CPEN Medication Administration 5 — Questions and Answers
Question 1: An 8-year-old (30 kg) requires epinephrine 0.01 mg/kg IV for refractory anaphylaxis. The concentration available is 1:10,000 (0.1 mg/mL). What volume should be given?
- 3 mL (Correct answer)
- 0.3 mL
- 30 mL
- 0.03 mL
Correct answer: 3 mL
Dose = 0.01 × 30 = 0.3 mg; volume = 0.3 mg ÷ 0.1 mg/mL = 3 mL.
Question 2: A neonate requires phenobarbital for seizures. Which potential side effect requires the nurse to have resuscitation equipment at the bedside?
- Respiratory depression and apnea (Correct answer)
- Hyperglycemia
- Hypertensive crisis
- Tachyarrhythmia
Correct answer: Respiratory depression and apnea
Phenobarbital can cause significant respiratory depression, especially in neonates and when combined with other CNS depressants.
Question 3: Which statement is TRUE regarding the use of weight-based dosing in obese pediatric patients?
- Some medications should be dosed on ideal body weight (IBW) to avoid toxicity (Correct answer)
- All medications should be dosed on actual body weight without exception
- Obese children always need lower doses regardless of the drug
- BMI is not considered when calculating pediatric drug doses
Correct answer: Some medications should be dosed on ideal body weight (IBW) to avoid toxicity
Lipophilic drugs and some antibiotics must be adjusted to ideal or adjusted body weight in obese pediatric patients to prevent toxicity.
Question 4: A 10 kg infant receives an IV antibiotic that requires infusion over 30 minutes. The total dose is 100 mg diluted in 20 mL NS. At what rate should the pump be set?
- 40 mL/hr (Correct answer)
- 20 mL/hr
- 60 mL/hr
- 10 mL/hr
Correct answer: 40 mL/hr
Rate = volume ÷ time = 20 mL ÷ 0.5 hr = 40 mL/hr.
Question 5: When administering medications through an intraosseous (IO) route, which of the following is the most important consideration?
- Flush forcefully with saline before each medication to confirm placement and ensure delivery (Correct answer)
- IO route cannot be used for resuscitation medications
- Medications given IO are absorbed slower than IV and should be doubled in dose
- IO sites should not be used if IV access can eventually be obtained
Correct answer: Flush forcefully with saline before each medication to confirm placement and ensure delivery
IO placement must be confirmed with a saline flush to ensure patency; medications reach systemic circulation at rates comparable to central IV access.
Question 6: A pediatric patient is receiving a continuous heparin infusion. Which laboratory value is used to monitor the therapeutic effect of heparin?
- Activated Partial Thromboplastin Time (aPTT) (Correct answer)
- Prothrombin Time (PT/INR)
- Platelet count
- Fibrinogen level
Correct answer: Activated Partial Thromboplastin Time (aPTT)
The aPTT is the standard monitoring parameter for unfractionated heparin therapy, with a therapeutic range typically 60–100 seconds.
Question 7: A nurse discovers a medication error after administering the wrong dose to a pediatric patient. What is the priority action?
- Assess the patient for adverse effects and notify the physician immediately (Correct answer)
- Complete an incident report before contacting anyone
- Document the error and monitor the patient without notifying the physician unless symptoms appear
- Notify the pharmacy first to determine if the error is clinically significant
Correct answer: Assess the patient for adverse effects and notify the physician immediately
Patient safety is the first priority — immediate assessment and physician notification allows for prompt intervention if harm has occurred.
CPEN Medication Administration 5
An 8-year-old (30 kg) requires epinephrine 0.01 mg/kg IV for refractory anaphylaxis.
The concentration available is 1:10,000 (0.1 mg/mL).
What volume should be given?