Chapter 38 Medication Administration and Safety for Infants and Children

Chapter 38  Medication Administration and Safety for Infants and Children

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. What should the nurse use to prepare liquid medication in volumes less than 5 mL?

a. Calibrated syringe
b. Paper measuring cup
c. Plastic measuring cup
d. Household teaspoon

ANS: A
For volumes of 5 mL or less, an oral syringe designed for oral medication administration
only should be used. Measuring cups would be too large. A household teaspoon may or
may not be accurate and the AAP recommends metric-only measuring devices.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 853 OBJ: Nursing Process: Implementation
MSC: Client Needs: Physiologic Integrity

2. Which food is appropriate to mix with medication?

a. Formula or milk
b. Applesauce
c. Baby food
d. Orange juice

ANS: 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. Formula, milk,
baby food, and orange juice are essential foods in a child’s diet. Medications may alter their
flavor and cause the child to avoid them in the future.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 855 OBJ: Nursing Process: Implementation
MSC: Client Needs: Physiologic Integrity

3. Which physiologic difference affects 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

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. Infants up to 8
months of age tend to have prolonged motility. The longer the intestinal transit time, the
more medication is absorbed. The gastric secretions of infants are less acidic than in older
children or adults. Gastric emptying is usually slower in infants.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 852 OBJ: Nursing Process: Implementation
MSC: Client Needs: Physiologic Integrity

4. Which factor should the nurse remember when administering topical medication to an infant

as compared with an adolescent?
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.
d. The skin of infants is less sensitive to allergic reactions.

ANS: B
Infants and young children have a thinner outer skin layer (stratum corneum), which
increases the absorption of topical medication. 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. The smaller muscle mass in infants affects
site selection for injected medications but should not affect administration of topical
medications. The young child’s skin is more prone to irritation, making contact dermatitis
and other allergic reactions more common.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 852 OBJ: Nursing Process: Implementation
MSC: Client Needs: Physiologic Integrity

5. 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
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. A chewed tablet
may have an offensive taste, and chewing it may alter its absorption, effectiveness, or
release time. Forcing a child, or anyone, to swallow a tablet is not acceptable and may be
dangerous.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 855 OBJ: Nursing Process: Implementation
MSC: Client Needs: Physiologic Integrity