CPEN Medication Administration 4 — Questions and Answers
Question 1: When using the intranasal (IN) route for medication delivery in a pediatric patient, what device is preferred to atomize the medication?
- Mucosal Atomization Device (MAD) (Correct answer)
- Bulb syringe
- Nebulizer mask
- Standard needleless syringe tip
Correct answer: Mucosal Atomization Device (MAD)
The MAD atomizes the medication into fine particles that maximize mucosal absorption and minimize the risk of the child swallowing the dose.
Question 2: A nurse is about to give IV vancomycin rapidly and the child develops flushing, erythema, and hypotension. What is the most likely cause?
- Red Man Syndrome from rapid infusion (Correct answer)
- Anaphylaxis to vancomycin
- Vasovagal response
- Septic shock progression
Correct answer: Red Man Syndrome from rapid infusion
Red Man Syndrome is a rate-dependent reaction caused by mast cell degranulation from rapid vancomycin infusion, not a true allergy.
Question 3: Which of the following is a 'high-alert' medication in pediatric emergency nursing that requires a double-check before administration?
- Concentrated electrolytes (e.g., potassium chloride) (Correct answer)
- Oral amoxicillin suspension
- Normal saline flush
- Topical lidocaine cream
Correct answer: Concentrated electrolytes (e.g., potassium chloride)
Concentrated potassium chloride is a high-alert medication because accidental IV bolus administration can cause fatal cardiac arrest.
Question 4: A 5-year-old is prescribed ibuprofen 10 mg/kg PO. The child weighs 20 kg and the suspension is 100 mg/5 mL. How many mL should be given?
- 10 mL (Correct answer)
- 5 mL
- 20 mL
- 2 mL
Correct answer: 10 mL
Dose = 10 × 20 = 200 mg; volume = (200 ÷ 100) × 5 = 10 mL.
Question 5: A 3-year-old in status epilepticus has no IV access. Which medication and route is the recommended first-line treatment per current guidelines?
- Midazolam IM or intranasal (Correct answer)
- Phenobarbital IM
- Diazepam IM
- Lorazepam sublingual
Correct answer: Midazolam IM or intranasal
Midazolam given IM or intranasally is the recommended first-line benzodiazepine when IV access is unavailable in pediatric status epilepticus.
Question 6: Which of the following best describes the 'rights' of medication administration that all nurses must follow?
- Right patient, drug, dose, route, time, reason, and documentation (Correct answer)
- Right patient, drug, dose, and route only
- Right drug, dose, and time as the minimum standard
- Right patient and right drug are the two most critical rights
Correct answer: Right patient, drug, dose, route, time, reason, and documentation
The seven rights of medication administration provide a framework to prevent errors at each step of the administration process.
Question 7: A nurse receives a verbal order for a medication during a pediatric emergency. What is the safest practice after receiving the verbal order?
- Repeat the order back and confirm with the ordering provider before administering (Correct answer)
- Administer immediately without delay then document later
- Have another nurse write it down and administer
- Refuse to act on verbal orders unless written first
Correct answer: Repeat the order back and confirm with the ordering provider before administering
Read-back confirmation of verbal orders is a Joint Commission-required safety practice that reduces communication errors.
CPEN Medication Administration 4
When using the intranasal (IN) route for medication delivery in a pediatric patient, what device is preferred to atomize the medication?