Pediatric Nurse Exam Pediatric Nurse Pharmacology and Medication Administration 4 — Questions and Answers
Question 1: A nurse is administering vancomycin IV to a child and notices flushing, erythema, and hypotension developing during the infusion. What is the most likely cause?
- Red man syndrome from too-rapid infusion (Correct answer)
- Anaphylactic allergic reaction
- Vancomycin toxicity
- Phlebitis at the IV site
Correct answer: Red man syndrome from too-rapid infusion
Red man syndrome is a histamine-related reaction caused by rapid vancomycin infusion, characterized by flushing and hypotension.
Question 2: A 2-year-old is prescribed oral metronidazole for a Clostridium difficile infection. Which food should the parents be counseled to avoid during treatment?
- Foods containing alcohol or alcohol-based sauces (Correct answer)
- Dairy products
- Citrus fruits
- High-fiber foods
Correct answer: Foods containing alcohol or alcohol-based sauces
Metronidazole causes a disulfiram-like reaction when combined with alcohol, resulting in nausea, vomiting, and flushing.
Question 3: Which calculation method uses body surface area to determine pediatric drug doses?
- West nomogram or BSA formula (Correct answer)
- Clark's rule using child's weight in pounds
- Young's rule using child's age
- Fried's rule using age in months
Correct answer: West nomogram or BSA formula
Body surface area (BSA) calculated via the West nomogram is considered the most accurate method for pediatric dose calculation.
Question 4: A neonatal nurse is preparing to give IV phenytoin. Which finding represents an absolute contraindication to IV phenytoin in neonates?
- Phenytoin should not be given IV to neonates; fosphenytoin or phenobarbital are preferred (Correct answer)
- Heart rate below 120 bpm
- Serum glucose above 150 mg/dL
- Weight less than 2 kg
Correct answer: Phenytoin should not be given IV to neonates; fosphenytoin or phenobarbital are preferred
IV phenytoin contains propylene glycol, which is toxic to neonates; fosphenytoin or phenobarbital are the safer alternatives.
Question 5: A school-age child is receiving chemotherapy and develops a fever of 38.5°C. The nurse should anticipate which priority action?
- Obtain blood cultures and prepare for broad-spectrum antibiotic administration (Correct answer)
- Administer acetaminophen and monitor temperature every 4 hours
- Apply cooling blanket and increase oral fluid intake
- Notify infection control and place child in droplet precautions
Correct answer: Obtain blood cultures and prepare for broad-spectrum antibiotic administration
Febrile neutropenia in oncology patients is a medical emergency requiring prompt cultures and empiric antibiotics.
Question 6: A nurse is educating parents on how to use an epinephrine auto-injector (EpiPen Jr) for their child with anaphylaxis. Which instruction is correct?
- Inject into the outer mid-thigh, hold for 10 seconds, and call 911 immediately after (Correct answer)
- Inject into the upper arm deltoid and wait 30 minutes before seeking care
- Administer only if the child is unconscious and not breathing
- Give two doses simultaneously if symptoms are severe
Correct answer: Inject into the outer mid-thigh, hold for 10 seconds, and call 911 immediately after
The outer thigh is the correct injection site for the auto-injector; 911 should be called immediately because epinephrine is temporary.
Question 7: A preterm infant is receiving caffeine citrate for apnea of prematurity. Which finding indicates a therapeutic response?
- Decreased frequency of apneic episodes (Correct answer)
- Improved blood glucose levels
- Reduction in oxygen requirements
- Increased urine output
Correct answer: Decreased frequency of apneic episodes
Caffeine citrate stimulates the respiratory center, so a reduction in apneic episodes is the expected therapeutic outcome.
Pediatric Nurse Exam Pediatric Nurse Pharmacology and Medication Administration 4
A nurse is administering vancomycin IV to a child and notices flushing, erythema, and hypotension developing during the infusion.
What is the most likely cause?