FRANDSEN CHAPTER 4 TEST BANK – EXTRA CHAPTER ON INFANTS AND
PEDIATRIC PATIENTS | QUESTIONS AND ANSWERS | STUDY GUIDE 2026/2027
1. When considering physiologic variables that influence safe pharmacotherapy in clients
younger than 18, which principle should the nurse integrate into care?
A. The physiology of clients older than 15 can be considered to be the same as an
adult client.
B. The younger the client, the greater the variation in medication action compared to
an adult.
C. The larger the client's body mass index, the more his or her physiology varies from
that of an adult.
D. Pediatric clients have a greater potential to benefit from pharmacotherapy than
adult clients. - ANS ✔✔ANS: B
Rationale: Safe pharmacotherapy depends on a variety of factors, age being only one of
them. The younger the client, the greater the variation in medication action when compared
to an adult. This does not necessarily equate to a greater potential for benefit, however. BMI
is not the main or sole basis of variations between adults and children. An adolescent cannot
be assumed to be physiologically equivalent to an adult; decisions should take into account
physical size, weight, and development rather than strictly age.
2. An infant born at full gestation 3 weeks ago is seen in the emergency department (ED) with
signs and symptoms of failure to thrive. This pediatric client is classified into what pediatric
age group?
A. Child
B. Young infant
C. Neonate
D. Early postnatal - ANS ✔✔ANS: C
Rationale: Neonates are considered to be infants from full-term newborn 0 to 4 weeks of
age. None of the other terms accurately describes the appropriate pediatric age group of this
client. A child is between 1 to 12 years of age. An infant is between 4 weeks to 1 year of
age, while postnatal refers to period immediately after birth.
3. What is the primary failing that contributes to safety issues related to the practice of
pediatric pharmacology?
A. A lack of scientific understanding of the anatomy and physiology of children and
infants
B. The historical lack of pediatric participation in the drug testing process
C. The fact that research grants in pharmacology have traditionally specified adult
participation
D. Assumptions that there are no physiologic differences between adults and children - ANS ✔✔ANS: B
Rationale: Historically, researchers used only adults to test medications, and prescribers
simply assumed that smaller doses would elicit the same results in pediatric clients. The
knowledge base surrounding anatomical and physiological differences between adults and
children is substantial, and grant funding is not typically limited to adult participation.
4. A 9-year-old boy with severe influenza symptoms will be treated with ribavirin, an antiviral
, that is usually taken by adults twice daily in doses of 600 mg PO. After learning that the
child's body surface area (BSA) is 1.10, the nurse will anticipate that the child will likely
receive how much ribavirin for each dose?
A. 110 mg
B. 380 mg
C. 545 mg
D. 660 mg - ANS ✔✔ANS: B
Rationale: The prescriber calculates a dose based on a known adult dose by using the
following equation: pediatric dose = BSA/1.73 adult dose. Thus, 1.1 ÷ 1.73 600 = 381.5
mg. This would likely be rounded to 380 mg.
5. Significant pharmacodynamic variations exist between adult clients and pediatric clients.
Which factor is known to contribute to differences in the ways that drugs affect target cells
in children and infants? Select all that apply.
A. Inability of children to accurately describe adverse effects
B. Immaturity of children's organ systems
C. Differences in the body composition of children
D. The lack of active immunity in children
E. Differences in the function of humoral immunity in children - ANS ✔✔ANS: B, C
Rationale: Immature organ systems and changing body compositions mean that drugs affect
children differently. Causes of pharmacodynamic variability across the life span include
differences in body composition, immature systems, and genetic makeup. Total body water,
fat stores, and protein amounts change throughout childhood and greatly influence the
effectiveness of drugs in the pediatric population. Children are indeed less able to describe
adverse effects, but this is not a pharmacodynamics variation. Differences in the function of
the immune system are not noted to significantly influence pharmacodynamics.
6. A 2-year-old child with a recent history of idiopathic nausea and vomiting was prescribed
promethazine by the health care provider. The immaturity of this child's gastrointestinal
system will primarily influence what aspect of pharmacokinetics?
A. Absorption
B. Distribution
C. Metabolism
D. Elimination - ANS ✔✔ANS: A
Rationale: Gastric emptying and intestinal motility greatly affect the child's drug absorption.
The GI tract is less directly involved in distribution, metabolism, and elimination.
7. A neonate has been prescribed a water-soluble drug for the treatment of an acute infection.
The nurse recognizes that the percentage of body water in an infant is significantly higher
than that of an adult. What implication does this have for pharmacotherapy of an infant and
the nurse providing care?
A. The drug will need to be emulsified before administration.
B. The infant's fluid intake will be reduced before and after administration.
C. The infant will have a fat-soluble drug substituted.
D. The infant may require an increased dose of the drug. - ANS ✔✔ANS: D
Rationale: In adults, total body water is approximately 60%, whereas in newborns, it is 80%.
This difference means that water-soluble drugs are diluted easily and readily moved into
intercellular tissue. As a result, serum drug concentrations are lower, and increased dosages
PEDIATRIC PATIENTS | QUESTIONS AND ANSWERS | STUDY GUIDE 2026/2027
1. When considering physiologic variables that influence safe pharmacotherapy in clients
younger than 18, which principle should the nurse integrate into care?
A. The physiology of clients older than 15 can be considered to be the same as an
adult client.
B. The younger the client, the greater the variation in medication action compared to
an adult.
C. The larger the client's body mass index, the more his or her physiology varies from
that of an adult.
D. Pediatric clients have a greater potential to benefit from pharmacotherapy than
adult clients. - ANS ✔✔ANS: B
Rationale: Safe pharmacotherapy depends on a variety of factors, age being only one of
them. The younger the client, the greater the variation in medication action when compared
to an adult. This does not necessarily equate to a greater potential for benefit, however. BMI
is not the main or sole basis of variations between adults and children. An adolescent cannot
be assumed to be physiologically equivalent to an adult; decisions should take into account
physical size, weight, and development rather than strictly age.
2. An infant born at full gestation 3 weeks ago is seen in the emergency department (ED) with
signs and symptoms of failure to thrive. This pediatric client is classified into what pediatric
age group?
A. Child
B. Young infant
C. Neonate
D. Early postnatal - ANS ✔✔ANS: C
Rationale: Neonates are considered to be infants from full-term newborn 0 to 4 weeks of
age. None of the other terms accurately describes the appropriate pediatric age group of this
client. A child is between 1 to 12 years of age. An infant is between 4 weeks to 1 year of
age, while postnatal refers to period immediately after birth.
3. What is the primary failing that contributes to safety issues related to the practice of
pediatric pharmacology?
A. A lack of scientific understanding of the anatomy and physiology of children and
infants
B. The historical lack of pediatric participation in the drug testing process
C. The fact that research grants in pharmacology have traditionally specified adult
participation
D. Assumptions that there are no physiologic differences between adults and children - ANS ✔✔ANS: B
Rationale: Historically, researchers used only adults to test medications, and prescribers
simply assumed that smaller doses would elicit the same results in pediatric clients. The
knowledge base surrounding anatomical and physiological differences between adults and
children is substantial, and grant funding is not typically limited to adult participation.
4. A 9-year-old boy with severe influenza symptoms will be treated with ribavirin, an antiviral
, that is usually taken by adults twice daily in doses of 600 mg PO. After learning that the
child's body surface area (BSA) is 1.10, the nurse will anticipate that the child will likely
receive how much ribavirin for each dose?
A. 110 mg
B. 380 mg
C. 545 mg
D. 660 mg - ANS ✔✔ANS: B
Rationale: The prescriber calculates a dose based on a known adult dose by using the
following equation: pediatric dose = BSA/1.73 adult dose. Thus, 1.1 ÷ 1.73 600 = 381.5
mg. This would likely be rounded to 380 mg.
5. Significant pharmacodynamic variations exist between adult clients and pediatric clients.
Which factor is known to contribute to differences in the ways that drugs affect target cells
in children and infants? Select all that apply.
A. Inability of children to accurately describe adverse effects
B. Immaturity of children's organ systems
C. Differences in the body composition of children
D. The lack of active immunity in children
E. Differences in the function of humoral immunity in children - ANS ✔✔ANS: B, C
Rationale: Immature organ systems and changing body compositions mean that drugs affect
children differently. Causes of pharmacodynamic variability across the life span include
differences in body composition, immature systems, and genetic makeup. Total body water,
fat stores, and protein amounts change throughout childhood and greatly influence the
effectiveness of drugs in the pediatric population. Children are indeed less able to describe
adverse effects, but this is not a pharmacodynamics variation. Differences in the function of
the immune system are not noted to significantly influence pharmacodynamics.
6. A 2-year-old child with a recent history of idiopathic nausea and vomiting was prescribed
promethazine by the health care provider. The immaturity of this child's gastrointestinal
system will primarily influence what aspect of pharmacokinetics?
A. Absorption
B. Distribution
C. Metabolism
D. Elimination - ANS ✔✔ANS: A
Rationale: Gastric emptying and intestinal motility greatly affect the child's drug absorption.
The GI tract is less directly involved in distribution, metabolism, and elimination.
7. A neonate has been prescribed a water-soluble drug for the treatment of an acute infection.
The nurse recognizes that the percentage of body water in an infant is significantly higher
than that of an adult. What implication does this have for pharmacotherapy of an infant and
the nurse providing care?
A. The drug will need to be emulsified before administration.
B. The infant's fluid intake will be reduced before and after administration.
C. The infant will have a fat-soluble drug substituted.
D. The infant may require an increased dose of the drug. - ANS ✔✔ANS: D
Rationale: In adults, total body water is approximately 60%, whereas in newborns, it is 80%.
This difference means that water-soluble drugs are diluted easily and readily moved into
intercellular tissue. As a result, serum drug concentrations are lower, and increased dosages
