The nurse is caring for a child who weighs 75 lb. The medication ordered for the child has a therapeutic dosage range of 33 mg/kg per day to 48 mg/kg per day. The medication ordered is to be given 4 times per day. Which dosages would be appropriate for the nurse to administer to this child in one dose?

Choice A reason: Signing a form to bypass pregnancy testing violates isotretinoin safety protocols, risking fetal harm due to teratogenicity. Encouraging testing ensures compliance, making this unsafe and incorrect compared to addressing the caregiver’s concerns while prioritizing the teen’s safety for acne treatment.

Choice B reason: Speaking to the teen alone respects privacy but doesn’t address the caregiver’s refusal or ensure testing compliance, required for isotretinoin. Encouraging testing with the caregiver’s consent is safer, making this inadequate and incorrect compared to securing agreement for mandatory pregnancy testing.

Choice C reason: Acknowledging the caregiver’s discomfort builds trust while emphasizing the necessity of pregnancy testing for isotretinoin’s safe use, preventing fetal harm. This aligns with pediatric medication safety protocols, making it the best action to ensure the 16-year-old can safely receive acne treatment.

Choice D reason: Testing without caregiver knowledge violates consent and trust, risking legal and ethical issues. Encouraging open discussion ensures compliance, making this unethical and incorrect compared to the nurse’s role in facilitating agreement for required pregnancy testing for the teen’s isotretinoin therapy.

Choice A reason: Assuming fear of pregnancy may misinterpret the 12-year-old’s concerns, potentially shutting down dialogue. Asking about worries invites her to share specific fears, making this presumptive and incorrect compared to the nurse’s role in exploring the child’s feelings about menstruation openly.

Choice B reason: Suggesting fear of pain narrows the conversation, missing other possible concerns like embarrassment or myths. Asking about worries allows broader exploration, making this limiting and incorrect compared to the nurse’s approach to understanding the girl’s specific fears about getting her period.

Choice C reason: Dismissing the child’s fear by calling periods “good” may invalidate her feelings, discouraging openness. Asking about worries validates concerns, making this dismissive and incorrect compared to the nurse’s role in fostering a supportive dialogue about menstruation with the 12-year-old.

Choice D reason: Asking what the child has heard about periods encourages her to express specific worries, facilitating education and reassurance. This aligns with pediatric nursing communication principles, making it the most appropriate response to address the 12-year-old’s concerns about menarche during the check.