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Maternal Child Nursing 3rd Edition McKinney James Test Bank

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Maternal Child Nursing 3rd Edition McKinney James Test Bank

 

ISBN-13: 978-1416058960

ISBN-10: 1416058966

 

Description

Maternal Child Nursing 3rd Edition McKinney James Test Bank

 

ISBN-13: 978-1416058960

ISBN-10: 1416058966

 

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Free Nursing Test Questions:

James: Nursing Care of Children: Principles and Practice, 3rd Edition

Test Bank

Chapter 14: Medicating Infants and Children

MULTIPLE CHOICE

 

  1. Which of the following would the nurse use to prepare liquid medication in volumes less than 5 milliliters?
a. Calibrated syringe
b. Paper measuring cup
c. Plastic measuring cup
d. Household teaspoon

 

 

ANS:   A

 

  Feedback
A To ensure accuracy, a calibrated syringe without a needle should be used to prepare a liquid dosage less than 5 milliliters.
B Paper measuring cups are not calibrated for liquid volumes less than 5 milliliters.
C A liquid volume less than 5 milliliters cannot be measured accurately in a plastic measuring cup.
D A household teaspoon is not accurate enough to measure small amounts of medication

 

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: pg 378

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. Which of the following food choices is appropriate to mix with medication?
a. Formula or milk
b. Applesauce
c. Syrup
d. Orange juice

 

 

ANS:   B

 

  Feedback
A Formula and milk are essential foods in a child’s diet. Medications may alter their flavor and cause the child to avoid them in the future.
B To prevent the child from developing a negative association with an essential food, a nonessential food such as applesauce is best for mixing with medications.
C Syrup is not used to mix with medications because of its high sugar content.
D Orange juice is considered an essential food; therefore, the nurse should not mix medications with it.

 

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: pg 378

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. Which physiologic difference would affect the absorption of oral medications administered to a 3-month-old infant?
a. More rapid peristaltic activity
b. More acidic gastric secretions
c. Usually more rapid gastric emptying
d. Variable pancreatic enzyme activity

 

 

ANS:   D

 

  Feedback
A Infants up to 8 months of age tend to have prolonged motility. The longer the intestinal transit time, the more medication is absorbed.
B The gastric secretions of infants are less acidic than in older children or adults.
C Gastric emptying is usually slower in infants.
D Pancreatic enzyme activity is variable in infants for the first 3 months of life as the gastrointestinal system matures. Medications that require specific enzymes for dissolution and absorption might not be digested to a form suitable for intestinal action.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 373

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. Which factor should the nurse remember when administering topical medication to an infant?
a. Infants require a larger dosage because of a greater body surface area.
b. Infants have a thinner stratum corneum that absorbs more medication.
c. Infants have a smaller percentage of muscle mass compared with adults.
d. The skin of infants is less sensitive to allergic reactions.

 

 

ANS:   B

 

  Feedback
A A similar dose of a topical medication administered to an infant compared with an adult is approximately three times greater in the infant because of the greater body surface area.
B Infants and young children have a thinner outer skin layer (stratum corneum), which increases the absorption of topical medication.
C The smaller muscle mass in infants affects site selection for injected medications.
D The young child’s skin is more prone to irritation, making contact dermatitis and other allergic reactions more common.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pgs 373-374

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. What is the appropriate nursing response to a parent who asks, “What should I do if my child cannot take a tablet?”
a. “You can crush the tablet and put it in some food.”
b. “Find out if the medication is available in a liquid form.”
c. “If the child can’t swallow the tablet, tell the child to chew it.”
d. “Let me show you how to get your child to swallow tablets.”

 

 

ANS:   B

 

  Feedback
A A tablet should not be crushed until it is determined that it will not alter the effectiveness of the medication.
B A tablet should not be crushed without knowing whether it will alter the absorption, effectiveness, release time, or taste. Therefore telling the parent to find out whether the medication is available in liquid form is the most appropriate response.
C A chewed tablet may have an offensive taste, and chewing it may alter its absorption, effectiveness, or release time.
D Forcing a child, or anyone, to swallow a tablet is not acceptable and may be dangerous.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pgs 377-378

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. What is the maximum safe volume that a neonate can receive in an intramuscular injection?
a. 0.25 milliliter
b. 0.5 milliliter
c. 1 milliliter
d. 1.5 milliliters

 

 

ANS:   B

 

  Feedback
A This is an acceptable volume to inject, but it is not the maximum.
B The maximum volume of medication for an intramuscular injection to a neonate is 0.5 milliliter.
C This volume is appropriate for an intramuscular injection to an infant or older child, not a neonate.
D This volume is not appropriate for a neonate. It is appropriate for an intramuscular injection to a child 3 to 14 years of age.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 380

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. Which muscle would the nurse select to give a 6-month-old infant an intramuscular injection?
a. Deltoid
b. Ventrogluteal
c. Dorsogluteal
d. Vastus lateralis

 

 

ANS:   D

 

  Feedback
A The deltoid muscle is not used for intramuscular injections in young children.
B The ventrogluteal muscle is safe for intramuscular injections for children older than 18 months.
C The dorsogluteal muscle does not develop until a child has been walking for at least 1 year.
D The vastus lateralis is not located near any vital nerves or blood vessels. It is the best choice for intramuscular injections for children younger than 3 years of age.

 

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: pg 381

OBJ:    Nursing Process Step: Planning         MSC:   NCLEX: Physiological Integrity

 

  1. The nurse is planning to administer an intramuscular injection to a 13-year-old child. What is the maximum volume of medication that can be injected into the dorsogluteal site?
a. 0.5 to 1 milliliter
b. 1 to 1.5 milliliters
c. 1.5 to 2 milliliters
d. 2 to 2.5 milliliters

 

 

ANS:   C

 

  Feedback
A This is an acceptable volume to inject, but it is not the maximum.
B This is an acceptable volume to inject, but it is not the maximum.
C The maximum volume of medication for an intramuscular injection to an older child (6 to 14 years) is 1.5 to 2.0 milliliters.
D This volume exceeds the amount that can be safely injected into one site for a 13-year-old child.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 380

OBJ:    Nursing Process Step: Planning         MSC:   NCLEX: Physiological Integrity

 

  1. Which of the following parameters should guide the nurse when administering a subcutaneous injection?
a. Do not to give injections in edematous areas.
b. Attach a clean 1-inch needle to the syringe.
c. The maximum volume injected into one site is 2 milliliters.
d. Do not pinch up tissue before inserting the needle.

 

 

ANS:   A

 

  Feedback
A Subcutaneous injections should never be given in areas of edema because absorption is unreliable.
B A short (no more than  to  inch) needle should be used to deposit medication into subcutaneous tissue.
C Volumes for subcutaneous injections are small, usually averaging 0.5 milliliters.
D The skin is pinched up for a subcutaneous injection to raise the fatty tissue away from the muscle.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pgs 380, 382

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. Which of the following actions is correct when administering ear drops to a 2-year-old child?
a. Administer the ear drops straight from the refrigerator.
b. Pull the pinna of the ear back and down.
c. Massage the pinna after administering the medication.
d. Pull the pinna of the ear back and up.

 

 

ANS:   B

 

  Feedback
A Medication should be at room temperature because cold solutions in the ear will cause pain.
B For children younger than 3 years, the pinna, or lower lobe, of the ear should be pulled back and down to straighten the ear canal.
C The tragus of the ear should be massaged to ensure the drops reach the tympanic membrane.
D For children younger than 3 years, the pinna of the ear should be pulled back and down to straighten the ear canal. For a child 3 years or older the pinna is pulled up and back.

 

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: pg 385

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. What is the main purpose for using a volume-control device to administer intravenous fluids to children?
a. To avoid fluid overload
b. To aid in measuring intake
c. To administer antibiotics
d. To ensure adequate intravenous fluid intake

 

 

ANS:   A

 

  Feedback
A A volume-control device such as a Buretrol or an infusion pump allows the nurse to set a specific volume of fluid to be given in a specific period of time (usually 1 hour) and decreases the risk of inadvertently administering a large amount of fluid.
B Although the use of a volume-control device allows for accurate measurement of intake, the primary purpose for using this equipment is to prevent fluid overload.
C Medications such as antibiotics can be administered with a volume-control device; however, this equipment is used primarily to minimize the risk of fluid overload.
D The risk of fluid overload is the primary reason for using a volume-control device.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 388

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. Which of the following is the most important nursing action before discharge for a mother who is apprehensive about giving her child insulin?
a. Review the side effects of insulin with the mother.
b. Have the mother verbalize that she knows the importance of follow-up care.
c. Observe the mother while she administers an insulin injection.
d. Help the mother devise a rotation schedule for injections.

 

 

ANS:   C

 

  Feedback
A Although reviewing side effects is important, this could be done over the phone or by the pharmacist when the medication is picked up.
B This is important but not directly relevant to the mother’s concern.
C It is important that the nurse evaluate the mother’s ability to give the insulin injection prior to discharge. Watching her give the injection to the child will give the nurse an opportunity to offer assistance and correct any errors.
D This is important but not as important as having the mother demonstrate the procedure.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 373

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. A nurse has just initiated an intravenous piggyback of gentamicin. What is the best time for a trough serum level to be measured?
a. Just before the next dose
b. When the infusion is finished
c. One hour after the medication is administered
d. Depends on the specific medication

 

 

ANS:   A

 

  Feedback
A The medication trough is the level at which the serum concentration is lowest. Trough levels are usually obtained just before the next medication dose.
B The serum concentration would be increasing as the infusion finishes. concentration trough.
C The serum concentration would be increasing during this time period. concentration trough.
D The peak concentration, or the concentration after the medication has been distributed, varies according to the specific medication. Trough is always the lowest just before the next medication dose.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 375

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. A nurse should routinely ask a colleague to double-check a medication calculation and the actual medication before administering which of the following medications?
a. Antibiotics
b. Acetaminophen
c. Anticonvulsants
d. Anticoagulants

 

 

ANS:   D

 

  Feedback
A The nurse always double-checks a dosage calculation, but it is not necessary to have a second nurse check the medication before administering antibiotics.
B The nurse always double-checks a dosage calculation, but it is not necessary to have a second nurse check the medication before administering acetaminophen.
C The nurse always double-checks a dosage calculation, but it is not necessary to have a second nurse check the medication before administering anticonvulsant medications.
D The nurse should ask another nurse to check the dosage calculation and the medication before administering anticoagulants.

 

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: pg 377

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. Which of the following nursing actions is correct when administering heparin subcutaneously?
a. Insert the needle with the bevel up at a 15-degree angle.
b. Insert the needle into the skin at a 45-degree angle.
c. Inject the needle into the tissue on the upper back.
d. Massage the injection site when the injection is complete.

 

 

ANS:   B

 

  Feedback
A This technique is used for an intradermal injection.
B For a subcutaneous injection, the nurse would pinch the skin and inject at a 45-degree angle.
C The upper back is used for intradermal injections.
D The nurse would not massage the site after administering heparin.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 382

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. Which of the following would indicate that a school-age child is using a metered-dose inhaler correctly?
a. The child uses his inhaled steroid before the bronchodilator.
b. The child exhales forcefully as he squeezes the inhaler.
c. The child holds his breath for 10 seconds after the first puff.
d. The child waits 10 minutes before taking a second puff.

 

 

ANS:   C

 

  Feedback
A If one of the child’s medications is an inhaled steroid, it should be administered last.
B The child should inhale slowly as the inhaler is squeezed or depressed.
C After a puff the child should hold his breath for about 10 seconds or until he counts slowly to 5.
D The child does not need to wait this long to take a second puff of medication. He can take a second puff after holding his breath for 10 seconds.

 

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: pg 386

OBJ:    Nursing Process Step: Evaluation      MSC:   NCLEX: Physiological Integrity

 

  1. Which of the following steps is appropriate when using EMLA cream before intravenous catheter insertion?
a. Rub a liberal amount of cream into the skin thoroughly.
b. Cover the skin with a gauze dressing after applying the cream.
c. Leave the cream on the skin for 1 to 2 hours before the procedure.
d. Use the smallest amount of cream necessary to numb the skin surface.

 

 

ANS:   C

 

  Feedback
A The EMLA cream should not be rubbed into the skin.
B After the cream is applied to the skin surface, it is covered with a transparent occlusive dressing.
C The cream should be left in place for a minimum of 1 hour up to 2 hours.
D The nurse would use a liberal amount of EMLA cream.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 387

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. A child is receiving intravenous fluids. How frequently would the nurse assess and document the condition of the child’s intravenous site?
a. Every hour
b. Every 2 hours
c. Every 4 hours
d. Every shift

 

 

ANS:   A

 

  Feedback
A The nurse assesses and documents an IV site at least every hour for signs and symptoms of infiltration and phlebitis.
B The nurse should assess a child’s IV site more frequently.
C The nurse should assess a child’s IV site more frequently than every 4 hours. Serious complications could occur during this time interval.
D The nurse should assess a child’s IV site more frequently.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 388

OBJ:    Nursing Process Step: Assessment    MSC:   NCLEX: Physiological Integrity

 

  1. What is the hourly maintenance fluid rate for an intravenous infusion in a child weighing 19.5 kilograms?
a. 19 milliliters
b. 61 milliliters
c. 195 milliliters
d. 1475 milliliters

 

 

ANS:   B

 

  Feedback
A The formula for calculating daily fluid requirements is 0 to 10 kg: 100 ml/kg/day; 10 to 20 kg: 1000 ml for the first 10 kg of body weight plus 50 ml/kg/day for each kg between 10 and 20. To determine an hourly rate, divide the total milliliters per day by 24.
B The formula for calculating daily fluid requirements is 0 to 10 kg: 100 ml/kg/day; 10 to 20 kg: 1000 ml for the first 10 kg of body weight plus 50 ml/kg/day for each kg between 10 and 20. To determine an hourly rate, divide the total milliliters per day by 24.
C The formula for calculating daily fluid requirements is 0 to 10 kg: 100 ml/kg/day; 10 to 20 kg: 1000 ml for the first 10 kg of body weight plus 50 ml/kg/day for each kg between 10 and 20. To determine an hourly rate, divide the total milliliters per day by 24.
D The formula for calculating daily fluid requirements is 0 to 10 kg: 100 ml/kg/day; 10 to 20 kg: 1000 ml for the first 10 kg of body weight plus 50 ml/kg/day for each kg between 10 and 20. To determine an hourly rate, divide the total milliliters per day by 24.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 389

OBJ:    Nursing Process Step: Assessment    MSC:   NCLEX: Physiological Integrity

 

  1. The nurse administering an IV piggyback medication to a preschool child would take which of the following actions?
a. Dilute the medication in at least 20 milliliters and infuse over at least 15 minutes.
b. Flush the IV tubing before and after the infusion with normal saline solution.
c. Inject the medication into the IV catheter using the port closest to the child.
d. Inject the medication into the IV tubing in the direction away from the child.

 

 

ANS:   A

 

  Feedback
A Medications given by IV piggyback are diluted in at least 20 milliliters of IV solution and administered over at least 15 minutes.
B When administering medications by IV piggyback, the nurse flushes the tubing after the medication has infused, usually with 16 to 20 milliliters of IV solution.
C The nurse is using the IV push method when injecting medication into the IV tubing using the port closest to the child.
D The IV retrograde method involves clamping the IV tubing below the injection port and injecting medication into the tubing in a direction away from the child, causing it to flow into the tubing above the injection port.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 390

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. What nursing action is indicated when a child receiving a unit of packed red blood cells complains of chills, headache, and nausea?
a. Continue the infusion and take the child’s vital signs.
b. Stop the infusion immediately and notify the physician.
c. Slow the infusion and assess for cessation of symptoms.
d. Start a dextrose solution and stay with the child.

 

 

ANS:   B

 

  Feedback
A If the child is displaying signs of a transfusion reaction, the transfusion cannot continue.
B If a reaction is suspected, as in this case, the transfusion is stopped immediately and the physician is notified.
C If the child is displaying signs of a transfusion reaction, the transfusion cannot continue.
D Dextrose solutions are never infused with blood products because the dextrose causes hemolysis. This action does not address the blood infusion. If the child is displaying signs of a transfusion reaction, the transfusion is stopped immediately.

 

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: pg 392

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

  1. What is the best action for the nurse to take when giving medications to a 3-year-old child?
a. Tell the child to take the medication “right now.”
b. Tell the child to take the medication or he will have to get a shot.
c. Allow the child to choose fruit punch or apple juice when giving the medication.
d. Tell the child that another child his age just took his medication like a “good boy.”

 

 

ANS:   C

 

  Feedback
A Direct confrontation typically results in a “no” response.
B Threatening a child with a shot is inappropriate.
C Realistic choices allow the child to feel some control.
D Comparisons are not helpful in getting a child to cooperate.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 378

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

SHORT ANSWER

 

  1. You need to administer ibuprofen, 120 mg, to your 4-year-old patient. Ibuprofen comes in liquid form in a dose of 100 mg/5 ml. How many milliliters will you give?

 

ANS:

6 ml

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: pg 378

OBJ:    Nursing Process Step: Planning         MSC:   NCLEX: Physiological Integrity

 

  1. You need to administer ceftriaxone sodium to your 3-year-old patient who weighs 33 pounds. The physician’s order states to administer ceftriaxone sodium 50 mg/kg once a day. How many milligrams will you prepare?

 

ANS:

750 mg

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: pgs 376-377

OBJ:    Nursing Process Step: Planning         MSC:   NCLEX: Physiological Integrity

 

 

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