Pharm 2 adaptive
Which drug may cause sudden infant death syndrome? Nalidixic acid Promethazine ***Phenothiazines Hexachlorophene
Phenothiazines may cause sudden infant death syndrome. Nalidixic acid may cause cartilage erosion in children. Promethazine may cause respiratory depression in children under the age of 2 years. Hexachlorophene causes central nervous system toxicity, especially in infants.
Which type of immune preparation, made from donated blood, contains antibodies that provide passive immunity?
Specific immune globulin Specific immune globulins contain a high concentration of antibodies directed at specific antigens. Toxoid vaccines contain a bacterial toxin that has been changed to a nontoxic form. Killed vaccines contain killed microbes or isolated microbes. Live attenuated vaccines are composed of live microbes that have been weakened or rendered completely avirulent. Breat milk is a natural one.
Which adverse effect on pediatric clients is associated with nalidixic acid? Kernicterus Gray syndrome Tendon rupture ***Cartilage erosion
Nalidixic acid can cause cartilage erosion in pediatric clients. Sulfonamides can cause kernicterus. Chloramphenicol can cause Gray syndrome in neonates and infants. Fluoroquinolones can cause tendon rupture in pediatric clients.
Hypertension develops in a school-aged child with acute glomerulonephritis. What medication does the nurse anticipate that the healthcare provider will prescribe? Digoxin ***Furosemide Diazepam Phenytoin
Furosemide inhibits the reabsorption of sodium and chloride from the loop of Henle and distal tubule, increasing urine output and thereby decreasing blood pressure. Digoxin increases the contractility and output of the heart; it is not an antihypertensive. Diazepam is inappropriate; it relaxes skeletal muscle, not the smooth muscle of the arterioles. Phenytoin is an anticonvulsant; it does not reduce blood pressure.
A 6-year-old child is about to have an intravenous catheter inserted. What is the nurse's best response when the child starts to cry?
"Do you want the IV in your right or left arm? Giving the child a choice provides a sense of control over the fearful situation. Children need assistance in coping and should not be left alone when afraid. Six-year-old children fear bodily harm, especially disfigurement. Fears should be acknowledged, not minimized. The child is too fearful to care about the effect of the medication.
Which statements are true regarding the pharmacokinetic changes observed in infants? Select all that apply.
An infant's fat content is higher ***An infant's gastric pH is less acidic ***An infant's gastric emptying is slow ***An infant's first-pass metabolism is slow An infant's transdermal absorption is rapid
A nurse is planning to screen a school-aged child for impaired hearing because the child is receiving an antibiotic that affects hearing. Which medication does the nurse suspect may have caused hearing impairment? Amoxicillin Ciprofloxacin Clindamycin ***Gentamicin
Gentamicin can be ototoxic because of its effects on the eighth cranial nerve. Reactions to amoxicillin are usually allergic in nature. Impaired hearing does not occur with ciprofloxacin or with clindamycin.
Which type of vaccines triggers the recipient's immune system to produce antitoxins?
Toxoid vaccines 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
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.
A child with acute lymphoid leukemia is started on a chemotherapy protocol that includes prednisone. What side effect of this medication does the nurse anticipate? Alopecia Anorexia Weight loss ***Mood changes
Mood swings may result from steroid therapy. Alopecia does not result from steroid therapy. An increased appetite, not anorexia, results from steroid therapy. Weight gain, not weight loss, results from steroid therapy.
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?
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.
Which vaccination is given to young children to provide protection against tetanus and diphtheria but not pertussis?
DT 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.
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? ***It may cause transient diarrhea. One dose is all that will be needed. Rectal itching will be relieved the next day. Other family members will not need to take it.
Diarrhea is expected with the administration of mebendazole; the parents should be informed so they do not become alarmed. Reinfestation is common; the medication should be taken again in 2 weeks. The medication will not affect rectal itching; it will eradicate the pinworms, and this takes time to accomplish. All family members should take the medication because cross-contamination frequently occurs.
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?
6:00 AM, 2:00 PM, 10:00 PM
The alkylating agent cyclophosphamide is prescribed for a school-aged child with cancer. What is the most important sign or symptom for the nurse to be alert for while the child is receiving this medication? Irritability Unpredictable nausea ***Pain with urination Hyperplasia of the gums
Cystitis is a potentially serious adverse reaction to cyclophosphamide; it sometimes can be prevented by increasing hydration because the fluid flushes the bladder. Irritability may be present but is not a result of cyclophosphamide administration. Unpredictable nausea is an expected but manageable side effect of cyclophosphamide. Hyperplasia of the gums is unrelated to cyclophosphamide administration; it may occur with prolonged phenytoin therapy.
An adolescent with type 1 diabetes who has a history of inadequate adherence to therapy is admitted to the hospital with a blood glucose level of 700 mg/dL (38.9 mmol/L). A continuous insulin infusion is started. What complication should the nurse make a priority of detecting while the adolescent is receiving the infusion? Hypovolemia *** Hypokalemia Hypernatremia Hypercalcemia
Insulin causes potassium to move into the cells along with glucose, thereby reducing the serum potassium level. Hypokalemia can lead to lethal cardiac dysrhythmias. Insulin does not result in reduced blood volume, alter the sodium level directly, or affect calcium mobilization.
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. 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 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.
An 8-year-old child is being given insulin glargine before breakfast. What is the most appropriate information for the nurse to give the parents concerning a bedtime snack?
Offer a snack to prevent hypoglycemia during the night Insulin glargine is released continuously throughout the 24-hour period; a bedtime snack will prevent hypoglycemia during the night. Providing a snack when signs of hyperglycemia are present is unsafe because it intensifies hyperglycemia; if hyperglycemia is present, the child needs insulin. Because insulin glargine is a long-acting insulin, bedtime snacks are recommended to prevent a hypoglycemic episode during the night. When hypoglycemia develops, the child will be asleep; the child should eat the snack before going to bed.
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?
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.
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 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 levels of a drug will decrease. Levels of a drug cannot remain constant after drug absorption, nor will they immediately disappear.
A teenager with allergies is using oxymetazoline nasal spray. What effect should the nurse assess the client for if more than the recommended dose is taken? (Afrin)
Increased nasal congestion With frequent and continued use, oxymetazoline can cause rebound congestion of mucous membranes. Nasal polyps may be associated with allergies but are unrelated to nasal spray use. Ringing in the ears (tinnitus) is not associated with oxymetazoline, although this medication may cause hypotension, tachycardia, and dizziness. Bleeding tendencies are related to inadequate clotting mechanisms, which are not associated with the use of this nasal spray.
Which vaccine is administrated through the intranasal route?
Influenza (live) 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.
Which antiepileptic drug is used as the first-line treatment for absence seizures?
Valproic acid 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 2-year-old child is admitted to the hospital with severe pain. Which factors should be considered when administering opioids to this child? Select all that apply. Diet modification ***Dosing calculations Body mass index ***Presence of other symptoms ***Appropriate dosage form
While administering opioids in children, the dose must be calculated and double-checked to avoid errors because excessive doses may be fatal in children. Opioids may cause side effects such as hallucinations and dizziness; therefore, the child should be monitored for signs and symptoms indicating side effects. Proper dosage forms such as oral, subcutaneous, and rectal administration of drugs should be chosen according to the client's condition. Diet modification and information on body mass index of the client is not required for the administration of opioids.
The nurse is teaching the parents of an epileptic child about disease management. Which statement made by the parent indicates effective learning? Select all that apply. "My child should take carbamazepine before meals." "I should administer valproic acid along with milk." ***"I should stop giving phenytoin if any skin rash develops." ***"I should shake the suspension dosage forms before administering them to the child." ***"I should maintain a record to measure the symptoms of epilepsy before and after administration of drug."
With regard to disease management for an epileptic child, phenytoin may cause a hypersensitivity reaction leading to rashes. In such cases, phenytoin should be stopped, and the prescriber should be informed. All suspension dosage forms are shaken before administration; shaking allows uniform distribution of the drug throughout the solvent. Maintaining a record helps the healthcare team evaluate and alter the possible outcomes of treatment if needed. Carbamazepine should be taken with meals, rather than before, to reduce gastrointestinal distress. Valproic acid should not be administered with milk since it irritates the gastric mucosa.
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? Whenever a bleed is suspected ***In the morning on scheduled days At bedtime while the child is lying quietly in bed On a regular schedule at the parents' convenience
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.
