GI/GU
Meds
Meds
When teaching a parent about giving omeprazole to their young child, which instruction is most important?
A. “Give the medication with or without food.”
B. “Give the medication 30 minutes before a meal.”
C. “Crush the capsule and mix with acidic juice like orange juice.”
D. “Double the dose if your child misses one.”
Correct Answer:
B. “Give the medication 30 minutes before a meal.”
Rationale: Omeprazole is most effective when given 30 minutes before meals to suppress acid production during digestion.
A nurse is caring for a child with impetigo. Under which of the following circumstances should oral antibiotics be considered?
A. Lesions are limited to a small area on the face.
B. Lesions are widespread or not responding to topical treatment.
C. The child is older than 12 years.
D. The child has a history of allergic reactions to penicillin.
Correct Answer:
B. Lesions are widespread or not responding to topical treatment.
Rationale: Oral antibiotics are indicated when impetigo is extensive, not responding to topical treatment, or if there is a risk of complications. Common oral antibiotics include amoxicillin/clavulanate, cephalexin, or dicloxacillin
A nurse is assessing a child who has been taking methotrexate for Juvenile Rheumatoid Arthritis. Which finding should be reported to the provider immediately?
A. Mild fatigue after school
B. Occasional nausea
C. Small mouth ulcers
D. Yellowish skin tone and dark urine
Correct Answer:
D. Yellowish skin tone and dark urine
Rationale: These signs suggest liver dysfunction or hepatotoxicity, a serious side effect of methotrexate. This requires immediate medical evaluation and likely lab testing.
Which statement by the parent of a child using an insulin pump requires further teaching?
A. “I still need to check my child’s blood sugar several times a day.”
B. “We can use a continuous glucose monitor with the pump.”
C. “If my child’s blood sugar is high, I can give a bolus dose through the pump.”
D. “We no longer need to monitor blood glucose now that the pump is in use.”
Correct Answer:
D. “We no longer need to monitor blood glucose now that the pump is in use.”
Rationale: Blood glucose monitoring is still necessary, even with a pump, to ensure effective glucose control and to identify pump malfunctions or insulin delivery issues.
A nurse is teaching the parent of a child prescribed Ritalin. Which statement by the parent indicates a need for further teaching?
A. “I will give the medication before breakfast.”
B. “I’ll monitor his weight weekly.”
C. “I can stop the medication during school breaks.”
D. “I’ll give an extra dose if my child is especially hyper.”
Correct Answer:
D. “I’ll give an extra dose if my child is especially hyper.”
Rationale: Ritalin should be given exactly as prescribed. Extra doses can cause serious side effects. PRN (as needed) use is not appropriate.
A 4-year-old child is brought to the emergency department after ingesting an unknown quantity of a medication approximately 30 minutes ago. The child is alert and has no signs of respiratory distress. The healthcare provider orders activated charcoal. Which of the following is the most appropriate nursing action?
A. Administer activated charcoal immediately, as it is effective within 1 hour of ingestion.
B. Delay administration until the child is sedated to prevent aspiration.
C. Administer activated charcoal only if the child is intubated.
D. Withhold activated charcoal if the child is alert and oriented.
Correct Answer:
A. Administer activated charcoal immediately, as it is effective within 1 hour of ingestion.
Rationale: Activated charcoal is most effective when administered within 1 hour of ingestion for certain substances, including acetaminophen. It works by adsorbing the toxin in the gastrointestinal tract, preventing further absorption. In this scenario, the child is alert and has no signs of respiratory distress, making immediate administration appropriate. Delaying or withholding activated charcoal is not recommended unless contraindications are present, such as altered mental status or risk of aspiration.
A 15-year-old adolescent presents with mild acne vulgaris characterized by comedones and occasional papules. Which of the following is the first-line treatment for this condition?
A. Oral isotretinoin
B. Topical benzoyl peroxide
C. Topical corticosteroids
D. Oral tetracycline
Correct Answer:
B. Topical benzoyl peroxide
Rationale: For mild acne, topical benzoyl peroxide is commonly used as it helps reduce bacteria and inflammation. Oral isotretinoin is reserved for severe cases, and corticosteroids can worsen acne. Tetracycline is an oral antibiotic used for moderate to severe acne
A nurse is reviewing immunization records for a child on immunosuppressive therapy for JRA. Which vaccine should be delayed or avoided?
A. Influenza (inactivated)
B. Human papillomavirus (HPV)
C. Measles, mumps, rubella (MMR)
D. Hepatitis B
Correct Answer:
C. Measles, mumps, rubella (MMR)
Rationale: Live vaccines (e.g., MMR, varicella) are generally contraindicated or delayed during immunosuppression due to the risk of infection. Inactivated vaccines are safe.
A nurse assesses a child with hypothyroidism who has been taking Synthroid for 3 months. Which finding indicates the dosage may be too low?
A. Increased appetite
B. Restlessness and irritability
C. Cold extremities and constipation
D. Excessive sweating and weight loss
Correct Answer:
C. Cold extremities and constipation
Rationale: These are signs of hypothyroidism, suggesting the dose may be too low. Dosage may need adjustment if symptoms persist.
Which of the following assessments should the nurse include when monitoring a pediatric client on Adderall? (Select all that apply.)
A. Height and weight
B. Blood pressure and heart rate
C. Blood glucose levels
D. Behavior and mood changes
E. Serum potassium levels
Correct Answers: A, B, and D
Rationale: Adderall can suppress growth, increase BP and HR, and cause mood or behavioral changes. Monitoring growth and cardiovascular status is essential.
A nurse is administering a dose of N-acetylcysteine (Mucomyst) for a Tylenol overdose to a 3yo child. What indicates appropriate nursing judgement?
A. Nurse administers the medication 24hrs post overdose.
B. Nurse mixes medication with a small amount of juice to mask the bad taste and smell, and increase compliance.
C. Nurse educates family that the acetaminophen blood levels peak 12hrs post overdose
D. Nurse explains that kidney enzymes are the most important lab work to monitor with Tylenol overdoses
Correct Answer:
B. Nurse mixes medication with a small amount of juice to mask the bad taste and increase compliance with taking the medication.
Rationale: medication has a bad smell and taste and the patient will need coaxing and upper too assist with compliance. Masking with a small amount of juice or even soda is recommended to help improve compliance.
An adolescent is prescribed topical tretinoin for acne vulgaris. Which of the following instructions should the nurse provide?
A. "Apply the medication to the entire face, even if only a few areas are affected."
B. "Use the medication once a day at bedtime."
C. "Avoid sun exposure while using this medication."
D. "Apply the medication after using astringents."
Correct Answer: C. "Avoid sun exposure while using this medication."
Rationale: Topical retinoids can increase sensitivity to sunlight, so it's important to avoid sun exposure and use sunscreen. Applying the medication to the entire face can help prevent new lesions, and it should be used as directed, typically at night. Astringents can irritate the skin and should be avoided.
A nurse is caring for a child receiving long-term corticosteroid therapy for muscular dystrophy. Which of the following findings should the nurse report to the healthcare provider?
A. Weight gain and puffy face
B. Difficulty sleeping
C. Frequent infections
D. Increased appetite
Correct Answer:
C. Frequent infections
Rationale: Corticosteroids suppress the immune system, making the child more vulnerable to infections. This must be reported immediately. While weight gain, insomnia, and increased appetite are common, they are less urgent unless severe.
The parent of a child using an insulin pump asks what to do when the child is sick. Which response by the nurse is appropriate?
A. “Stop the pump until your child feels better.”
B. “Check blood glucose and ketones more frequently.”
C. “Give double the usual insulin dose.”
D. “Only give insulin if your child eats.”
Correct Answer: B. “Check blood glucose and ketones more frequently.”
Rationale: During illness, blood glucose and ketones must be monitored closely. Insulin should still be administered, as illness can increase glucose levels even without eating.
A child with significant burns is started on proton pump inhibitor therapy. What is the primary purpose of this medication?
A. To reduce inflammation in burned tissue
B. To prevent stress-related gastric ulceration
C. To increase gastrointestinal motility
D. To manage nausea during dressing changes
Correct Answer:
B. To prevent stress-related gastric ulceration
Rationale: Burn patients are at risk for Curling’s ulcers. Prophylactic GI medications like PPIs reduce gastric acid and help prevent ulceration
While a child is receiving prednisone therapy for nephrotic syndrome, which of the following should the nurse monitor?
A. Blood glucose levels
B. Serum calcium levels
C. Hemoglobin and hematocrit
D. Serum potassium levels
Correct Answer:
A. Blood glucose levels
Rationale: Prednisone can cause hyperglycemia, so monitoring blood glucose levels is essential. It does not typically affect serum calcium, hemoglobin/hematocrit, or potassium levels.
Before applying a pediculicide to a child's scalp, what is the nurse’s most important action?
A. Instruct the child to shampoo with conditioner
B. Ensure the child’s hair is dry
C. Protect the child’s eyes with a dry towel
D. Leave the medication on the scalp for 30 minutes
Correct Answer:
C. Protect the child’s eyes with a dry towel
Rationale: The nurse should minimize eye exposure, as these agents can cause chemical conjunctivitis. The standard procedure is shampooing first (without conditioner), applying medication to damp or dry hair as directed, and ensuring it remains on for the recommended duration (often ~10 minutes) before rinsing
A nurse is reinforcing teaching to the parent of a child newly prescribed a urotrophin modulator for Duchenne Muscular Dystrophy (DMD). Which statement by the parent indicates correct understanding of the medication’s purpose?
A. “This drug will cure my child’s condition.”
B. “It helps replace the dystrophin gene my child is missing.”
C. “It may help slow the muscle damage caused by DMD.”
D. “It improves my child’s energy levels so he can exercise more.”
Correct Answer:
C. “It may help slow the muscle damage caused by DMD.”
Rationale: Urotrophin modulators aim to increase levels of urotrophin, a protein similar to dystrophin, to protect muscle fibers and slow disease progression. They do not cure the condition or replace the missing gene directly.
A child taking levothyroxine is scheduled for a follow-up. Which lab test does the nurse expect to be reviewed to evaluate the effectiveness of the therapy?
A. Serum potassium
B. Hemoglobin A1c
C. TSH (thyroid-stimulating hormone)
D. ALT (alanine transaminase)
Correct Answer:
C. TSH (thyroid-stimulating hormone)
Rationale: TSH and T4 levels are monitored to evaluate whether Synthroid is effectively maintaining thyroid hormone levels within the desired range.
Which nursing intervention is most appropriate before performing a dressing change on a pediatric burn patient?
A. Apply topical antimicrobial immediately prior to removal
B. Administer prescribed analgesic 30–60 minutes before the procedure
C. Cleanse the wound with hydrogen peroxide
D. Remove blisters using sterile forceps
Correct Answer:
B. Administer prescribed analgesic 30–60 minutes before the procedure
Rationale: Dressing changes are painful. Pre-medication with analgesia ensures comfort and cooperation. Hydrogen peroxide and blister debridement may delay healing or increase risk of infection
A 4-year-old child is diagnosed with a urinary tract infection (UTI). The healthcare provider prescribes an oral antibiotic. Which of the following antibiotics is commonly used as first-line treatment for UTIs in children?
A. Amoxicillin
B. Nitrofurantoin
C. Trimethoprim/sulfamethoxazole (Bactrim)
D. Ciprofloxacin
Correct Answer:
C. Trimethoprim/sulfamethoxazole (Bactrim)
Rationale: Trimethoprim/sulfamethoxazole is commonly used as a first-line oral antibiotic for treating UTIs in children. It is effective against common uropathogens like Escherichia coli. However, its use should be guided by local resistance patterns and patient-specific factors. Amoxicillin is less effective due to increased resistance, nitrofurantoin is not recommended for pyelonephritis, and ciprofloxacin is typically reserved for more severe infections due to its broad-spectrum activity and potential side effects.
Which scenario suggests treatment failure in a child treated with permethrin for scabies?
A. Mild itch persisting for 1 week
B. No visible burrows after 1 month
C. New lesions and pruritus 4 weeks after treatment
D. Rash improved but itching worsened initially
Correct Answer:
C. New lesions and pruritus 4 weeks after treatment
Rationale: Persistent or recurrent lesions or itching beyond 4 weeks may indicate reinfestation or application error—requiring reevaluation and possible retreatment
Which of the following signs in a child receiving antibiotics for osteomyelitis indicates possible nephrotoxicity?
A. Decreased urine output
B. Diarrhea
C. Rash on the trunk
D. Elevated temperature
Correct Answer:
A. Decreased urine output
Rationale: Many antibiotics, especially aminoglycosides, can cause kidney damage. Monitoring urine output helps detect nephrotoxicity early.
A nurse is teaching a parent how to mix NPH and regular insulin in one syringe. Which action is correct?
A. Draw up NPH insulin first, then regular insulin
B. Shake both vials before drawing up insulin
C. Draw up regular insulin first, then NPH insulin
D. Mix insulin doses and store in the fridge for later use
Correct Answer: C. Draw up regular insulin first, then NPH insulin
Rationale: Always draw up clear (regular) insulin before cloudy (NPH) to prevent contaminating the regular insulin with NPH.
A nurse is caring for a 5‑year‑old child with a partial‑thickness burn on the leg for which silver sulfadiazine (Silvadene) cream is prescribed. Which nursing action is most appropriate when performing the dressing change?
A. Cleanse the burn with povidone-iodine solution, then apply Silvadene twice daily.
B. Gently cleanse the wound with mild soap and warm water, rinse thoroughly, pat dry, then apply a thin layer of Silvadene and a clean non-adherent dressing.
C. Change the dressing every 8 hours to ensure the silver sulfadiazine remains effective.
D. Apply Silvadene cream liberally until it oozes, wrap the site tightly to promote healing.
Correct Answer: B
Rationale:
Silver sulfadiazine is applied as a thin layer on a clean, dry wound, covered with a non‑adherent dressing to prevent trauma at dressing removal
Cleansing should be with mild soap and warm water (or saline)—not harsh antiseptics like povidone-iodine or peroxide, which can impair healing
Dressing changes are typically done once daily, as more frequent changes can delay healing and increase risk of infection and discomfort
Overly tight wrapping risks edema; and excessive application of cream can interfere with skin assessment