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The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed gestational diabetes and pneumonia. She is given medications that pose a possible fetal risk, but the potential benefits may warrant the use of the medications in her situation. The nurse recognizes that these medications are in which U.S. Food and Drug Administration pregnancy safety category?
- A. Category A
- B. Category B
- C. Category C
- D. Category D
Correct Answer: D
Rationale: Pregnancy category D fits the description given, as it indicates evidence of human fetal risk, but potential benefits may warrant use in pregnant women despite risks. Category A indicates no risk to the human fetus; Category B indicates no risk to animal fetus with no human data available; Category C indicates adverse effects in animal fetus with no human data available.
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The nurse is preparing to give an injection to a 4-year-old child. Which intervention is age appropriate for this child?
- A. Give the injection without any advanced preparation.
- B. Give the injection, and then explain the reason for the procedure afterward.
- C. Offer a brief, concrete explanation of the procedure at the patient's level and with the parent or caregiver present.
- D. Prepare the child in advance with details about the procedure without the parent or caregiver present.
Correct Answer: C
Rationale: For a 4-year-old child, offering a brief, concrete explanation about a procedure just beforehand, with the parent or caregiver present, is appropriate. No preparation, explaining afterward, or preparing without a parent are not age-appropriate interventions.
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.
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.
A 7-year-old child will be receiving amoxicillin (Amoxil) 50 mg/kg/day in two divided doses. The child weighs 55 pounds. The medication, once reconstituted, is available as an oral suspension of 125 mg/5 mL. Identify how many milliliters will the child receive per dose.
Correct Answer: 25 mL
Rationale: Convert pounds to kilograms: 55 pounds = 25 kg. 25 kg x 50 mg/kg/day = 1250 mg/day. To get the amount per dose, divide 1250 by 2, which equals 625 mg/dose. To calculate the milliliters: 125 mg/5 mL = 625 mg/x mL. (125 * x) = (5 * 625); 125x = 3125; x = 25 mL/dose.
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.