units= 70 units x 60.9kg = 4263.63 Rounded to the nearest 100 units becomes 4300 units

How many micrograms per milliliter of dobutamine will a patient receive if the drug is ordered at 12 mcg/kg/min to run at 2.4 mL/h for a child weighing 18 kg? Record your answer using a whole number

Answer: 5,400 Rationale: A nurse will multiply the patient's weight of 18 kg by the dosage rate of 12 mcg/kg/min to yield 216 mcg/min. A nurse will then multiply 216 mcg/min by 60 min/1 h and then by 1 h/2.4 mL to yield 5,400 mcg/mL

How many milligrams of amoxicillin will a nurse administer to a child weighing 77 lb if the healthcare provider has prescribed amoxicillin 20 mg/kg PO? Record your answer using a whole number.

Answer: 700mg Rationale: The child weighs 77 lb. First, to convert the lb in the equation to kg, divide it by 2.2 (1 kg is equal to 2.2 lb). 77 / 2.2 = 35 kg. The dosage required is 20 mg/kg. Therefore, the nurse multiplies the child' s weight of 35 kg x 20 mg/kg to yield 700 mg.

How many milliliters per hour is the 24-hour fluid maintenance requirement for a neonate weighing 4 lbs and is receiving 100 mL/kg per 24 hours? Record your answer using a whole number.

Answer: 8mL/hr Rationale: A nurse takes a patient's weigh of 4 lb and multiplies by 1 kg/2.2 lb to yield a weight of 1.8 kg. A nurse then multiplies a patient's weight of 1.8 kg by the fluid maintenance requirement of 100 mL/kg to yield 180 mL. This total of 180 mL is divided by 24 hours to yield a rate of 7.5 mL/h, which rounds to 8 mL/h.

Which parameter affects the maximum amount of intravenous fluid intake for a pediatric patient? A- Body weight B- Dietary intake C- Age of the child D- Medication ordered

Answer: A Rationale: The maximum amount of intravenous fluid varies with body weight. The patient's 24-hour fluid status is monitored closely to prevent overhydration. The medication ordered may be diluted based on the type of medication and the route of administration. The dietary intake refers to liquid and solid foods. The child's age does not affect maximum fluid intake because weight can vary in children of the same age.

Which statement regarding therapy is correct if the safe dose for an intravenous medication is 2 to 5 mcg/kg/min and a health care provider prescribes 100 mcg/min intravenous for a 55-lb pediatric patient? A- The prescription is safe for the patient. B- The prescription exceeds the safe dose range C- The prescription requires clarification from the health care provider. D- The prescription is less than the minimum required dose.

Answer: A Rationale First, a nurse converts the patient's weight from pounds to kilograms: 55 lb × 1 kg/2.2 lb = 25 kg. The minimum safe dose is 2 mcg multiplied by 25 kg, which is 50 mcg/min. The maximum limit of the safe dose range is 5 mcg multiplied by 25 kg, which is 125 mcg/min. The prescribed rate of 100 mcg/min falls in between the acceptable range of 50 and 125 mcg/min. Therefore the prescription is safe for the patient. The prescription does not exceed the safe dose range of 125 mcg/min and does not require any clarification from the health care provider. The prescription is not less than the minimum required dose of 50 mcg/min

Which statement is correct regarding a health care provider's order for morphine sulfate 1.5 mg intravenous (IV) q4h for pain for a child who weighs 24 lb when the recommended single dose is 0.1 to 0.2 mg/kg q4h? A- A nurse can safely administer the prescribed dose. B- Morphine sulfate cannot be prescribed for pediatric patients. C- A variation of 10% from the safe dose range is acceptable for pediatric patients. D- A nurse should contact the health care provider because the dose is not within the safe range.

Answer: A Rationale First, a nurse converts the patient's weight from pounds to kilograms: 24 lb × 1 kg/2.2 lb = 10.91 kg. A nurse then multiplies the patient's weight by the dosing range: 0.1 mg/kg × 10.91 kg yields 1.09 mg as the minimum dose, and 0.2 mg/kg × 10.91 kg yields 2.18 mg as the maximum dose. Therefore the order of morphine sulfate 1.5 mg IV q4h can be safely administered because it falls in the range of 1.09 to 2.18 mg. Morphine sulfate is a potent painkiller that can be prescribed for pediatric patients. The rule of 10% variation is often applied with adults, but not always in the pediatric setting. Because the drug is prescribed within the safe range, a nurse does not need to contact the health care provider

Which step will a nursing student complete after taking a 5-year-old boy's weight of 18.4 kg and multiplying by his height of 109.2 cm to calculate his body surface area? A- Divide the product by 3600. B- Convert the units for height and weight. C- Take the square root of the quotient. D- Round the number to the nearest hundredth.

Answer: A Rationale: A nursing student should divide the product of the weight in kilograms times the height in centimeters by 3,600 and then find the square root of the quotient. If the weight was reported in pounds and the height in inches, a nursing student would need to convert them to kilograms and centimeters, respectively. However, the parameters are reported in the correct units. Taking the square root of the quotient would occur after a nursing student has divided the product by 3,600. Rounding to the nearest hundredth is the final step in a body surface area calculation

A pediatric patient weighing 66 pounds has been prescribed gentamycin 175 mg intravenous (IV) every 12 hours, and the safe and therapeutic dosage range is 5 to 7.5 mg/kg in 24 hours. Which action does the nurse take based on the prescription? A. Contact the provider because the dose is too high. B. Administer the prescription of 175 mg IV every 12 hours as ordered. C. Administer a single dose of 175 mg IV and then adjust the second dose to 50 mg. D. Administer 112.5 mg every 12 hours so as to not exceed the safe and therapeutic range.

Answer: A Rationale: Calculate the safe and therapeutic range in 24 hours. Minimum: Maximum: Prescribed dose in 24 hours = 175 mg x 2 = 350 mg. This dosage is over the safe and therapeutic level of 225 mg. A nurse needs to contact the provider to make an adjustment to the dosage. The nurse cannot make any adjustment without contacting the provider. The nurse should not administer a dose that is too high as it increases the risk for adverse effects.

Which nursing action is correct if the safe dose range for a medication is 2.5 to 4.5 mg/kg/dose and a health care provider orders 50 mg of the medication to be administered to a 12-kg pediatric patient? A. A nurse carries out the order. B. A nurse modifies the dose to safe limits. C. A nurse calls the health care provider for clarification. D. A nurse holds the medication administration.

Answer: A Rationale: To determine the safe dose range, a nurse multiplies the patient's weight by the lower end of the range (12 kg × 2.5 mg/kg) to yield 30 mg and multiplies the patient's weight by the upper end of the range (12 kg × 4.5 mg/kg) to yield 54 mg. The prescribed daily dose of the drug is 50 mg, which is well within the safe limit. Hence, a nurse should carry out the order without any further questions. A nurse cannot modify the dose without the consent of the health care provider. Because the prescribed dose is within the safe limit, a nurse does not need to call the health care provider for any clarification or hold the administration of the medication

Which body surface area in square meters is correct for a child weighing 30 kg and measuring 120 cm in height? A- 1.00 B- 1.07 C- 1.15 D- 3.69

Answer: A Rationale: Using the formula for calculating body surface area, a nurse will multiply the weight in kilograms and the height in centimeters. The product is then divided by 3,600. The square root of the quotient gives a child's body surface area in square meters: [30 kg × 120 cm]/3,600 and take the square root of the quotient to yield 1.00 m ; 1.07, 1.15, and 3.69 m are larger answers that may be derived by miscalculations.

Which range of milliliters per dose will a nurse administer to a pediatric patient receiving acetaminophen 10 to 15 mg/kg every 4 to 6 hours for a fever higher than 101.5°F if the child weighs 43 lb and the product is available as 160 mg/5 mL? A. 2.2 to 19.5 B. 6.1 to 9.14 C. 10 to 15 D. 15 to 20

Answer: B Rationale: First, a nurse calculates the patient's weight in kilograms by dividing 43 by 2.2; the patient weighs 19.5 kg. If the dose is 10 to 15 mg/kg, a nurse multiplies the dosage range by the child's weight to determine the child will receive 195.5 to 292.5 mg of acetaminophen. If there are 160 mg in 5 mL, a nurse multiplies 5 by the low end of the range, 195.5, to get 975, then divides this by 160 to determine that the child can receive 6.1 mL. To determine the high end, a nurse multiplies 5 by 292.5 to get 1,462.5, then divides this by 160 to determine that 9.14 mL is the maximum dose the child can receive. The range of 2.2 to 19.5 contains quantities that are both too low and too high. The range of 10 to 15 mL and 15 to 20 mL are both too high

What is the minimum dose of a medicine dosed at 20 mg/kg/d in four divided doses that can be administered to a pediatric patient who weighs 25 kg? A- 31.25 mg B- 125 mg C- 500 g D- 500 mg

Answer: B Rationale: The minimum safe dose range is 20 mg/kg multiplied by 25 kg, which equals 500 mg per day. The dose of 500 mg should be given in four divided doses, so a nurse divides 500 by 4 to get 125 mg per dose. A dose of 500 mg is the total daily dose, not a single dose. A dose of 31.25 mg is too small. A dose of this medication would not be measured in grams.

Which body surface area in square meters is accurate for a child who weighs 10.5 lb and has a height of 15 inches? A. 0.050 B. 0.209 C. 0.225 D. 0.890

Answer: C Rationale: The formula to determine body surface area by the square root method is the square root of [patient's weight in kg] × [patient's height in cm]/3,600. Therefore, in this case, a nurse converts the patient's weight from 10.5 lb by dividing by 2.2 to yield 4.77 kg. The height of 15 inches is multiplied by 2.5 cm to yield 37.5 cm. A nurse multiples 4.77 kg by 37.5 cm and divides the product by 3,600, and finally a nurse takes the square root of the quotient to yield 0.225 meters squared. The other options, 0.209 m , 0.050 m , and 0.890 m , are incorrect calculations.

Which amount in milligrams for each dose is correct for an infant weighing 2.8 kg who is prescribed a medication dosed as 1.5 mg/kg/d divided in four equal doses? A. 0.25 mg/dose and 1.00 mg/day B. 0.50 mg/dose and 2.00 mg/day C. 1.05 mg/dose and 4.20 mg/day D. 4.20 mg/dose and 16.80 mg/day

Answer: C Rationale: To determine the amount of drug for each dose, the nurse multiples an infant's weight of 2.8 kg by the dose of 1.5 mg/kg/d, which yields a total of 4.20 mg/d. Given that the daily dose is provided in four equal doses, a nurse would divide 4.20 mg by 4 to yield 1.05 mg for each dose. The amounts of 0.25 and 0.50 mg are below this quantity, and 4.20 is the total dose received each day and not representative of each individual dose

A neonate weighing 2.1 kg is ordered dopamine 2.5 mcg/kg/min at 0.75 mL/hr in the neonatal critical care unit. Dopamine is available as 200 mg/5 mL, and the pediatric dosage range is 2 to 20 mg/kg/min. The drug was diluted as follows: dopamine 25 mg in D5W to make a total of 50 mL for syringe pump. Which statement is correct in the given context? A- The nurse must administer the drug to the patient as per the dilution order. B- Infusion rate concentration is more than the dilution orders according to weight. C- Dilution concentration is more than the infusion rate according to weight. D- Dilution concentration and the infusion rate concentration according to weight are the same.

Answer: C Rationale: Concentration rate of the drug per minute: Infant's weight 2.1 kg x 2.5 mcg/kg/min = 5.25 mcg/min. Concentration rate of the drug per hour: 5.25 mcg/min x 60 min = 315 mcg/hour Concentration of the solution to be infused is obtained by dividing concentration per hour by the ordered mL per hour: (315 mcg/hr)/(0.75 mL/hr) = 420 mcg/mL Concentration of the solution to be obtained as per dilution instruction: 25 mg = 25,000 mcg. 25,000 mcg : 50mL x mcg : 1 mL 50 x = 25,000 x = 25,000/50 x = 500 mcg/mL Hence, the concentration of the drug according to weight obtained as per dilution order is more than the infusion rate. The nurse cannot administer the drug according to dilution order; he or she must check the concentration as per the infusion rate as well as dilution order and should ensure that both the concentrations are same. The nurse can administer the drug only when both the concentrations are the same, which is not true in this case.

Which dose of prednisolone in milligrams will the nurse administer to a 60-lb pediatric patient prescribed prednisolone 1 mg/kg every 12 hours for an asthma exacerbation? A. 21 B. 23 C. 25 D. 27

Answer: D Rationale: The nurse converts the patient's weight of 60 lb to kilograms by dividing by 2.2 to yield 27.3 kg. The nurse then multiples the weight in kilograms by 1 mg/kg to yield a dose of 27 mg. The amounts of 21 mg, 23 mg, and 25 mg are not enough.