Nokea
For accurate medication administration to pediatric patients, the nurse must consider which of these factors?
- A. Organ maturity
- B. Renal output
- C. Body temperature
- D. Height
Correct Answer: A
Rationale: To administer medications to pediatric patients accurately, one must take into account organ maturity, body surface area, age, and weight. Renal output, body temperature, and height alone are not primary considerations for accurate medication administration.
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An 83-year-old woman has been given a thiazide diuretic to treat heart failure. She and her caregiver should be told to watch for which problems?
- A. Constipation and anorexia
- B. Fatigue, leg cramps, and dehydration
- C. Daytime sedation and lethargy
- D. Edema, nausea, and blurred vision
Correct Answer: B
Rationale: Electrolyte imbalance, leg cramps, fatigue, and dehydration are common complications when thiazide diuretics are given to elderly patients. The other options do not describe typical complications associated with thiazide diuretics in the elderly.
Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason?
- A. Decreased fetal surface area
- B. Increased placental surface area
- C. Enhanced blood flow to the fetus
- D. Increased amount of protein-bound drug in maternal circulation
Correct Answer: C
Rationale: Drug transfer to the fetus is more likely during the last trimester of pregnancy as a result of enhanced blood flow to the fetus. Increased fetal surface area, not decreased, is a factor that affects drug transfer to the fetus. The placenta's surface area does not increase during this time. Drug transfer is increased because of an increased amount of free drug, not protein-bound drug, in the mother's circulation.
When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations?
- A. West nomogram
- B. Clark rule
- C. Height-to-weight ratio
- D. Milligram per kilogram of body weight formula
Correct Answer: D
Rationale: The milligram per kilogram formula, based on body weight, is the most common method of calculating doses for pediatric patients. West nomogram and Clark rule are available but less commonly used, and height-to-weight ratio is not a standard method.
The nurse recognizes that an elderly patient may experience a reduction in the stomach's ability to produce hydrochloric acid. This change may result in which effect?
- A. Delayed gastric emptying
- B. Increased gastric acidity
- C. Decreased gastrointestinal motility
- D. Altered absorption of some drugs
Correct Answer: D
Rationale: Reduction in the stomach's ability to produce hydrochloric acid is an aging-related change that results in a decrease in gastric acidity and may alter the absorption of some drugs. It does not directly cause delayed gastric emptying, increased gastric acidity, or decreased gastrointestinal motility.
An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug therapy?
- A. Drug therapy will be based on the patient's weight.
- B. Drug therapy will be based on the patient's age.
- C. The patient will receive the maximum dose that is expected to reduce the blood pressure.
- D. The patient will receive the lowest possible dose at first, and then the dose will be increased as needed.
Correct Answer: D
Rationale: As a general rule, dosing for elderly patients should follow the principle of 'start low, and go slow,' meaning start with the lowest possible dose and increase slowly if needed, based on patient response. Dosing is not primarily based on weight or age, and maximum doses are not initially given.