Nur 611-Advanced Patient Assessment and Diagnostic
Skills
d) - answers✔✔SL is a 31 week gestational age infant. She was born two weeks ago. Her
birthweight is 1.5 kilograms. What is SL's post-natal and post-menstrual age?
a) 31 weeks post-natal age; 33 weeks post-menstrual age
b) 29 weeks post-natal age; 31 weeks post-menstrual age
c) 2 weeks post-natal age; 29 weeks post-menstrual age
d) 2 weeks post-natal age; 33 weeks post-menstrual age
e) 31 weeks post-natal age; 2 weeks post-menstrual age
d) - answers✔✔A neonate is defined as having what post-natal age?
a) < 121 days of age
b) < 1 year of age
c) < 2 years of age
d) ≤ 4 weeks of age
a) - answers✔✔Which of the following could potentially alter the rate or extent of absorption in
infants and neonates relative to adults?
a) Differences in intragastric pH
b) Maturation in drug transporters that impact central nervous system penetration
,c) Maturation in plasma proteins that bind to drugs
d) Maturation in renal clearance
b) - answers✔✔Gastric emptying rate reaches adult capacity by what age?
a) 1 year of age
b) 6-8 months of age
c) 1 month of age
d) 2 years of age
b) - answers✔✔Which of the following factors can alter drug distribution in infants?
a) Differences in bacterial colonization of the intestines
b) Changes in total body water and total body fat with age
c) Drug-drug interactions that lead to drug metabolism inhibition
d) Less skin hydration
b) - answers✔✔The binding of drugs to plasma proteins depends on which of the following
factors?
a) Gastric pH
b) Binding affinity for the protein
c) Timing of drug administration
d) Maturation in the expression of drug metabolizing enzymes
b) - answers✔✔The pharmacological action of a drug is attributed to which of the following?
,a) Plasma protein bound drug concentrations
b) Unbound drug concentrations
a) - answers✔✔Which of the following is true regarding renal function in infants?
a) Tubular secretion and reabsorption processes are immature at birth
b) Near adult values in glomerular filtration rate are reached by 2 weeks after birth
c) Dosing recommendations for renally eliminated drugs typically do not depend on post-natal
age
d) Renal blood flow reaches adult values by 1 month of age
Schwartz formula - answers✔✔Which equation is used commonly to estimate creatinine
clearance in the pediatric population?
b) - answers✔✔Penicillins undergo glomerular filtration and tubular secretion. Which of the
following may be true about the half-life of elimination for penicillins in infants?
a) Shorter half-life of elimination due to increased glomerular filtration and tubular secretion
b) Increased half-life of elimination due to reduced glomerular filtration and tubular secretion
c) No change in half-life of elimination
# of weeks from first day of LMP - answers✔✔What is gestational age?
age since birth - answers✔✔What is postnatal age?
, gestational age plus postnatal age - answers✔✔What is postconceptional age?
postnatal age minus how many weeks the offspring is preterm by - answers✔✔What is
corrected age?
low birth weight; <2.5 kg - answers✔✔LBW
very low birth weight; <1.5 kg - answers✔✔VLBW
extremely low birth weight; <1 kg - answers✔✔ELBW
32 to <37 weeks - answers✔✔moderately to late preterm
28 to <32 weeks - answers✔✔very preterm
<28 weeks - answers✔✔extremely preterm
1 month to 1 year old - answers✔✔infant
limited patient population, no healthy volunteers, trial patients usually sick (variability), low
parental consent, perceived study risks, limited blood volume for sampling, failed trials can't be
repeated - answers✔✔What are some challenges in pediatric drug development? (7)
higher gastric pH (increased F of weak bases, decreased F of weak acids); lower bile salts,
different transporter expression, slower rate of absorption - answers✔✔Absorption differences
in peds (4)
Skills
d) - answers✔✔SL is a 31 week gestational age infant. She was born two weeks ago. Her
birthweight is 1.5 kilograms. What is SL's post-natal and post-menstrual age?
a) 31 weeks post-natal age; 33 weeks post-menstrual age
b) 29 weeks post-natal age; 31 weeks post-menstrual age
c) 2 weeks post-natal age; 29 weeks post-menstrual age
d) 2 weeks post-natal age; 33 weeks post-menstrual age
e) 31 weeks post-natal age; 2 weeks post-menstrual age
d) - answers✔✔A neonate is defined as having what post-natal age?
a) < 121 days of age
b) < 1 year of age
c) < 2 years of age
d) ≤ 4 weeks of age
a) - answers✔✔Which of the following could potentially alter the rate or extent of absorption in
infants and neonates relative to adults?
a) Differences in intragastric pH
b) Maturation in drug transporters that impact central nervous system penetration
,c) Maturation in plasma proteins that bind to drugs
d) Maturation in renal clearance
b) - answers✔✔Gastric emptying rate reaches adult capacity by what age?
a) 1 year of age
b) 6-8 months of age
c) 1 month of age
d) 2 years of age
b) - answers✔✔Which of the following factors can alter drug distribution in infants?
a) Differences in bacterial colonization of the intestines
b) Changes in total body water and total body fat with age
c) Drug-drug interactions that lead to drug metabolism inhibition
d) Less skin hydration
b) - answers✔✔The binding of drugs to plasma proteins depends on which of the following
factors?
a) Gastric pH
b) Binding affinity for the protein
c) Timing of drug administration
d) Maturation in the expression of drug metabolizing enzymes
b) - answers✔✔The pharmacological action of a drug is attributed to which of the following?
,a) Plasma protein bound drug concentrations
b) Unbound drug concentrations
a) - answers✔✔Which of the following is true regarding renal function in infants?
a) Tubular secretion and reabsorption processes are immature at birth
b) Near adult values in glomerular filtration rate are reached by 2 weeks after birth
c) Dosing recommendations for renally eliminated drugs typically do not depend on post-natal
age
d) Renal blood flow reaches adult values by 1 month of age
Schwartz formula - answers✔✔Which equation is used commonly to estimate creatinine
clearance in the pediatric population?
b) - answers✔✔Penicillins undergo glomerular filtration and tubular secretion. Which of the
following may be true about the half-life of elimination for penicillins in infants?
a) Shorter half-life of elimination due to increased glomerular filtration and tubular secretion
b) Increased half-life of elimination due to reduced glomerular filtration and tubular secretion
c) No change in half-life of elimination
# of weeks from first day of LMP - answers✔✔What is gestational age?
age since birth - answers✔✔What is postnatal age?
, gestational age plus postnatal age - answers✔✔What is postconceptional age?
postnatal age minus how many weeks the offspring is preterm by - answers✔✔What is
corrected age?
low birth weight; <2.5 kg - answers✔✔LBW
very low birth weight; <1.5 kg - answers✔✔VLBW
extremely low birth weight; <1 kg - answers✔✔ELBW
32 to <37 weeks - answers✔✔moderately to late preterm
28 to <32 weeks - answers✔✔very preterm
<28 weeks - answers✔✔extremely preterm
1 month to 1 year old - answers✔✔infant
limited patient population, no healthy volunteers, trial patients usually sick (variability), low
parental consent, perceived study risks, limited blood volume for sampling, failed trials can't be
repeated - answers✔✔What are some challenges in pediatric drug development? (7)
higher gastric pH (increased F of weak bases, decreased F of weak acids); lower bile salts,
different transporter expression, slower rate of absorption - answers✔✔Absorption differences
in peds (4)
