CPEN Medication Administration 2 — Questions and Answers
Question 1: A 4-year-old (18 kg) requires IV morphine for pain. The standard pediatric dose is 0.1 mg/kg. What is the correct dose?
- 1.8 mg (Correct answer)
- 0.18 mg
- 18 mg
- 0.9 mg
Correct answer: 1.8 mg
0.1 mg/kg × 18 kg = 1.8 mg is the correct weight-based dose.
Question 2: Which route of administration provides the most rapid onset of action for a pediatric patient in anaphylaxis?
- Intramuscular (IM) (Correct answer)
- Subcutaneous (SQ)
- Oral (PO)
- Rectal (PR)
Correct answer: Intramuscular (IM)
IM epinephrine, given in the anterolateral thigh, provides rapid absorption and is the preferred route in anaphylaxis.
Question 3: A nurse is preparing to administer adenosine 0.1 mg/kg IV to a 20 kg child for SVT. What dose should be prepared?
- 2 mg (Correct answer)
- 0.2 mg
- 20 mg
- 1 mg
Correct answer: 2 mg
0.1 mg/kg × 20 kg = 2 mg; adenosine must be followed by a rapid saline flush due to its extremely short half-life.
Question 4: When administering IV push medications through a peripheral IV in a pediatric patient, what is the most important step before injection?
- Verify patency by flushing with normal saline (Correct answer)
- Ensure the IV site is in the antecubital fossa
- Use a 10 mL syringe to increase pressure
- Confirm the patient's allergies are not documented
Correct answer: Verify patency by flushing with normal saline
Confirming IV patency with a saline flush prevents extravasation and ensures the medication reaches systemic circulation.
Question 5: A 6-year-old receives a medication that causes acute dystonia. Which drug is most commonly associated with this reaction in pediatric emergency patients?
- Metoclopramide (Reglan) (Correct answer)
- Ondansetron (Zofran)
- Diphenhydramine (Benadryl)
- Lorazepam (Ativan)
Correct answer: Metoclopramide (Reglan)
Metoclopramide is a dopamine antagonist and is the most common cause of drug-induced acute dystonia in children.
Question 6: Which pediatric weight-based dosing reference is recommended by ACEP and PALS for use during resuscitation?
- Broselow-Luten tape (Correct answer)
- Harriet Lane Handbook
- Pediatric Dosage Handbook
- UpToDate calculator
Correct answer: Broselow-Luten tape
The Broselow-Luten tape correlates length with weight to provide pre-calculated drug doses and equipment sizes during resuscitation.
Question 7: A 3-year-old needs rectal diazepam for status epilepticus. What is the most critical nursing action after administration?
- Hold buttocks together for several minutes to ensure retention (Correct answer)
- Place child prone to prevent aspiration
- Massage the rectal area vigorously
- Administer a saline enema to aid absorption
Correct answer: Hold buttocks together for several minutes to ensure retention
Holding the buttocks together for 3–5 minutes prevents expulsion and ensures adequate drug absorption.
CPEN Medication Administration 2
A 4-year-old (18 kg) requires IV morphine for pain.
The standard pediatric dose is 0.1 mg/kg.
What is the correct dose?