Difficulty: Medium
Average Score: 93%
Simulated
Passage / Scenario
History and Physical: School-age child admitted, diagnosed with cystic fibrosis at 3 months of age, has experienced failure to thrive, and has chronic obstructive pulmonary disease. The child presents with wheezing, rhonchi, paroxysmal cough, and dyspnea. The parent reports large, frothy, foul-smelling stools. The child has deficient levels of vitamin A, D, E, and K. Barrel-shaped chest, Clubbing of the fingers bilaterally, Respiratory rate 40/min with wheezing and rhonchi noted bilaterally, dyspnea, and paroxysmal cough. Vital Signs: Temperature 38.4┬░ C (101.1┬░ F), Heart rate 100/min, Respiratory rate 40/min, Blood pressure 100/57 mm Hg. Laboratory Results: Sputum culture positive for Pseudomonas aeruginosa, Stool analysis positive for presence of fat and enzymes, Chest x-ray indicates obstructive emphysema, WBC count 20,000/mm3 (5,000 to 10,000/mm3).A nurse is reviewing the child's medical record. Which of the following medications should the nurse expect the provider to prescribe or reconcile from the child's home medication list? Select all that apply.
Correct answer
B,D,E
Rationale
The correct answers are B (Dornase alfa), D (Water-soluble vitamins), and E (Pancreatic lipase). Dornase alfa is used in cystic fibrosis, water-soluble vitamins are commonly prescribed for children for overall health, and pancreatic lipase is used in pancreatic insufficiency. Meperidine is not typically prescribed for children due to safety concerns. Acetaminophen is a common over-the-counter medication that may or may not be on the home medication list. The nurse should not expect the provider to prescribe or reconcile meperidine, acetaminophen, or other unspecified medications from the list.