Chapter 6 - Pediatric Considerations
A 4-year-old patient is discharged on an oral liquid drug suspension of 4 mL per dose. Which device will the nurse recommend to ensure the highest level of accuracy in home administration?
(a) Measuring spoon, (b) Graduated Medicine Cup, (c) Household teaspoon, (d) Oral syringe
What is an oral syringe
What is the best measure for the nurse to use to determine a patient's kidney function?
(a) Creatinine clearance, (b) Estimated glomerular filtration rate, (c) Serum creatinine level, (d) Blood urea nitrogen level
What is the estimated glomerular filtration rate
When caring for a patient recovering from an episode of opioid toxicity, the nurse determines that the patient has opioid use disorder based on which finding?
(a) Withdrawal symptoms, (b) A history of daily use, (c) Craving that results in drug-seeking behaviors, (d) Intravenous, rather than oral, use of the drug
What is a craving that results in drug-seeking behaviors
The Joint Commission recommends which of the following abbreviations for the "Do Not Use" list?
(a) qd, (b) NPO, (c) Subling, (d) bid
What is qd
The nurse is administering an intramuscular injection to a 5-year-old child. Choose the correct site the nurse will use.
(a) Ventral forearm, (b) Dorsogluteal, (c) Deltoid muscle, (d) Ventrogluteal
What is ventrogluteal
A parent is learning to administer drug to a school-age child. Which strategy will the nurse teach the parent to achieve cooperation in a child of this age?
(a) Enlisting physical restraint, (b) Establishing drug contracts, (c) Providing age-appropriate explanations, (d) Tolerating violent reactions
What is providing age-appropriate explanations
An older adult patient has just started on hydrochlorothiazide and is advised by the health care provider to eat foods rich in potassium. What is the nurse's best recommendation of foods to consume?
(a) Cabbage and corn, (b) Bread and cheese, (c) Avocados and mushrooms, (d) Brown rice and fish
What are avocados and mushrooms
A patient hospitalized with a fractured femur after an automobile accident develops nausea and vomiting, abdominal cramps, and restlessness. The nurse suspects that the patient is experiencing which reaction?
(a) Opioid withdrawal, (b) Alcohol toxicity, (c) Flashbacks from LSD use, (d) Nicotine withdrawal
What is opioid withdrawal
(a) Patient advocacy, (b) Technology, (c) Infection control, (d) Collaborative patient and family care
What is collaborative patient and family care
The clinic nurse is preparing to administer an intradermal injection. Which needle and gauge are most appropriate for this procedure?
(a) 3/4 to 5/8-inch needle, 25 to 27 gauge, (b) 5/8 to 1 1/2-inch needle, 18 to 25 gauge, (c) 1 to 1 1/2-inch needle, 20 to 21 gauge, (d) 1/4 to 1/2 inch needle, tuberculin syringe
What is 1/4 to 1/2 inch needle, tuberculin syringe
Which of the following strategies are helpful when working with adolescent patients to promote adherence? (Select all that apply)
(a) Allow flexibility in the treatment plan, (b) Use future-oriented examples and consequences to support the need for drug therapy, (c) Guarantee the adolescent patient privacy when obtaining history, (d) Set up a mutually developed drug contract
What is a and d
What changes with agin alter drug distribution? (Select all that apply)
(a) An increase in muscle mass and a decrease in fat, (b) A decrease in muscle mass and an increase in fat, (c) A decrease in serum albumin levels, (d) An increase in total body water, (e) A decrease in kidney mass
(a) Report the finding to the nursing supervisor to enable the nurse's participation in a nondisciplinary program, (b) Confront the nurse and demand that the drugs be returned before someone notices their absence, (c) Ask the nurse to request pain medications from a physician rather than stealing them from the hospital
What is Report the finding to the nursing supervisor to enable the nurse's participation in a nondisciplinary program
A patient refuses to take the prescribed medication. Which is the nurse's best response to this patient?
(a) Leave the medication at the patient's bedside, (b) Persuade the patient to take the medication, (c) Tell the patient there is no choice in the matter, (d) Explain the benefits and side effects of the drug
What is Explain the benefits and side effects of the drug
The nurse is teaching a patient to use an inhaler. What common teaching point is essential for the nurse to include?
(a) Cleaning the metered-dose inhaler is not recommended, (b) The semi-Fowler or high Fowler position is recommended, (c) Spacers decrease delivery of medication and are not used, (d) Nebulizers change the drug to a large-particle powder mist
What is the semi-fowler or high fowler position is recommended
A nurse caring for a child with a developmental delay prepares to teach the patient about prescribed drugs. Which actions are essential to ensure patient safety? (Select all that apply)
(a) Assess the child's developmental age, (b) Assess the side effects the same as those experienced by adults, (c) Consider the actions and uses of the drug, (d) Focus on the child's chronologic age, (e) Involve the family in teaching sessions
What is a, c, e
The older adult patient has questions about oral drug metabolism. Information on what subject inmost important to include in this patient's teaching plan?
(a) First-pass effect, (b) Enzyme function, (c) Glomerular filtration rate, (d) Motility
What is the first-pass effect
A patient is to start disulfiram to help with alcohol use disorder. The nurse providing medication education about the drug will include which topics in the education plan? (Select all that apply)
(a) Importance of taking the medication every day, (b) That better results are experienced when a support group helps with treatment adherence, (c) Common food and hygiene products that contain alcohol, (d) That disulfiram treatment should be stopped 1 day before alcohol consumption, (e) That disulfiram works by disrupting the metabolism of alcohol, (f) That the use of alcohol with disulfiram may cause nausea and vomiting and may even be fatal.
What is a, b, c, e, f
The patient asks the nurse how to dispose of old medications. What should the nurse tell the patient? (Select all that apply)
(a) Mix old drugs with cat litter before disposing, (b) Flush the medications down the toilet, (c) Remove personal information from the bottle (d) Add water and crush drugs before disposing, (e) Throw bottle of medications into the trashcan
What is a and c
The nurse is administering oral medication to a patient. Which are important considerations? (Select all that apply)
(a) Always administer GI-irritating drugs with food, (b) Avoid mixing medications into infant formula, (c) Enteric-coated capsules may be chewed, (d) Stop oral medications for nausea and vomiting, (e) Cut all transdermal patches to the correct dose
The principle of Atraumatic Care includes... (Select all that apply)
(a) Pain management, (b) Collaborative care with family members, (c) Restraining infants to administer drugs, (d) Keeping the child apart form family members when administering drugs
What is a and b
The nurse is reviewing a patient's list of drugs. The nurse understands that the older adult's slower absorption of oral drugs is primarily because of which phenomenon?
(a) Decreased cardiac output, (b) Increased gastric emptying time, (c) Decreased gastric blood flow, (d) Increased gastric acid secretion
What is decreased gastric blood flow
Which treatments will the nurse anticipate administering to a patient who has been admitted with alcohol toxicity? (Select all that apply)
(a) Naloxone, (b) Thiamine, (c) Intravenous fluids, (d) Naltrexone, (e) Intravenous glucose solution, (f) Flumazenil
What is b, c, e
The nurse prepares to administer medication. Which drug orders are complete? (Select all that apply)
(a) Aspirin 81 mg PO daily, (b) Multivitamin Sustained, (c) Vitamin D 2000 units PO, (d) Ciprofloxacin 500 mg PO tid, (e) Promethazine 25 mg IV STAT
What is a and d
(a) Perform an assessment on the patient for risk of aspiration, (b) Crush and mix the medications into the patient's meal, (c) Administer drugs on a full stomach to avoid GI upset, (d) Administer unpleasant tasting drugs with glass of water
What is perform an assessment on the patient for risk of aspiration