MN580 UNIT 9 QUIZ

MN580 UNIT 9 QUIZ Chapter 26. Prescribing Medications in Pediatrics Questions with Answers Exam Guide 1. A pharmaceutical company has developed a new drug that was tested only on adults. The FDA has declared this drug to have potential benefits for ill children. According to the Pediatric Research Equity Act (PREA), what may the pharmaceutical company be required to do? A. Conduct pediatric drug studies to determine whether the drug is safe and effective in children. Correct B. Provide labeling stating that the safety and efficacy of the drug is not established for children. C. Receive a patent extension for conducting pediatric studies to determine use in children. D. Survey existing data about the drug to determine potential use in the pediatric population. 2. The primary care pediatric nurse practitioner prescribes a new medication for a child who develops a previously unknown adverse reaction. To report this, the nurse practitioner will A. access the BPCA website. B. call the PREA hotline. C. log onto the FDA Medwatch website. Correct D. use the AAP online PediaLink program. 3. The primary care pediatric nurse practitioner is considering use of a relatively new drug for a 15monthold child. The drug is metabolized by the liver, so the nurse practitioner will consult a pharmacologist to discuss giving the drug: A. less often or at a lower dose. Correct B. more often or at a higher dose. C. via a parenteral route. D. via the oral route. 4. The primary care pediatric nurse practitioner is considering using a drug for an “off label” use in a child. The nurse practitioner has used the drug in a similar situation previously, has consulted a pharmacology resource and the FDA website, and has determined that there are no significant contraindications and warnings for this child. What else must the nurse practitioner do when prescribing this drug?. A. Discuss recommendations with the parents and document their consent. Correct B. Document anecdotal reports of previous use of the drug by other providers. C. Follow up daily with the parents to determine safe administration of the drug. D. Report this use to the FDA Medwatch website for tracking purposes. 5. The primary care pediatric nurse practitioner is counseling an adolescent who was recently hospitalized for an asthma exacerbation and learns that the child usually forgets to use twice daily inhaled corticosteroid medications that are supposed to be given at 0800 and 2000 each day. Which strategy may be useful in this case to improve adherence? A. Ask the adolescent to identify two times each day that may work better. Correct B. Consider having the school nurse supervise medication administration. C. Prescribing a daily oral corticosteroid medication instead. D. Suggest that the parent enforce the medication regimen each day. 6. The primary care pediatric nurse practitioner is treating a toddler who has a lower respiratory tract illness with a low-grade fever. The child is eating and taking fluids well and has normal oxygen saturations in the clinic. The nurse practitioner suspects that the child has a viral pneumonia and will A. order an antiviral medication and schedule a follow up appointment. B. prescribe a broad-spectrum antibiotic until the lab results are received. C. teach the parents symptomatic care and order labs to help with the diagnosis. Correct D. write a prescription for an antibiotic to be given if the child’s condition worsens. 7. The single mother of a 4yearold who attends day care tells the primary care pediatric nurse practitioner that she had difficulty giving her child a twice daily amoxicillin for 10 days to treat otitis media during a previous episode several months earlier because she works two jobs and is too busy. The child has an ear infection in the clinic today. What will the nurse practitioner do? A. Administer an intramuscular antibiotic. B. Order twice daily amoxicillin for 5 days. C. Prescribe azithromycin once daily for 5 days. Correct D. Reinforce the need to adhere to the plan of care. 8. The parent of a school age child who has asthma tells the primary care pediatric nurse practitioner that the child often comes home from school with severe wheezing after gym class and needs to use his metered dose inhaler right away. What will the nurse practitioner do? A. Recommend that the child go to the school nurse when symptoms start. B. Review the child’s asthma action plan and possibly increase his steroid dose. C. Suggest asking the school to excuse the child from gym class. D. Write the prescription for two metered dose inhalers with spacers. Correct Chapter 41. Genitourinary Disorders Questions 1. A 30monthold girl who has been toilet trained for 6 months has daytime enuresis and dysuria and a low-grade fever. A dipstick urinalysis is negative for leukocyte esterase and nitrites. What is the next step? A. Begin empiric treatment with trimethoprim sulfamethoxazole. B. Discuss behavioral interventions for toilet training. C. Reassure the child’s parents that the child does not have a urinary tract infection. D. Send the urine to the lab for culture. Correct 2. The clean catch urine specimen of a child with dysuria, frequency, and fever has a colony count between 50,000 and 100,000 of E. coli. What is the treatment for this child? A. Obtain a complete blood count and C-reactive protein. B. Perform sensitivity testing before treating with antibiotics. C. Repeat the culture if symptoms persist or worsen. D. Treat with antibiotics for urinary tract infection. Correct 3. A dipstick urinalysis is positive for leukocyte esterase and nitrites in a school age child with dysuria and foul-smelling urine but no fever who has not had previous urinary tract infections. A culture is pending. What will the pediatric nurse practitioner do to treat this child? A. Order ciprofloxacin ER once daily for 3 days if the culture is positive. B. Prescribe trimethoprim sulfamethoxazole (TMP) twice daily for 3 to 5 days. Correct C. Reassure the child’s parents that this is likely an asymptomatic bacteriuria. D. Wait for urine culture results to determine the correct course of treatment. 4. A preschool age child with no previous history has mild flank pain and fever but no abdominal pain or vomiting. A urinalysis is positive for leukocyte esterase and nitrites. A culture is pending. Which is the correct course of treatment for this child? A. Hospitalize for intravenous antibiotics. B. Order amoxicillin clavulanate. Correct C. Prescribe trimethoprim sulfamethoxazole. D. Refer for a voiding cystourethrogram. 5. A 3yearold child has just completed a 7-day course of amoxicillin for a second febrile urinary tract infection and currently has a negative urine culture. What is the next course of action? A. Obtain a renal and bladder ultrasound. Correct B. Prescribe prophylactic antibiotics to prevent recurrence. C. Refer the child for a voiding cystourethrogram. D. Screen urine regularly for leukocyte esterase and nitrites. 6. A 9 month old infant with a history of three urinary tract infections is diagnosed with grade II vesicoureteral reflux. Which medication will be prescribed? A. Amoxicillin 10 mg/kg as a single daily dose B. Ceftriaxone IM 50 mg/kg as a single daily dose C. Nitrofurantoin 12 mg/kg as a single daily dose D. TMPSMX; TMP 2 mg/kg as a single daily dose Correct 7. The parent of a toddler diagnosed with grade V vesicoureteral reflux asks the primary care pediatric nurse practitioner how the disease will be treated. What will the nurse practitioner tell this parent? A. That long-term antibiotic prophylaxis will prevent scarring B. That surgery to correct the condition is possible Correct C. that the child will most likely require kidney transplant