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IHP 310 -Pediatric Considerations Assignment
IHP 310 -Pediatric Considerations Assignment
MULTIPLE CHOICE
- The nurse is preparing to administer a medication to a 6-month-old infant. The nurse will monitor closely for signs of drug toxicity based on the knowledge that, compared to adults, infants have
| a. | an increased percentage of total body fat. |
| b. | immature hepatic and renal function. |
| c. | more protein receptor sites. |
| d. | more rapid gastrointestinal transit time. |
ANS: B
The liver and kidneys are the primary organs for metabolism and excretion and are immature in infants. This allows drugs to accumulate and increases the risk for drug toxicity. Infants have a lower proportion of body fat than adults and fewer protein receptors. They do have more rapid gastrointestinal transit time, but this decreases the amount of drug absorbed.
DIF: Cognitive Level: Understanding (Comprehension) REF: pp. 44-45
TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The nurse reviews information about a drug and learns that it is best absorbed in an acidic environment. When giving this drug to a 1-year-old patient, the nurse will expect to administer a dose that will be
| a. | equal to an adult dose. |
| b. | less than an adult dose. |
| c. | more than an adult dose. |
| d. | twice the usual adult dose. |
IHP 310 -Pediatric Considerations Assignment
- The nurse assumes care for an infant who is showing signs of drug toxicity to a drug given several hours prior. The nurse checks the dose and confirms that the dose is consistent with standard dosing guidelines. Which characteristic of the drug will likely explain this response in this patient?
| a. | It is acidic. |
| b. | It is highly protein-bound. |
| c. | It is not fat-soluble. |
| d. | It is water-soluble. |
DIF: Cognitive Level: Applying (Application) REF: p. 45
TOP: Nursing Process: N/A
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The parent is concerned about giving a child medication because of the lack of knowledge about the effects of drugs on children. The nurse discusses legislation passed in 2012 about pediatric pharmacology. Which is true about this law?
| a. | It forbids providers from prescribing medications unless they have been U.S. Food and Drug Administration (FDA) approved for use in children. |
| b. | It mandates consistent, evidence-based dosing guidelines for use in children. |
| c. | It provides federal grants to fund pediatric pharmaceutical research. |
| d. | It requires drug manufacturers to study pediatric medication use. |
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 44
TOP: Nursing Process: N/A
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The nurse will administer an intravenous (IV) medication to an adolescent patient. When preparing the adolescent for the IV insertion, which is an appropriate action by the nurse?
| a. | Allowing the patient to verbalize concerns about the procedure |
| b. | Covering the insertion site with a bandage after the procedure is completed |
| c. | Explaining any possible adverse drug reactions |
| d. | Reassuring the patient that only one body part will be used |
DIF: Cognitive Level: Applying (Application) REF: p. 48
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- An infant will receive a topical medication. What instruction will the nurse include when teaching the parents how to administer the medication?
| a. | “Apply a thin layer to the affected area.” |
| b. | “Apply liberally to the skin on and around the area.” |
| c. | “Use the medication less frequently than what is recommended for adults.” |
| d. | “Use the medication more frequently than what is recommended for adults.” |
IHP 310 -Pediatric Considerations Assignment
DIF: Cognitive Level: Applying (Application) REF: p. 44
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Health Promotion and Maintenance
- The provider has ordered that vitamin D drops be given to a newborn. Based on the knowledge of drug distribution in infants, the nurse understands that the infant may need
| a. | a higher dose. |
| b. | a lower dose. |
| c. | less frequent dosing. |
| d. | more frequent dosing. |
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 45
TOP: Nursing Process: N/A
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The nurse is caring for a 5-year-old child. The child is taking a drug that has a known therapeutic range in adults, and the nurse checks that the ordered dose is correct and notes that the child’s serum drug level is within normal limits. The child complains of a headache, which is a common sign of toxicity for this drug. Which action will the nurse take?
| a. | Administer the drug since the drug levels are normal. |
| b. | Attribute the headache to nondrug causes. |
| c. | Hold the next dose and contact the provider. |
| d. | Request an order for an analgesic medication. |
DIF: Cognitive Level: Applying (Application) REF: p. 45
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Health Promotion and Maintenance
- The nurse is preparing to give a 7-year-old child a bitter-tasting oral medication. The child asks the nurse if the medicine tastes bad. To help the child take this medication, which action will the nurse take?
| a. | Allow the child to delay taking the medication until the parent arrives. |
| b. | Enlist the assistance of other staff to help restrain the child. |
| c. | Tell the child that it doesn’t taste bad if it is swallowed quickly. |
| d. | Tell the child that it tastes bad and offer a choice of beverages to drink afterward. |
DIF: Cognitive Level: Applying (Application) REF: p. 47
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The nurse is preparing to administer an oral liquid medication to an 11-month-old child who is fussy and uncooperative. Which action will the nurse take to facilitate giving this medication?
| a. | Adding honey to the medication to improve the taste |
| b. | Putting the medication in the infant’s formula |
| c. | Requesting an injectable form of the medication |
| d. | Using a syringe and allowing the parent to give the medication |
DIF: Cognitive Level: Applying (Application) REF: p. 47
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- A 2-year-old child will receive several doses of an intramuscular medication. The nurse caring for this child will use which intervention to help the child cope with this regimen?
| a. | Allowing the child to give “pretend” shots to a doll with an empty syringe |
| b. | Allowing the child to select a Band-Aid to wear after each medication is given |
| c. | Ensuring privacy while giving the medication |
| d. | Explaining that the medicine will help the child to feel better |
IHP 310 -Pediatric Considerations Assignment
DIF: Cognitive Level: Applying (Application) REF: p. 47
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- A preschool-age child has moderate dehydration and needs a rapid bolus of fluids. To provide atraumatic care and administer fluids most effectively, what action will the nurse take?
| a. | Wait until the child is sleeping to insert the IV. |
| b. | Ask the child’s parents to restrain the child during venipuncture so fluids may be administered. |
| c. | Request an order for nasogastric (NG) fluids to avoid the trauma of venipuncture. |
| d. | Use a lidocaine preparation prior to insertion of the IV needle. |
DIF: Cognitive Level: Applying (Application) REF: p. 47
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The nurse is preparing to administer an intramuscular medication to a 4-year-old child who starts to cry and screams, “I don’t want a shot!” What is the nurse’s next action?
| a. | Acknowledge that shots hurt and tell the child to be brave. |
| b. | Engage the child in a conversation about preschool and favorite activities. |
| c. | Enlist the assistance of another nurse to help restrain the child. |
| d. | Explain to the child that it will only hurt for a few seconds. |
DIF: Cognitive Level: Applying (Application) REF: p. 48
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- A 14-year-old female who has type 1 diabetes mellitus that has been well controlled for several years is admitted to the hospital for treatment of severe hyperglycemia. The patient’s lab values indicate poor glycemic control for the past 3 months. The nurse caring for this patient will suspect which cause for the change in diabetic control?
| a. | Adolescent rebellion and noncompliance |
| b. | Changes in cognitive function |
| c. | Hormonal fluctuations |
| d. | Possible experimentation with drugs or alcohol |
DIF: Cognitive Level: Applying (Application) REF: p. 48
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
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- The nurse is teaching a 15-year-old female patient and her parents about an antibiotic the adolescent will begin taking. The drug is known to decrease the effectiveness of oral contraceptive pills (OCPs). The nurse will
| a. | ask the adolescent and her parents whether she is taking OCPs. |
| b. | tell her parents privately that pregnancy may occur if she is taking OCPs. |
| c. | tell her privately that the medication may decrease the effectiveness of OCPs. |
| d. | warn her and her parents that she may get pregnant if she is relying on OCPs. |
IHP 310 -Pediatric Considerations Assignment
ANS: C
When soliciting adolescent health histories, the nurse should consider issues related to sexual practices and should provide privacy when asking sensitive questions or giving sensitive information. The other actions do not allow for patient privacy.
DIF: Cognitive Level: Applying (Application) REF: p. 48
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- What is NOT a challenge associated with over-the-counter (OTC) medication and the pediatric client?
| a. | Many OTC drugs have not been tested thoroughly in children. |
| b. | OTC cough and cold medication contain a combination of ingredients. |
| c. | Children’s doses are often expressed in terms of age range. |
| d. | OTC drugs should not be given to children under the age of 2. |
DIF: Cognitive Level: Applying (Application) REF: p. 49
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The parent of a school-age child tells the nurse that the child often misses the midday dose of a medication because the child forgets to take it to school. What will the nurse suggest?
| a. | Asking the pharmacist to divide the prescription into two labeled packages |
| b. | Discussing a different medication with the child’s provider |
| c. | Putting the bottle of pills in the child’s lunchbox |
| d. | Requesting permission for the child to come home from school during the day |
DIF: Cognitive Level: Applying (Application) REF: p. 50
TOP: Nursing Process: Planning/Nursing Intervention
MSC: NCLEX: Health Promotion and Maintenance