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Pediatric Success : NCLEX-style QandA Review (2019)

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Pediatric Success : NCLEX-style QandA Review (2019) - Page 1 preview imageRichardsonr1cTHIRDEDITIONNCLEX~StyleQ&AReview
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 3 preview imageBE PREPAREDFOR SUCCESSSAVE 20%+ FREE SHIPPINGOrder today online atwww.FADavis.comUse Promo Code:REVIEW20Promotion subject to change without notice. Valid for purchases from www.FADavis.com by individuals in the U.S. only.“The most essentialfacts you will ever needfrom a trusted series.”—Amazon student reviewerDon’t have time to read your textbook?Try the Essential Nursing Content + Practice Questions seriesContent Review | Case Studies | NCLEX®-Prep
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 5 preview imagePediatricSuccessNCLEX®-Style Q&A ReviewTHIRD EDITIONBeth Richardson,PhD, RN, CPNP, FAANPAssociate Professor EmeritusIndiana University School of NursingIndianapolis, IndianaPediatric Nurse PractitionerHealthNetIndianapolis, Indiana
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 6 preview imageF. A. Davis Company1915 Arch StreetPhiladelphia, PA 19103www.fadavis.comCopyright © 2019 by F. A. Davis CompanyCopyright © 2019 by F. A. Davis Company. All rights reserved. This book is protected bycopyright. No part of it may be reproduced, stored in a retrieval system, or transmitted inany form or by any means, electronic, mechanical, photocopying, recording, or otherwise,without written permission from the publisher.Printed in the United States of AmericaLast digit indicates print number: 10 9 8 7 6 5 4 3 2 1Acquisitions Editor:Jacalyn SharpSenior Content Project Manager:Julia L. CurcioElectronic Project Editor:Sandra A. GlennieIllustration and Design Manager:Carolyn O’ BrienAs new scientifi c information becomes available through basic and clinical research, rec-ommended treatments and drug therapies undergo changes. The author(s) and publisherhave done everything possible to make this book accurate, up to date, and in accord withaccepted standards at the time of publication. The author(s), editors, and publisher arenot responsible for errors or omissions or for consequences from application of the book,and make no warranty, expressed or implied, in regard to the contents of the book. Anypractice described in this book should be applied by the reader in accordance with profes-sional standards of care used in regard to the unique circumstances that may apply in eachsituation. The reader is advised always to check product information (package inserts) forchanges and new information regarding dose and contraindications before administeringany drug. Caution is especially urged when using new or infrequently ordered drugs.Authorization to photocopy items for internal or personal use, or the internal or personaluse of specific clients, is granted by F. A. Davis Company for users registered with theCopyright Clearance Center (CCC) Transactional Reporting Service, provided that thefee of $.25 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923.For those organizations that have been granted a photocopy license by CCC, a separatesystem of payment has been arranged. The fee code for users of the Transactional Report-ing Service is: 978-0-8036-6812-6 / 19 0+$.25.
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 7 preview imageI thank my children, Jason, Sarah, and Walker; my grandchildren,Caroline, Darren, Sadie, and Sam; and my friends, especially David,for all their love and support.To students, graduates, and colleagues: thank you for all you doin caring for children and their families.
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 8 preview image
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 9 preview imageviiContributors toPrevious EditionsSusan P. Wade, MSN, RN, CPN,CCRNClinical Assistant ProfessorIndiana UniversityPurdue UniversityFort Wayne, IndianaSherrilyn Coffman, DNS, RN, CPNProfessor and Assistant DeanNevada State CollegeHenderson, NevadaDawn Marie Daniels, DNS, RN,PHCNS-BCClinical Nurse SpecialistRiley Hospital for ChildrenIndianapolis, IndianaMary Jo Eoff, RN, MSN, CPNPClinical InstructorIndiana UniversityIndianapolis, IndianaJoyce Foresman-Capuzzi, BSN, RN,CEN, CPN, CCRN, CTRN, CPEN,SANE-A, EMT-PClinical Nurse Educator/EmergencyDepartmentLankenau HospitalWynnewood, PennsylvaniaPaige Johnson, RN, MSN, MPH,CRNPPediatric Nurse PractitionerChildren ’s Mercy Hospital, Department ofHematology/OncologyKansas City, MissouriDominique Leveque, MSN, RN,CPNP, FNP-CWorkplace Health ServicesClarian Health PartnersIndianapolis, IndianaChristina Bittles McCarthy, MSN, RN,CPNPPediatric Nurse PractitionerIndiana University, Department ofOrthopedic SurgeryIndianapolis, IndianaPatricia A. Normandin, RN, MSN,CEN, CPN, CPEN, DNP(c)Pediatric Nursing InstructorUniversity of Massachusetts, LowellLowell, MassachusettsJulie A. Poore, RN, MSNVisiting LecturerIndiana UniversityIndianapolis, IndianaSusan P. Wade, MSN, RN, CPN,CCRNClinical Assistant ProfessorIndiana UniversityPurdue UniversityFort Wayne, IndianaCele Walter, BSN, RN, CPN, NCSNHigh School NursePaul VI High SchoolHaddonfield, New JerseyCandace F. Zickler, RN, MSN, CPNPSupervisor, Health ServicesMetropolitan School District of PerryTownshipIndianapolis, Indiana
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 11 preview imageixReviewers forPrevious EditionsJacoline Sommer Albert, ADN, RN,BScN, DISenior InstructorThe Aga Khan UniversityKarachi, PakistanMonique Alston-Davis, MSN, Ed, CPNAssistant ProfessorMontgomery CollegeSilver Spring, MarylandCathryn J. Baack, PhD, RN, CPNPAssistant ProfessorMedCentral College of NursingMansfield, OhioJoyce Beard, MSN, PHCNS-BC,NCSN, RNAssistant Clinical ProfessorUniversity of North Carolina, PembrokePembroke, North CarolinaVicky H. Becherer, MSN, RNAssistant Teaching ProfessorUniversity of Missouri, St. LouisSt. Louis, MissouriStacee Bertolla, RN, MSN, CPNPInstructorUniversity of South AlabamaMobile, AlabamaMaría del Rosario C. Biddenback, RN,MSN, FNP-CProfessorNapa Valley CollegeNapa, CaliforniaKathleen Borge, MS, RNCFaculty Chair, Women and Children’sHealthSamaritan HospitalTroy, New YorkPam Bowden, RN, MS, PNPFacultyNorth Hennepin Community CollegeBrooklyn Park, MinnesotaTwila J. Brown, PhD, RNAssistant ProfessorSoutheast Missouri State UniversityCape Girardeau, MissouriKatherine Bydalek, MSN, FNP-BC,PhDAssistant ProfessorUniversity of South AlabamaMobile, AlabamaDena Christianson, MSN, PNPAdjunct FacultyNova Southeastern UniversityFort Lauderdale, FloridaKaren Clancy, MS, RN, CNPClinical InstructorOhio State UniversityNeonatal Nurse PractitionerColumbus Children’s HospitalColumbus, OhioMyra L. Clark, MS, FNP-CAssistant ProfessorNorth Georgia College and StateUniversityDahlonega, GeorgiaLori Clay, MSN, RNAssistant ProfessorArkansas State UniversityJonesboro, ArkansasSallie Coke, PhD, APRN, CPNP,CFNPAssociate ProfessorGeorgia College and State UniversityMilledgeville, Georgia
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 12 preview imagexPEDIATRICSUCCESSGeorgina Colalillo, MS, RN, CNEAssociate Professor, Nursing DepartmentQueensborough Community CollegeBayside, New YorkJudith Drumm, DNS, RN, CPNProfessor/NursingPalm Beach Atlantic UniversityWest Palm Beach, FloridaElizabeth Fiske, PhD, RN, NNP-BC,PCNS, BCAssociate ProfessorCarson-Newman UniversityJefferson City, TennesseeJennifer Bell Frank, MSN, APRN, BCInstructorJacksonville State UniversityJacksonville, AlabamaMarianne Fraser, MSN, RN, BCAssistant ProfessorUniversity of UtahSalt Lake City, UtahSusan Golden, MSN, RNNursing FacultyEastern New Mexico University, RoswellRoswell, New MexicoHeather Janiszewski Goodin, PhD,RN, AHN-BCProfessorCapital UniversityColumbus, OhioKathy L. Ham, RN, EdDAssistant ProfessorSoutheast Missouri State UniversityCape Girardeau, MissouriBrenda J. Walters Holloway, APRN,FNP, DNScClinical Assistant ProfessorUniversity of South AlabamaSpanish Fort, AlabamaTeresa L. Howell, DNP, RN, CNEAssociate Professor of NursingMorehead State UniversityMorehead, KentuckyMary C. Kishman, PhD, RNAssociate ProfessorCollege of Mount St. JosephCincinnati, OhioKatherine R. Kniest, RN, MSN, CNEProfessorWilliam Rainey Harper CollegePalatine, IllinoisRobyn Leo, MSNAssociate ProfessorWorcester State CollegeWorcester, MassachusettsBarbara J. MacDougall, MSN, ARNPNova Southeastern UniversityFt. Lauderdale, FloridaSheila Matye, MSN, RN, CNEAssociate Clinical ProfessorMontana State University, College ofNursingGreat Falls, MontanaKathleen T. Mohn, RN, MSEd, CLNCInstructorCollege of Southern NevadaLas Vegas, NevadaJennifer Morton, MS, MPH, RNAssistant ProfessorUniversity of New EnglandPortland, MaineIrene Owens, MSN, APRNInstructorLake Sumter Community CollegeLeesburg, FloridaBrenda Pavill, RN, FNP, PhD, IBCLCProfessorMisericordia UniversityDallas, PennsylvaniaDelia Pittman, PhDNursing ProfessorMidAmerica Nazarene UniversityOlathe, KansasJanine T. Reale, MS, RN, CNEInstructor, Nursing FacultyRivier UniversityNashua, New Hampshire
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 13 preview imageREVIEWERSFORPREVIOUSEDITIONSxiDeborah A. Roberts, RN, BSN, MSN,EdDInstructorSonoma State University, Department ofNursingSonoma, CaliforniaRebecca L. Shabo, RN, PNP-BC, PhDAssociate ProfessorKennesaw State UniversityKennesaw, GeorgiaCynthia A. Shartle, RN, MSN, APRN,BC-FNPADN FacultySouth Texas CollegeMcAllen, TexasPatsy M. Spratling, RN, MSNNursing InstructorHolmes Community CollegeRidgeland, MississippiLinda Strong, MSN, RN, CPNP, CNEAssistant Professor, Pediatric NursingCuyahoga Community CollegeCleveland, OhioBev Valkenier, BScN, RN, MSNLecturerUniversity of British ColumbiaVancouver, British Columbia, CanadaLinda Walters, RN, MSN, PhD (a.b.d.)Nursing InstructorIndiana State UniversityTerre Haute, IndianaElizabeth M. Wertz, RN, BSN, MPM,EMT-P, PHRN, FACMPEChief Executive OfficerPediatric Alliance, PCCarnegie, PennylvaniaSarah Whitaker, DNS, RNNursing Program DirectorDona Ana Community CollegeLas Cruces, New MexicoBarbara White, RN, MSN, CCRNNursing InstructorSouthwestern Michigan CollegeDowagiac, Michigan
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 15 preview imagexiiiContents1Fundamentals of Critical Thinking Related to Test Taking:The RACE Model. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1HOW TO USE THIS REVIEW BOOK. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1Test Preparation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1RACE Model. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22Pharmacology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3KEYWORDS3ABBREVIATIONS3CONVERSIONS4QUESTIONS4ANSWERS AND RATIONALES123Growth and Development. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21KEYWORDS21ABBREVIATIONS21QUESTIONS21ANSWERS AND RATIONALES314Pediatric Health Issues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43KEYWORDS43ABBREVIATIONS43QUESTIONS44ANSWERS AND RATIONALES535Respiratory Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67KEYWORDS67ABBREVIATIONS67QUESTIONS68ANSWERS AND RATIONALES776Cardiovascular Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91KEYWORDS91ABBREVIATIONS91QUESTIONS91ANSWERS AND RATIONALES1007Gastrointestinal Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .109KEYWORDS109ABBREVIATIONS110QUESTIONS110ANSWERS AND RATIONALES1218Genitourinary Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .133KEYWORDS133ABBREVIATIONS133QUESTIONS133ANSWERS AND RATIONALES1449Endocrine Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .155KEYWORDS155ABBREVIATIONS155
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 16 preview imagexivPEDIATRICSUCCESSQUESTIONS155ANSWERS AND RATIONALES16510Hematological/Oncology Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .177KEYWORDS177ABBREVIATIONS177QUESTIONS177ANSWERS AND RATIONALES18611Neuromuscular Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .197KEYWORDS197ABBREVIATIONS197QUESTIONS197ANSWERS AND RATIONALES20712Orthopedic Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .219KEYWORDS219ABBREVIATIONS219QUESTIONS219ANSWERS AND RATIONALES22913Neurological Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .239KEYWORDS239ABBREVIATIONS239QUESTIONS240ANSWERS AND RATIONALES25014Leadership and Management. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .261KEYWORDS261ABBREVIATIONS261QUESTIONS261ANSWERS AND RATIONALES27115Comprehensive Exam. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .285QUESTIONS285ANSWERS AND RATIONALES301Glossary of English Words Commonly Encountered on NursingExaminations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .319Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .323
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 17 preview image11Fundamentals of CriticalThinking Related to TestTaking: The RACE ModelPediatric Success: NCLEX®-Style Q&A Reviewis designed to help you, the student, completeyour nursing program as well as succeed on the NCLEX-RN®examination.This book applies critical-thinking skills primarily to multiple choice questions and tosome alternate test items. It provides practice test questions and test-taking hints to helpyou analyze each item and choose the correct response.Another book in the Success series,Fundamentals Successby Nugent and Vitale, explainscritical thinking and the RACE Model, which are used in each book in the series. Thisinformation will help you answer questions on tests in your nursing courses and on theNCLEX-RN®examination. The key to successful studying is knowing the material thatwill be covered on the examinations. Course notes should be studied every night and cor-responding readings done before class. This will help you learn the material and retain itlonger. Once you know the material, it is important for you to be able to answer primarilymultiple choice questions correctly. The RACE Model will help you succeed with answer-ing questions.HOW TO USE THIS REVIEW BOOKThe book contains 14 chapters, a final comprehensive examination, and practice questionsonline. Test-taking hints are included with each question.This chapter, Chapter 1, provides guidelines for course test preparation and includes anexample of how to use the RACE Model.Chapter 2 focuses on pharmacology and has been included because of the expressedneed of students for extra testing in this area. In the NCLEX-RN®test plan (www.ncsbn.org), pharmacology and management of care have a large number of test items.This chapter includes questions centered on what the student nurse caring for children ofall ages needs to know about administering medications, drug actions, dosages, expectedeffects, adverse effects, and teaching families. Chapter 3 covers growth and developmentof children from infancy through adolescence. Chapter 4 covers material on issues relatedto pediatric health. Chapters 5 through 13 follow pediatric health problems through eachof the body systems. Each chapter contains practice questions, answers, and rationales forthe correct answer, including test-taking hints, keywords, and abbreviations.Chapter 14, “Leadership and Management,” relates to pediatric nursing. Graduatesneed to have a working knowledge of issues in these areas. Chapter 15 is a final 100-ques-tion comprehensive examination. There are also questions available online that you canaccess free for 30 days. Questions in this book are written primarily at the application andanalysis level and are either multiple choice, with four response choices, or alternate itemformat. Nursing faculty members write tests in these formats to familiarize students withthe NCLEX-RN®examination style.Test PreparationOne of the most important strategies for you is to study your course materials thoroughlyand know the assigned concepts for each examination in your class. It is best to study daily
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 18 preview image2PEDIATRICSUCCESSso that you really learn the material. Don’t wait and try to learn it all at once. The moretime you spend studying the topic, the better you will retain the material.After you feel confident that you know the material, choose the chapter(s) in this bookthat correspond(s) with the assigned test material in your nursing course. Answer the prac-tice questions to determine your level of knowledge about the topic. Carefully review thequestions you miss, making sure you read and understand the rationale for choosing thewrong distracter and why the correct response is indeed correct. The rationales provide agreat deal of information about the correct and incorrect options, which helps you under-stand the content more completely. The test-taking hints are strategies to help you logi-cally determine the correct response. If you still feel uncomfortable with the content area,review that chapter in your textbook for better understanding. This method of preparingfor an examination will help you identify your strengths and areas to focus on as you con-tinue to study.You may want to start with Chapter 2, “Pharmacology,” because you will be admin-istering medications to children throughout your pediatric nursing course. This chapterwill help you focus on teaching strategies for families of children receiving medications,differences in delivering drugs to children, and calculating dosages.RACE ModelThe RACE Model is a critical-thinking strategy to be used when answering multiplechoice questions. The RACE Model helps you analyze the question stem and determinethe correct response. For more detailed information about the RACE Model, seeTestSuccess: Test-Taking Techniques for Beginning Nursing Studentsby Nugent and Vitale.The RACE Model comprises:R- Recognize the keywords in the stem.A- Ask what the question is asking the nurse to do.C- Critically analyze each option in relation to the information in the stem.E- Eliminate as many options as possible to narrow your choice to the correct response.Some students believe they know the material but have difficulty choosing the correctresponse when answering multiple choice questions. Using the RACE Model will greatlyincrease your chances of choosing the correct response. To use it effectively during timedtests, you need to practice. Using the RACE Model as you prepare yourself with thechapter tests will help you. Following is a sample question:1.A 6-month-old is being seen in the clinic for a well-child checkup. The parents wantto know about starting solid foods. How should the nurse counsel them?1.“Since you started rice cereal from a spoon 2 months ago, you can add a newstrained vegetable each week.”2.“Introduce some mashed fruits first. After the infant is eating that well, startvegetables and rice cereal.”3.“Infants do best eating solids if you spoon-feed a new strained vegetable everyother day to see what their preferences are.”4.“Add rice cereal to each bottle. Next you can add fruits and vegetables fed byspoon.”Using the RACE Model:R- The client in the stem is the parent.A- The parents want to know how to add solid foods to their infant’s diet.C- Infants start rice cereal between 4 and 6 months. This is fed to the infant by spoonunless there is an indication to place it in the bottle. That is not stated in the stemof this question. Either strained fruits or vegetables are added to the infant’s diet atabout 6 months of age. The infant stays on that choice for several days to determinewhether the infant is allergic.E- Now you can eliminate choices 2, 3, and 4 because they do not contain choices thatyou know are correct. The remaining choice is 1, the correct response.
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 19 preview image32PharmacologyKEYWORDSThe following words include English vocabulary, nursing/medical terminology, concepts, princi-ples, or information relevant to content specifically addressed in the chapter or associated withtopics presented in it. English dictionaries, your nursing textbooks, and medical dictionaries suchasTaber ’ s Cyclopedic Medical Dictionaryare resources that can be used to expand your knowl-edge and understanding of these words and related information.Acetaminophen (Tylenol)Albuterol (Proventil)Amoxicillin (Amoxil)Amoxicillin/clavulanate potassium(Augmentin)Amphotericin BAnticholinergicBaclofenDiphenhydramine (Benadryl)Benzoyl peroxideCarbamazepine (Tegretol)Chlorhexidine (Hibiclens)Ciprofl oxacin (Cipro)Collagenase (Santyl)Cyclophosphamide (Cytoxan)Dexamethasone (Decadron)Diclofenac (Voltaren)Digoxin (Lanoxin)Diltiazem (Cardizem)ErythromycinFilgrastim (Neupogen)Gamma globulinGentamicin (Garamycin)Growth hormoneIbuprofen (Advil, Motrin)Ifosfamide (Ifex)Indomethacin (Indocin)IntradermalIsotretinoin (Accutane)Levothyroxine (Synthroid)Lindane (Kwell, G-Well)Mesna (Mesnex)Metoclopramide (Reglan)Morphine sulfate (Duramorph)Nasal decongestantNPH insulinOxybutynin (Ditropan)Pancreatic enzymesPenicillinPhenytoin (Dilantin)PrednisoneProstaglandin EPyrantel pamoate (Antiminth)Ribavirin (Virazole)Rifampin (Rifadin)Salicylic acidSympathomimeticTerbinafine (Lamisil)Trimethoprim/sulfamethoxazole (Septra,Bactrim)VancomycinVastus lateralisABBREVIATIONSCerebral palsy (CP)grain (gr)gram (g)milligram (mg)pound (lb)
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 20 preview image4PEDIATRICSUCCESSCONVERSIONS1 fl ounce=30 mL (fluid volume)1 g=15 gr1 g=1000 mg1 gr=60 mg (or 65 mg for Tylenol oraspirin)1 in=2.54 cm1 kg=2.2 lb1 L=1000 mL1 lb=454 g1 lb=16 ounces1 mg=1000 mcg1 ounce=28 g (weight)QUESTIONS1.A child is to receive phenytoin (Dilantin) 100 mg IV for seizure prophylaxis. Whichintervention is appropriate when administering this drug?1. Mix it in dextrose 5% in water and give over 1 hour.2. Administer no faster than 2 mg/kg/min.3. Do not use an inline fi lter.4. Monitor temperature prior to and after administration.2.The parent of a child who is being discharged from the clinic wants to know if thereis a difference between Advil and ibuprofen, saying, “I can buy ibuprofen over thecounter at a cheaper price than Advil.” What is the nurse’s best response?1. “Advil and ibuprofen are two different drugs with similar effects.”2. “There is no difference between the two medications, so you should usewhichever one is cheaper.”3. “Similarities exist between the drugs, but you need to consult the health-careprovider about the specific order.”4. “Ibuprofen is usually cheaper, so you should use it.”3.What time would the nurse most likely see signs and symptoms of hypoglycemiaafter administering NPH insulin at 0730?1. 0930 to 1030.2. 1130 to 1430.3. 1130 to 1930.4. 1530 to 1930.4.Morphine sulfate (Duramorph) 2 mg IV q2h prn for pain is ordered for a 12-year-old who has had abdominal surgery. Which is the most appropriate nursing action?1. Administer the morphine sulfate (Duramorph) using a syringe pump over 1 hour.2. Encourage the child to use incentive spirometer every hour during the day andwhen awake at night.3. Ask the health-care provider to change the medication to meperidine (Demerol).4. Administer the morphine sulfate (Duramorph) with Benadryl (diphenhydramine)to prevent itching.5.The parent of a child who is being treated forHaemophilus influenzaemeningitis tellsthe nurse that the family is being treated prophylactically with rifampin (Rifadin).Which should the nurse include in teaching about this medication?1. “The drug will change the color of the urine to orange-red, and it will causestaining.”2. “Adverse effects of the drug may cause urinary retention.”3. “The drug is given to treat meningitis.”4. “You will need to continue taking the drug for 7 days.”
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 21 preview imageCHAPTER2PHARMACOLOGY56.A 2-year-old child has been prescribed amoxicillin (Amoxil) bid for treatment ofpharyngitis. Which statement indicates that the parent knows how to give themedication?1. “If I miss giving my child a dose at breakfast, I will double up on the dose atnight.”2. “I will give the medication at breakfast and dinner.”3. “I know that amoxicillin (Amoxil) is a pill, but sometimes my child will not takeit.”4. “I will continue giving the amoxicillin (Amoxil) for 10 days even after my child isbetter.”7.A nurse is caring for a child who is receiving amphotericin B IV daily for a fungalinfection. Prior to starting the therapy, which should the nurse review?1. Aspartate aminotransferase and alanine aminotransferase serum levels.2. Serum amphotericin level.3. Serum protein and sodium levels.4. Blood urea, nitrogen, and creatinine levels.8.Which toxicity is specific to gentamicin (Garamycin)?1. Hepatatoxicity.2. Ototoxicity.3. Myocardial toxicity.4. Neurotoxicity.9.A nurse is administrating vancomycin intravenously and sets the pump to infuse themedication over 90 minutes. Which adverse reaction is the nurse trying to prevent?1. Vomiting.2. Headache.3. Flushing of the face, neck, and chest.4. Hypertension.10.The parents of an 8-year-old come to the clinic and ask the nurse if their childshould receive growth hormone to boost short stature. Which is the nurse’s bestresponse?1. “Growth hormone only works if the child has short bones.”2. “Can your child remember to take the pills every day?”3. “Test results are required before growth hormone can be started in children.”4. “How tall do you think your child should be?”11.A child has been receiving prednisone for the past 3 weeks, and the parent wants tostop the medication. What is the nurse’s best response?1. “There is no problem in stopping the medication since the child’s symptoms aregone.”2. “It is dangerous for steroids to be stopped suddenly.”3. “Your child may develop severe psychological symptoms when prednisone isstopped suddenly.”4. “Stopping the prednisone will require blood work.”12.A child who has been diagnosed with hypothyroidism is started on levothyroxine(Synthroid). Which should be included in the nurse’s teaching plan?1. The child will have more energy the next day after starting the medication.2. Optimal effectiveness of the medication may not occur for several weeks.3. The medication should be taken once a day at any time.4. The medication should be taken with milk.
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 22 preview image6PEDIATRICSUCCESS13.Which should the nurse include in the discharge teaching plan for a child beginninggrowth hormone therapy?1. The child is expected to grow 3 to 5 inches during the first year of treatment.2. The parents must measure the child’s weight and height weekly.3. The child will need to continue the therapy until he or she is 21 years old.4. There are no side effects from taking growth hormones.14.The onset of Humalog insulin is:1. 10 to 15 minutes.2. 30 minutes to 1 hour.3. 1 to 2 hours.4. 2 to 4 hours.15.Which should the nurse include in the teaching plan for a child started onmetoclopramide (Reglan)?1. The drug increases gastrointestinal motility.2. The drug decreases tone in the lower esophageal sphincter.3. The drug prevents diarrhea.4. The drug induces the release of acetylcholine.16.The nurse will monitor a child on high-dose prednisone for:1. Diabetes.2. Deep vein thrombosis.3. Nephrotoxicity.4. Hepatotoxicity.17.A nurse is administering cyclophosphamide (Cytoxan) to a child with leukemia.Which action by the nurse would be appropriate?1. Monitoring serum potassium levels.2. Checking for hematuria.3. Obtaining daily weights.4. Obtaining neurological checks every 4 hours.18.A nurse is giving ifosfamide (Ifex) as chemotherapy for a child who has leukemia.Mixed in with the ifosfamide (Ifex) is mesna (Mesnex). Mesna is given for whichreason?1. As combination chemotherapy.2. As an antiarrhythmic.3. To prevent hemorrhagic cystitis.4. To increase absorption of the chemotherapy.19.Which should a nurse anticipate be prescribed in chelation therapy for a childreceiving frequent blood transfusions?1. Dalteparin sodium (Fragmin).2. Deferoxamine (Desferal).3. Diclofenac (Voltaren).4. Diltiazem (Cardizem).20.Why is filgrastim (Neupogen) given to a child who has received chemotherapy?1. Reduce fatigue level.2. Prevent infection.3. Reduce nausea and vomiting.4. Increase mobilization of stem cells.21.A child comes to the clinic for diphtheria, pertussis, and tetanus (DTaP) andinactivated poliovirus vaccines. The child does not appear ill but has a temperatureof 101°F (38.3°C). The nurse should take which action?1. Withhold the vaccines and reschedule when the child is afebrile.2. Administer acetaminophen (Tylenol) and give the vaccines.3. Give the vaccines and instruct the parent to give acetaminophen (Tylenol) every 4hours as needed.4. Have the health-care provider order an antibiotic and give the vaccine.
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 23 preview imageCHAPTER2PHARMACOLOGY722.Which of the following would the nurse instruct the parent about treating apediculosis infestation?1. Apply spinosad (Natroba) to the scalp, leave it in place for 4 minutes, and thenadd water.2. Apply chlorhexidine (Hibiclens) to the scalp with sterile gloves and leave onovernight.3. Apply terbinafine (Lamisil) as a thin layer to the scalp twice a day for 5 days.4. Apply collagenase (Santyl) to the scalp with cotton applicator, leave in placeovernight, then shampoo.23.Amoxicillin (Amoxil) 250 mg PO twice a day is prescribed to treat strep throat in achild who weighs 42 lb. The desired dose is 50 mg/kg/day. The nurse determinesthat:1. The prescribed dose is too low.2. The prescribed dose is too high.3. The prescribed dose is safe.4. Not enough information is given to determine the safe dose.24.A child with a heart defect is placed on a maintenance dose of digoxin (Lanoxin)elixir. The dose is 0.07 mg/kg/day, and the child’s weight is 16 lb. The medicationis to be given two times a day. The nurse prepares how much digoxin (Lanoxin) forthe morning dose?1. 0.25 mg.2. 0.37 mg.3. 0.5 mg.4. 2.5 mg.25.Ciprofloxacin (Cipro) 300 mg daily is ordered for a child with a urinary tractinfection. The medication comes 250 mg/5 mL. How much of the medication willthe nurse prepare to give to the child?1. 1.2 mL.2. 3 mL.3. 6 mL.4. 12 mL.26.A nurse is caring for a child with congenital heart disease who is being treated withdigoxin (Lanoxin). Which is included in the family’s discharge teaching?1. Make sure the medication is taken with food.2. Repeat the dose if the child vomits.3. Take the child’s pulse prior to administration.4. Weigh the child daily.27.Which medication is the most effective treatment for acne?1. Salicylic acid.2. Benzoyl peroxide.3. Fluconazole (Diflucan).4. Clotrimazole (Lotrimin).28.Which would the nurse include when teaching an adolescent female beginningisotretinoin (Accutane) therapy?1. Apply a thin layer to the affected skin twice a day.2. Use Dove Sensitive Skin soap for added benefit.3. A pregnancy test will be done prior to starting treatment.4. Keep lips moistened to prevent inflammation.29.Which medication is used for the treatment of spasticity in cerebral palsy (CP)?1. Dexamethasone (Decadron).2. Baclofen (Lioresal)3. Diclofenac (Voltaren).4. Carbamazepine (Tegretol).
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 24 preview image8PEDIATRICSUCCESS30.Which assessment should be a priority to monitor in a child receiving a narcotic forpain relief?1. Respirations.2. Bowel sounds.3. Blood pressure.4. Oxygen saturation.31.Which is the correct method to instill eardrops in a 5-year-old?1. Pull the pinna of the ear downward and back for instillation.2. Place cotton tightly in the ear after instillation.3. Have the child remain upright after instillation.4. Pull the pinna of the ear upward and back for instillation.32.A health-care provider has ordered amoxicillin (Amoxil) 500 mg IVPB q8h for achild with tonsillitis. Which action by the nurse is appropriate?1. Question the order because the route is incorrect.2. Give the medication as ordered.3. Call the health-care provider because the dosing frequency is incorrect.4. Call the health-care provider and question the dose of the drug.33.Which should the nurse do first for a child diagnosed with conjunctivitis andordered to have eye ointment applied three times a day?1. Remove any discharge from the affected eye.2. Ensure the ointment is at room temperature.3. Hold the tip of the eye ointment tube parallel to the eye.4. Wash hands with soap and water.34.Which instruction about nose drops should be included in the teaching plan for theparents of a child with nasopharyngitis?1. “Do not use the drops for any other family member.”2. “Administer the drops as often as necessary until the nasal congestion subsides.”3. “Insert the dropper tip as far back as possible in the nasal passage.”4. “You can save the drops for the next time your child has the same symptoms.”35.Trimethoprim/sulfamethoxazole (Septra, Bactrim) should be given with:1. Breakfast and dinner.2. A snack.3. Glass of water.4. Glass of juice.36.An IV infusion of gamma globulin 2 g/kg over 12 hours has been ordered for a22-lb child. Which dose is correct?1. 11 g.2. 20 g.3. 22 g.4. 44 g.37.Lindane (Kwell) shampoo is used only once because it can cause:1. Hypertension.2. Seizures.3. Elevated liver functions.4. Alopecia.38.Which is essential for the nurse to teach the parent regarding administration ofalbendazole (Albenza)?1. Fever and rash are common adverse effects.2. The medication kills the eggs in about 48 hours.3. The drug should be given with a meal.4. The dose should be repeated in 2 weeks.
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 25 preview imageCHAPTER2PHARMACOLOGY939.A 6-month-old is prescribed 2.5% hydrocortisone for topical treatment of eczema.The nurse instructs the parent not to use the cream for more than a week. What isthe primary reason for this instruction?1. Adverse effects, such as skin atrophy and fragility, can occur with long-termtreatment.2. If after a week there is no improvement, then a stronger dose is required.3. The drug loses its efficacy after prolonged use.4. If no improvement is seen after a week, an antibiotic should be prescribed.40.A 15-kg child is started on cephalexin (Keflex) for treatment of cellulitis. The doseis 40 mg/kg/day, given twice a day. The nurse has a bottle of Keflex that indicatesthere are 250 mg/5 mL. How many milliliters must the nurse draw up for eachdose?1. 2.5 mL.2. 6 mL.3. 12 mL.4. 20 mL.41.A child with hives is prescribed diphenhydramine (Benadryl) 5 mg/kg per day individed doses every 6 hours. The child weighs 40 lb. How many milligrams shouldthe nurse give for each dose?1. 4.5 mg.2. 11.45 mg.3. 22.73 mg.4. 50 mg.42.When is the best time to give furosemide (Lasix)?1. 8:00 a.m.2. 12 noon.3. 6:00 p.m.4. Bedtime.43.Which assessment finding should the nurse observe following administration ofalbuterol (Proventil)?1. Decrease in wheezing.2. Decrease in respiratory rate from 34 to 22.3. Decrease in blood pressure.4. Decrease in heart rate.44.A child in the emergency room is being treated with albuterol (Proventil) aerosoltreatments for an acute asthma attack. She requires treatments every 2 hours. Whichadverse effect of the medication would the nurse expect?1. Lethargy and bradycardia.2. Decreased blood pressure and dizziness.3. Nervousness and tachycardia.4. Increased blood pressure and fatigue.45.A child with cystic fibrosis (CF) is placed on an oral antibiotic to be given four timesa day for 14 days. Which of the following schedules is the most appropriate?1. 8 a.m., 12 p.m., 4 p.m., 8 p.m.2. 7 a.m., 1 p.m., 7 p.m., 12 midnight.3. 9 a.m., 1 p.m., 5 p.m., 9 p.m.4. 10 a.m., 2 p.m., 6 p.m., 10 p.m.46.Which is the best area for the tuberculin skin test to be placed?1. Upper thigh.2. Scapular area.3. Back.4. Ventral forearm.
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 26 preview image10PEDIATRICSUCCESS47.A hospitalized child is to receive 75 mg of acetaminophen (Tylenol) for fever of101°F (38.3°C). If the acetaminophen (Tylenol) is 160 mg per 5 mL, how much willthe nurse administer?1. 0.4 mL.2. 1.5 mL.3. 2.3 mL.4. 3 mL.48.Which is a toxic reaction in a child taking digoxin (Lanoxin)?1. Weight gain.2. Tachycardia.3. Nausea and vomiting.4. Seizures.49.A 10-month-old with heart failure weighs 10 kg. Digoxin (Lanoxin) is prescribed as10 mcg/kg/day to be given every 12 hours. How much is given for each dose?1. 10 mcg.2. 50 mcg.3. 100 mcg.4. 500 mcg.50.Why is indomethacin (Indocin) given to a preterm neonate?1. Encourage ductal closure.2. Prevent hypertension.3. Promote release of surfactant.4. Protect the immature liver.51.Which drug is most important in treating an infant with transposition of the greatvessels?1. Digoxin (Lanoxin).2. Antibiotics.3. Prostaglandin E.4. Diuretics.52.Penicillin is given to a 2-year-old prior to dental work. The child weighs 44 lb.The order is for 25 mg/kg to be given 2 hours before the procedure. The penicillincomes in 250 mg/5 mL. How much of the medication will the nurse administer?1. 2.5 mL.2. 5 mL.3. 10 mL.4. 15 mL.53.Which is the most common adverse reaction to erythromycin?1. Weight gain.2. Constipation.3. Mouth sores.4. Nausea and vomiting.54.A child who weighs 20 kg is to receive 8 g of gamma globulin over 12 hours forthe treatment of idiopathic thrombocytopenia purpura. The concentration is 8 g in300 mL of normal saline. How many milliliters per hour will the child receive?1. 12 mL/hr.2. 25 mL/hr.3. 50 mL/hr.4. 40 mL/hr.55.The treatment for a child with sinus bradycardia is atropine 0.02 mg/kg/dose. Howmuch should the nurse give a child who weighs 20 kg?1. 0.02 mg.2. 0.04 mg.3. 0.2 mg.4. 0.4 mg.
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 27 preview imageCHAPTER2PHARMACOLOGY1156.The effect of atropine is:1. Anticholinergic.2. As a beta-adrenergic agonist.3. As a bronchodilator.4. Sympathomimetic.57.A common adverse reaction to atropine is:1. Diarrhea.2. Increased urine output.3. No tears when crying.4. Lethargy.58.Which should the nurse include in teaching parents about administering pancreaticenzymes to their child?1. The enzymes may be chewed or swallowed.2. The capsules may be opened and sprinkled over acidic food.3. Give the same amount of the medicine with meals and snacks.4. Store the enzymes in the refrigerator.59.Common side effects of oxybutynin (Ditropan) are:1. Increase in heart rate and blood pressure.2. Sodium retention and edema.3. Constipation and dry mouth.4. Insomnia and hyperactivity.60.Ribavirin (Virazole) is prescribed for a hospitalized child with respiratory syncytialvirus (RSV). The nurse prepares to administer the medication by which route?1. Oral.2. Subcutaneous.3. Intramuscular.4. Nebulizer.61.A child has an infusion of dextrose 5% via a line with a volume control chamber onthe pump. The nurse knows this system is used for administration of intravenoussolutions for which reason?1. Prevent accidental fluid overload.2. Reduce the potential for bacterial infection.3. Make administering of intravenous fluids easier.4. Is less costly.
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 28 preview image12ANSWERS AND RATIONALESThe correct answer number and rationale for why itis the correct answer are given inboldface blue type.Rationales for why the other possible answer optionsare incorrect also are given, but they are not in bold-face type.1.1. Mix intravenous doses in normal saline asmixtures precipitate with dextrose 5% inwater.2.Phenytoin (Dilantin) should be givenslowly (1–2 mg/kg/min) via pump.Rapid infusion may cause hypotension,arrhythmias, and circulatory collapse.3. An inline filter is recommended.4. Continuous monitoring of electrocardiogram,blood pressure, and respiratory status isessential because of potential side effects.TEST-TAKING HINT:The test taker mustknow both the side effects of the drug andhow to administer it safely.2.1. This does not answer the parent ’s question.2. This is not a true statement because Advilis enteric coated, and not all ibuprofens areenteric coated.3.This response answers the question andtells the parent the physician is the onlyone who can change a name brand to ageneric drug.4. The nurse should not make that judgment.The physician should be consulted.TEST-TAKING HINT:The nurse needs toanswer the parent’s question and be awarethat a physician chooses name brand orgeneric.3.1. Peak time for regular insulin is 2 to 3 hours.2. Peak time for Semilente insulin is 4 to 7hours.3.Peak time for NPH insulin is 4 to 12hours.4. Peak time for Lente insulin is 8 to 12 hours.TEST-TAKING HINT:NPH insulin works in anintermediate range; select an appropriateperiod of time.4.1. Giving morphine sulfate (Duramorph) over 1hour takes too long to relieve the pain. It canbe given by slow IV push.2.Because morphine sulfate (Duramorph)can depress respirations and the childhas just had abdominal surgery, deepbreathing should be encouraged.3. Meperidine (Demerol) is not used in childrenbecause of the risk of induced seizures.4. One of the side effects of morphinesulfate (Duramorph) is itching, anddiphenhydramine (Benadryl) is a goodmedication to give as needed in case ofitching. It should not be given together withthe morphine sulfate (Duramorph).TEST-TAKING HINT:The test taker must beaware of the major side effects of morphine(Duramorph) and the age of the client whois receiving the morphine (Duramorph).5.1.Rifampin (Rifadin) causes an orange-reddiscoloration of body fluids, includingurine. Knowledge of this can decreaseanxiety when such discoloration occurs.2. Urinary retention is not a side effect.Rifampin (Rifadin) is metabolized in the liverand should be used with caution in clientswith elevated liver enzymes.3. The drug is ordered prophylactically toguard against developing meningitis.4. The drug is given for 2 days as prophylactictreatment.TEST-TAKING HINT:Associate the “R” inrifampin (Rifadin) with the red in orange-red body fluids.6.1. Missed doses should be given as soon aspossible and not doubled with the next dose.2. Doses of antibiotics should be taken atregular intervals over 24 hours withoutinterrupting sleep to maintain maximumblood levels.3. Attempting to have the child take it wholecould cause the child to aspirate.4.A full course of the antibiotic must betaken to decrease the risk of resistanceto the antibiotic or recurrence of theinfection.TEST-TAKING HINT:The test taker mustknow specific information about antibiotictherapy.7.1. Liver damage is not associated withamphotericin therapy.2. Serum levels of the drug are not done.3. The drug should not cause a change insodium or protein levels.4.The drug tends to be nephrotoxic.Elevation of blood urea, nitrogen, andcreatinine levels indicates renal damage.If these levels are elevated, the health-care provider must be notified todetermine if the drug must be withheldfor the day.
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 29 preview imageCHAPTER2PHARMACOLOGY13TEST-TAKING HINT:This drug is nephrotoxic.Some nurses refer to the drug as“amphoterrible.”8.1. Hepatic and neurological toxicities are morecommon in fluoroquinolones.2.Nephrotoxicity and ototoxicity are themost significant adverse effects.3. Myocardial toxicity is not a commonreaction.4. Hepatic and neurological toxicities are morecommon in fluoroquinolones.TEST-TAKING HINT:Aminoglycosides causekidney damage and loss of hearing. Levelsare checked before and after dosing so thattoxicity can be prevented.9.1. Vomiting is a side effect but is not related tothe rate of infusion.2. Headache is not related to the rate ofinfusion.3.“Red man syndrome” or “red necksyndrome” is flushing of the face, neck,and upper chest associated with too rapidan infusion of vancomycin. This can beprevented with infusing the vancomycinover 90 to 120 minutes and pretreatingthe patient with diphenhydramine(Benadryl) prior to the infusion.4. Hypotension with shock can result from ahistamine release from rapid infusion.TEST-TAKING HINT:“Red man syndrome”is a side effect of too rapid an infusion ofvancomycin.10.1. This response does not answer the parents’question.2. Growth hormone is available as a parenteralmedication and is given intramuscularly orsubcutaneously.3.Growth hormone is approved for useonly in children to treat a documentedlack of growth hormone.4. The nurse must first answer the parents’question about growth hormone.TEST-TAKING HINT:Recall the reason forgiving growth hormone.11.1. Abrupt withdrawal can cause severe sideeffects.2.Abrupt cessation of long-term steroidtherapy can cause acute adrenalinsufficiency that could lead to death.Long-term steroid use can causeshrinkage of the adrenal glands, whichdecreases the production of the hormone.3. Central nervous system symptoms such asconfusion and psychosis are adverse effects ofsteroids.4. Gradual tapering of the dosages will preventsevere side effects and no blood work isrequired.TEST-TAKING HINT:The test taker mustknow about abrupt withdrawal of steroidsand the effects of steroids on the adrenalglands.12.1. The energy level takes much longer than 1day to increase.2.After starting therapy, peak levels ofthe drug may not be expected for manyweeks to months. Clients need to knowthis to prevent them from stopping themedication because they think it is notworking.3. The drug works best when taken on anempty stomach; the patient should select atime each day when the stomach is empty. Inchildren, just prior to bed may be the besttime, as most children do not eat prior tobedtime.4. The drug works best when taken on anempty stomach. Taking it with milk iscontraindicated.TEST-TAKING HINT:Know the effects oflevothyroxine and how to administer it.13.1.The expected growth rate with growthhormone therapy is 3 to 5 inches in thefirst year.2. Height and weight are measured monthly.3. Growth hormone is discontinued whenoptimal adult height is attained and fusion ofthe epiphyseal plates has occurred.4. Side effects include glucose intolerance,hypothyroidism, adrenocorticotropichormone deficiency, hypercalciuria,renal calculi, gastrointestinal upset, andintracranial tumor growth.TEST-TAKING HINT:Answer 2 is not correctas “must” is too strong. Answer 4 states“no side effects,” and this is unrealistic.To choose the correct answer, the testtaker must rely on knowledge of growthhormones.14.1.Humalog insulin is rapid-acting and hasan onset of 10 to 15 minutes.2. Regular insulin has an onset of 30 minutes to1 hour.3. NPH insulin has an onset of 1 to 2 hoursand is intermediate-acting.
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 30 preview image14PEDIATRICSUCCESS4. Ultralente insulin has an onset of 2 to 6hours and is a long-acting insulin.TEST-TAKING HINT:Review the onset, peak,and duration of all types of insulin.15.1.Metoclopramide (Reglan) is agastrointestinal stimulant that increasesmotility of the gastrointestinal tract,shortens gastric emptying time, andreduces the risk of the esophagus beingexposed to gastric content.2. Decreased tone in the esophageal sphincterincreases the risk of gastric contents beingregurgitated upward into the esophagus.3. There can be an increase in diarrhea becauseof the increase in gastrointestinal motility.4. Methyl scopolamine blocks effects ofacetylcholine and relaxes sooth muscles.TEST-TAKING HINT:Gastroesophagealreflux disease results in backward flowof gastric contents, so it is logical that adrug prescribed should promote forwardmovement of gastric content.16.1.One of the side effects of high-dosesteroids can be diabetes mellitus. Thechild needs to be evaluated so thatprompt treatment can be initiated. Thediabetes is self-limiting and after thesteroids are discontinued should nolonger be present. Other side effectsinclude mood changes, hirsutism, trunkobesity, thin extremities, gastric bleeding,poor wound healing, hypertension,immunosuppression, insomnia, andincreased appetite.2. This is not a side effect of steroids. Deepvein thrombosis is related to clottingabnormalities.3. This is not a side effect of steroids.4. This is not a side effect of steroids.TEST-TAKING HINT:Review side effects ofhigh-dose steroid use.17.1. There should not be a change in potassiumlevel, as the drug does not cause potassiumloss.2.Hemorrhagic cystitis is a major sideeffect of cyclophosphamide (Cytoxan);checking the urine for blood is anappropriate intervention.3. Weights are obtained daily with clientsreceiving chemotherapy because of nauseaand vomiting.4. There are no central nervous system sideeffects with cyclophosphamide (Cytoxan).TEST-TAKING HINT:Review major side effectsof cyclophosphamide.18.1. Mesna (Mesnex) is not a chemotherapeuticagent.2. Mesna (Mesnex) does not preventarrhythmias.3.Mesna (Mesnex) is a detoxifying agentused as a protectant against hemorrhagiccystitis induced by ifosfamide (Ifex) andcyclophosphamide (Cytoxan).4. There is no medication that increasesabsorption of chemotherapy.TEST-TAKING HINT:Review the action ofmesna (Mesnex).19.1. Dalteparin sodium (Fragmin) is ananticoagulant used as prophylaxis for post-operative deep vein thrombosis.2.Deferoxamine (Desferal) is an antidotefor acute iron toxicity.3. Diclofenac (Voltaren) is an anti-inflammatorydrug.4. Diltiazem (Cardizem) is an antianginal agentfor chronic stable angina.TEST-TAKING HINT:Deferoxamine (Desferal)is used to prevent iron overload.20.1. Chemotherapy may cause anemia, which cancompound the feeling of fatigue rather thanreduce fatigue.2. The drug does not prevent infection, but itdoes increase the number of neutrophils.3. The drug may cause nausea and vomitingrather than reduce it.4.The drug mobilizes stem cells to produceneutrophils.TEST-TAKING HINT:Recall the function of theneutrophils and how to stimulate them.21.1. Immunizations can be given when the childhas a low-grade fever as long as the child isnot ill appearing.2. Diagnose the problem before giving thevaccine. Just giving the acetaminophen(Tylenol) would not allow a diagnosis to bemade, as it may mask symptoms.3.Immunizations can be given when thechild has a low-grade fever as long as thechild is not ill appearing.4. The nurse would not want to give anantibiotic until a bacterial infection wasdiagnosed.TEST-TAKING HINT:Immunizations shouldnot be given when a child has a high feverand appears ill.
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Pediatric Success : NCLEX-style QandA Review (2019) - Page 31 preview imageCHAPTER2PHARMACOLOGY1522.1.Spinosad (Natroba) causes neuronalexcitation leading to lice paralysis anddeath.2. Chlorhexidine (Hibiclens) is a skin cleanser.Clean gloves, not sterile gloves, should beused in treating lice.3. Terbinafine (Lamisil) is an oral or nasalantifungal agent for the treatment of tineainfections.4. Collagenase (Santyl) is an enzyme used inskin débriding.TEST-TAKING HINT:Associate the nature ofthe parasite with the drug and applicationmethod.23.1.The dose prescribed is too low.Strep throat is treated with amoxicillin at50 mg/kg/day. Convert pounds to kilogramsby dividing by 2.2 (2.2 lb=1 kg)42 lb÷2.2=19.09 kgDosing parameters: 50 mg/kg/day×19.09=954.5 mg/dayOrdered dose: 250 mg bid=500 mg/day2. The dose prescribed is too low.3. The dose prescribed is too low.4. The dose prescribed is too low.TEST-TAKING HINT:First change pounds tokilograms. Calculate the ordered dose usingthe formula given in the question. Comparethe order against the calculated appropriatedose.24.1.0.25 mg.Convert pounds to kilograms by dividing by2.2 (2.2 lb=1 kg)16 lb÷2.2=7.27 kgCalculate the dosage by weight: 0.07 mg/day×7.27=0.5 mg/dayDivide the dose by 2 because it is to begiven 2 times a day: 0.5 mg/day÷2 doses=0.25 mg for each dose2. This dose is too high. Change the pounds tokilograms; the correct answer is 0.25 mg.3. This is the total amount of drug for an entireday. Change the pounds to kilograms; thecorrect answer is 0.25 mg. Remember todivide by 2.4. This dose is much too high. Change thepounds to kilograms; the correct answer is0.25 mg.TEST-TAKING HINT:Change the pounds tokilograms. The total amount is to be giventwice a day, so calculate each dose.25.1. The formula to determine the correct answeris:Desired over Available×Volume=amountto be given2. The formula to determine the correct answeris:Desired over Available×Volume=amountto be given3.Desired over Available×Volume=amount to be given300 mg/250 mg×5 mL=6 mL4. The formula to determine the correct answeris:Desired over Available×Volume=amountto be givenTEST-TAKING HINT:Use the formula todetermine the correct answer.26.1. Digoxin (Lanoxin) should not be taken withfood. Administer the medication 1 hourbefore or 2 hours after a meal.2. The dose should not be repeated if the childvomits.3.The child’s pulse should be monitoredbefore each dose. The dose should bewithheld according to the health-careprovider ’s parameters.4. Checking weight is not related to themedication.TEST-TAKING HINT:Know the principles ofgiving digoxin (Lanoxin). Knowing that thedrug is given to decrease the heart rate andincrease cardiac output should be a key tothe answer involving checking pulse.27.1. Salicylic acid is used in the treatment ofcorns and warts.2.Benzoyl peroxide inhibits growth ofPropionibacterium acnes(a gram-positivemicroorganism). It is effective againstinfl ammatory and anti-inflammatory acne.3. Fluconazole (Diflucan) is an oral antifungal.4. Clotrimazole (Lotrimin) is a topicalantifungal.TEST-TAKING HINT:The test taker needs toknow the specific treatment for acne.28.1. The drug is not topical.2. Dove Sensitive Soap is used for dry or easilyirritated skin.3.It is mandatory to have a pregnancy testdone before starting treatment becausespontaneous abortions and/or fetalabnormalities have been associated inpregnancy with the use of isotretinoin(Accutane).4. Inflammation of the lips is a side effect ofisotretinoin (Accutane), but moisture will notprevent the inflammation.TEST-TAKING HINT:Consider birth defectsassociated with isotretinoin (Accutane).
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Pediatric Success : NCLEX-style QandA Review (2019) - Certification Guides | National Council Licensure Examination