Dosage Calculations, 9th edition Pickar, Amy Pickar-Abernethy TEST BANK by ACADEMIAMILL

TEST BANK Dosage Calculations, 9th edition 9th Edition by Gloria D. Pickar, Amy Pickar-Abernethy

TABLE OF CONTENTS Ch 1: Fractions and Decimals Ch 2: Ratios, Percents, Simple Equations, and Ratio-Proportion Ch 3: Systems of Measurement Ch 4: Conversions: Metric and Household Systems Ch 5: Conversions for Other Clinical Applications: Time and Temperature Ch 6: Equipment Used in Dosage Measurement Ch 7: Interpreting Drug Orders Ch 8: Understanding Drug Labels Ch 9: Preventing Medication Errors Ch 10: Oral Dosage of Drugs Ch 11: Parenteral Dosage of Drugs Ch 12: Reconstitution of Solutions Ch 13: Pediatric and Adult Dosages Based on Body Weight Ch 14: Alternative Dosage Calculation Methods: Ratio-Proportion and Dimensional Analysis

Ch 15: Intravenous Solutions, Equipment, and Calculations Ch 16: Body Surface Area and Advanced Pediatric Calculations Ch 17: Advanced Adult Intravenous Calculations

Dosage Calculations 9th Edition Pickar Test Bank Chapter 1—Fractions and Decimals PROBLEM Complete the following. 1. Arrange the following decimals from largest to smallest: 1.5, 0.25, 1.025. ANS: 1.5, 1.025, 0.25 PTS: 1

DIF:

Knowledge

REF: Decimals

2. Arrange the following decimals from largest to smallest: 0.33, 0.045, 0.7. ANS: 0.7, 0.33, 0.045 PTS: 1

DIF:

Knowledge

REF: Decimals

3. Arrange the following fractions from smallest to largest:

, .

ANS: ,

PTS: 1

DIF:

Knowledge

REF: Fractions

4. Arrange the following fractions from smallest to largest:

ANS: ,

PTS: 1

DIF:

Knowledge

REF: Fractions

Perform the indicated operations. Reduce fractions in answers to lowest terms.

5. ANS:

PTS: 1

DIF:

Comprehension

REF: Adding Fractions

6. ANS:

PTS: 1

DIF: Comprehension

REF: Division of Fractions

DIF: Comprehension

REF: Subtracting Fractions

DIF:

REF: Division of Fractions

7. ANS:

PTS: 1

8. ANS:

PTS: 1

Comprehension

Perform the following computations. If the questions do not have a whole number as the answer, compute to the third decimal place, and round to the second decimal place. 9. ANS:

or 75.58 (rounded) PTS: 1 DIF: Comprehension REF: Addition and Subtraction of Decimals 10.

ANS:

or 0.05 (rounded) PTS: 1

DIF:

Comprehension

REF: Multiplying Decimals

11. ANS:

PTS: 1 DIF: Comprehension REF: Addition and Subtraction of Decimals 12. ANS:

PTS: 1

DIF:

Comprehension

REF: Dividing Decimals

13. Convert the following decimal to a fraction and reduce to lowest terms. 0.09 ANS: 0.09 = PTS: 1 DIF: Comprehension REF: Conversion between Fractions and Decimals 14. Convert the following decimal to a fraction and reduce to lowest terms. 0.175 ANS: 0.175 = PTS: 1

DIF:

Application

REF: Conversion between Fractions and Decimals

15. Convert the following fraction to a decimal and round to the nearest hundredth.

ANS:

PTS: 1

DIF:

Application

REF: Conversion between Fractions and Decimals

16. Convert the following fraction to a decimal and round to the nearest tenth.

ANS:

PTS: 1

DIF:

Application

REF: Conversion between Fractions and Decimals

17. Perform the indicated operation.

ANS:

PTS: 1 DIF: Comprehension REF: Addition and Subtraction of Fractions 18. Perform the indicated operation. 6.3 100 ANS: 6.3 100 = 630 PTS: 1

DIF:

Comprehension

REF: Multiplying Decimals

19. Perform the indicated operation and round the answer to the tenths place.

ANS: PTS: 1

DIF:

Application

REF: Multiplying Decimals

20. Perform the indicated operation and round the answer to the nearest tenths place. 123.56

ANS: 123.56

78 = 9,637.68 = 9,637.7

PTS: 1

DIF:

Application

REF: Multiplying Decimals

21. Perform the indicated operation. 350

0.07

ANS: 350 0.07 = 5,000 PTS: 1

DIF:

Comprehension

REF: Dividing Decimals

22. Perform the indicated operation. 25

0.4

ANS: 25 0.4 = 62.5 PTS: 1

DIF:

Comprehension

REF: Dividing Decimals

23. Perform the indicated operation and reduce to the lowest terms.

ANS:

PTS: 1

DIF:

Application

REF: Multiplying Fractions

24. Perform the indicated operation and reduce to the lowest term.

ANS:

PTS: 1

DIF:

Application

REF: Addition and Subtraction of Fractions

25. Perform the indicated operation and reduce to lowest term.

ANS:

PTS: 1

DIF:

Application

REF: Division of Fractions

26. Convert 0.45 to a fraction in the lowest terms. ANS:

PTS: 1

DIF:

Application

REF: Conversion between Fractions and Decimals

27. Convert 0.125 to a fraction in the lowest terms. ANS:

PTS: 1

28. Convert

DIF:

Application

REF: Conversion between Fractions and Decimals

to a decimal.

ANS: 4 8 = 0.5 PTS: 1 DIF: Comprehension REF: Conversion between Fractions and Decimals

29. Convert

to a decimal and round to the nearest hundredths place.

ANS: 5 8 = 0.625 = 0.63 PTS: 1

DIF:

Application

REF: Conversion between Fractions and Decimals

30. Find the least common denominator for the following pair of fractions.

, ANS: LCD = 33 PTS: 1 DIF: Comprehension REF: Reducing Fractions to Lowest Terms 31. Find the least common denominator for the following pair of fractions.

ANS: LCD = 30 PTS: 1 DIF: Comprehension REF: Reducing Fractions to Lowest Terms 32. Perform the indicated operation and reduce to the lowest terms.

ANS:

PTS: 1

DIF:

Application

REF: Addition and Subtraction of Fractions

33. Perform the indicated operation and reduce to lowest terms.

ANS: 4

PTS: 1

DIF:

Application

REF: Addition and Subtraction of Fractions

34. After surgery, a patient drinks 2 ounces of clear liquids every 2 hours. How many ounces will the patient drink in 8 hours? ANS: 2

PTS: 1

= 10 ounces DIF:

Application

REF: Multiplying Fractions

Chapter 2—Ratios, Percents, Simple Equations, and Ratio-Proportion PROBLEM Decimal 1.

Fraction

Percent

0.05

2. 3.

45%

4. 1. Complete row 1 in the table above. ANS: , 5% , 1:20 PTS: 1

DIF:

Application

REF: Ratios and Percents

2. Complete row 2 in the table above. ANS: 0.125, 12.5%, 1:8 PTS: 1

DIF:

Application

REF: Ratios and Percents

3. Complete row 3 in the table above. ANS: 0.45,

, 9:20

PTS: 1

DIF:

Application

REF: Ratios and Percents

4. Complete row 4 in the table above. ANS: 0.3,

, 30%

PTS: 1

DIF:

Application

REF: Ratios and Percents

Solve for X. Round answers to two decimal places.

Ratio

5. ANS:

Rounded to two decimal places, X = 0.63 PTS: 1

DIF:

Application

REF: Solving Simple Equations for X

6. ANS:

Rounded to two decimal places, X = 6.67 PTS: 1

DIF:

Application

REF: Solving Simple Equations for X

Compute the answers for the following word problems. 7. A class of students consists of 9 men and 51 women. Write a proper fraction to represent the part of the total class that is women. Reduce the fraction. Change the fraction to a percent.

Reduced fraction:

Percent:

ANS: There are 51 women in the class of 60 students.

PTS: 1

DIF:

Application

REF: Ratios and Percents

8. A student received a score of 48 points on a test that was worth 60 points. Write a fraction to represent the portion of the test the student had answered correctly. Reduce the fraction. Change the fraction to a percent. Reduced fraction:

Percent:

ANS:

PTS: 1

DIF:

Application

REF: Ratios and Percents

9. In order to pass a chapter test, a student must answer 80% or more of the questions correctly. If a chapter test has 25 questions, what is the smallest number of questions that the student must answer correctly in order to pass the test? ANS: At least 80% of 25 questions must be answered correctly.

The student must answer at least 20 questions correctly. PTS: 1

DIF:

Application

REF: Ratios and Percents

10. In order to pass a unit test, a student must answer 80% or more of the questions correctly. If a unit test has 75 questions, what is the largest number of questions that the student could answer incorrectly, but still pass the unit test? ANS: At least 80% of 75 questions must be answered correctly.

At least 60 questions must be answered correctly.

The largest number of questions that the student could answer incorrectly, but still pass the test, is 15 questions. PTS: 1

DIF:

Application

REF: Ratios and Percents

11. Change the following ratio to a fraction. Reduce to lowest terms. 3:6 ANS: 3:6=

PTS: 1 DIF: Comprehension REF: Converting among Ratios, Percents, Fractions, and Decimals 12. Change the following ratio to a fraction. Reduce to the lowest term. 5 : 35 ANS: 5 : 35 =

PTS: 1 DIF: Comprehension REF: Converting among Ratios, Percents, Fractions, and Decimals 13. Change the following ratio to a decimal. Round to the hundredths place. 3:7 ANS: 3:7=

= 0.428 = 0.43

PTS: 1 DIF: Analysis REF: Converting among Ratios, Percents, Fractions, and Decimals 14. Change the following ratio to a decimal. Reduce to the hundredths place. 0.26 : 0.92 ANS: 0.26 : 0.92 =

= 0.282 = 0.28

PTS: 1 DIF: Application REF: Converting among Ratios, Percents, Fractions, and Decimals 15. Change the following ratio to a decimal. Round to the hundredths place. 1.4 : 2.8 ANS: 1.4 : 2.8 =

= 0.5

PTS: 1 DIF: Application REF: Converting among Ratios, Percents, Fractions, and Decimals 16. Change the following ratio to a percent. Round to the hundredths place. 3:6 ANS: 3:6=

= 0.5 = 0.50 = 50%

PTS: 1 DIF: Application REF: Converting among Ratios, Percents, Fractions, and Decimals 17. Change the following ratio to a percent. Round to the hundredths place. 0.7 : 2.8 ANS: 0.7 : 2.8 =

= 0.25 = 25 %

PTS: 1 DIF: Application REF: Converting among Ratios, Percents, Fractions, and Decimals 18. Solve the following problem for X.

ANS:

PTS: 1

DIF:

Application

REF: Solving Simple Equations for X

19. Upon admission to the hospital, a child weighed 62 lb. One week later, upon discharge, the child weighed

lb. How much weight did the child lose?

ANS:

X = 4.5 lb PTS: 1

DIF:

Application

REF: Solving Simple Equations for X

20. A client is to receive 1,800 mL of fluid during a 24-hour period. The client is to receive of the fluid between 7 AM and 10 PM. Calculate how many mL the client will drink during that time.

ANS:

PTS: 1

DIF:

Application

REF: Solving Simple Equations for X

Determine what % one number is of another number. 21. 30 is what % of 100? ANS:

PTS: 1 DIF: Comprehension REF: Finding the Percentage of a Quantity 22. 5 is what % of 1,500? ANS:

PTS: 1 DIF: Comprehension REF: Finding the Percentage of a Quantity 23. 1 is what % of 100? ANS: 0.01 = 1% PTS: 1 DIF: Comprehension REF: Finding the Percentage of a Quantity 24. Convert as indicated.

written as a ratio. ANS: 3:4 PTS: 1 25. Convert as indicated.

written as a ratio. ANS:

DIF:

Comprehension

REF: Ratios

7:8 PTS: 1

DIF:

Comprehension

REF: Ratios

26. Find the value of X in the following equation.

ANS: 750 = 500X

PTS: 1

DIF:

Application

REF: Solving Simple Equations for X

27. Convert the following % to a decimal. 66% ANS: 66% = PTS: 1 DIF: Comprehension REF: Converting among Ratios, Percents, Fractions, and Decimals 28. Convert the following % to a decimal. 5.25% ANS:

PTS: 1 DIF: Comprehension REF: Converting among Ratios, Percents, Fractions, and Decimals 29. Convert the following decimal to a percent. 0.04 ANS: 0.04 100 = 4% PTS: 1 DIF: Comprehension REF: Converting among Ratios, Percents, Fractions, and Decimals

30. Convert the following decimal to a percent. 0.0016 ANS: 0.0016

100 = 0.16%

PTS: 1 DIF: Comprehension REF: Converting among Ratios, Percents, Fractions, and Decimals 31. Convert the following decimal to a percent. 0.99 ANS: 0.99 100 = 99% PTS: 1 DIF: Comprehension REF: Converting among Ratios, Percents, Fractions, and Decimals 32. Determine the percentage of a given number. 25% of 40 ANS: 0.25 40 = 10 PTS: 1 DIF: Comprehension REF: Converting among Ratios, Percents, Fractions, and Decimals 33. Determine the percentage of a given number. 75% of 50 ANS: 0.75 50 = 37.5 PTS: 1 DIF: Comprehension REF: Converting among Ratios, Percents, Fractions, and Decimals 34. Find the value of X in the following equation.

ANS:

24X = 12 X = -0.5

PTS: 1

DIF:

Application

REF: Solving Simple Equations for X

Chapter 3—Systems of Measurement SHORT ANSWER Express in proper metric, apothecary, or household notation. 1. one-half teaspoon ANS: PTS: 1

DIF: Comprehension

REF: The Household System

DIF: Comprehension

REF: Metric System

DIF: Comprehension

REF: Metric System

2. two and one-half liters ANS: 2.5 L PTS: 1 3. three-tenths of a gram ANS: 0.3 g PTS: 1 4. 25 milliequivalents ANS: 25 mEq PTS: 1 DIF: Comprehension REF: Other Common Drug Measurements: Units and Milliequivalents 5. two quarts ANS: qt ii PTS: 1

DIF:

Comprehension

REF: The Household System

DIF:

Comprehension

REF: The Household System

6. 15 drops ANS: 15 gtt PTS: 1

7. five-tenths of a milligram ANS: 0.5 mg

PTS: 1

DIF:

Comprehension

REF: Metric System

DIF:

Comprehension

REF: Metric System

DIF:

Comprehension

REF: The Household System

DIF:

Comprehension

REF: The Household System

DIF:

Comprehension

REF: The Household System

DIF:

Comprehension

REF: The Household System

DIF:

Comprehension

REF: The Household System

8. two hundred milliliters ANS: 200 mL PTS: 1 9. one teaspoon ANS: 1t PTS: 1 10. three tablespoons ANS: 3T PTS: 1 11. five pounds ANS: 5 lb PTS: 1 12. two ounces ANS: 2 oz PTS: 1 13. ten drops ANS: 10 gtt PTS: 1

Interpret the given notations. 14. 35 units ANS: 35 units PTS: 1 DIF: Comprehension REF: Other Common Drug Measurements: Units and Milliequivalents

15. 3.5 mg ANS: three and one-half milligrams PTS: 1

DIF:

Comprehension

REF: Metric System

DIF:

Comprehension

REF: The Household System

16. ANS: one-half teaspoon PTS: 1 17. 12.5 mL ANS: twelve and one-half milliliters PTS: 1

DIF:

Comprehension

REF: Metric System

DIF:

Comprehension

REF: The Household System

DIF:

Comprehension

REF: The Household System

18. 12 gtt ANS: twelve drops PTS: 1 19. 22 oz ANS: twenty-two ounces PTS: 1 20. 0.25 mg ANS: twenty-five hundredths of a milligram PTS: 1

DIF:

Comprehension

REF: Metric System

21. 30 mEq ANS: thirty milliequivalents PTS: 1 DIF: Comprehension REF: Other Common Drug Measurements: Units and Milliequivalents 22. 50 mcg

ANS: fifty micrograms PTS: 1

DIF: Comprehension

REF: Metric System

23. 0.04 g ANS: four-hundredths of a gram PTS: 1

DIF: Comprehension

REF: Metric System

24. 700 mL ANS: seven hundred milliliters PTS: 1

DIF: Comprehension

REF: Metric System

DIF: Comprehension

REF: The Household System

25. 2 T ANS: two tablespoons PTS: 1

Chapter 4—Conversions: Metric and Household Systems PROBLEM Convert each of the given quantities to the equivalent unit indicated. Your answers must be in the proper form for the metric, household, or apothecary system measurement requested in the question. Convert each of the given quantities to the equivalent unit indicated. 1. 1.5 g =

ANS: 1,500 1g = 1,000 mg

x = 1,500 mg PTS: 1

DIF:

2. 1.5 mg =

mcg

Application

REF: Converting within the Metric System

Application

REF: Converting within the Metric System

Application

REF: Converting within the Metric System

ANS: 1,500 1 mg = 1,000 mcg

x = 1,500 mcg PTS: 1

DIF:

3. 3,500 g =

ANS: 3.5 1 kg = 1,000 g

x = 3.5 kg PTS: 1

DIF:

4. 125 mg =

ANS: 0.125 1,000 mg = 1 g

x = 0.125 mg PTS: 1

DIF:

Application

REF: Converting within the Metric System

5. 250 mcg =

DIF:

Application

REF: Converting within the Metric System

DIF:

Application

REF: Converting between Systems of Measurement

ANS: 0.25 1 mg = 1,000 mcg

x = 0.25 mg PTS: 1 6. 0.4 mg = gr ANS:

gr i = 60 gr

0.4 mg = 0.4 ÷ 60 = PTS: 1

7. gr ANS: 15 1 gr = 60 mg

gr PTS: 1 8. 15 cm =

DIF:

Application

REF: Converting between Systems of Measurement

Application

REF: Converting between Systems of Measurement

Application

REF: Converting between Systems of Measurement

Application

REF: Converting between Systems of Measurement

ANS: 6 1 in = 2.5 cm

x = 6 in PTS: 1

DIF:

9. 50 inches =

ANS: 125 1 in = 2.5 cm

x = 125 cm PTS: 1 10. 30 kg =

DIF: lb

ANS: 66 30 kg = 30  2.2 = 66 lb 1 kg = 2.2 lb

x = 66 lb PTS: 1 11. 15 t = ANS:

DIF: mL

75 1 t = 5 mL 15 t = 15  5 = 75 mL PTS: 1 12. 10 in =

DIF:

Application

REF: Converting between Systems of Measurement

Application

REF: Converting between Systems of Measurement

Application

REF: Converting within the Metric System

Application

REF: Converting between Systems of Measurement

ANS: 25 cm 25

x = 25 cm PTS: 1 13. 0.4 g =

DIF: mg

ANS: 400 mg 400 1 g = 1,000 mg

x = 1,000 0.4 x = 400 mg PTS: 1 14. 220 lb =

DIF: kg

ANS: 100 kg 100 1 kg = 2.2 lb

x= x = 100 mg PTS: 1 15. 5.27 kg = ANS: 5,270 g

DIF: g

5,270 1 kg = 1,000 g

x = 5,270 g PTS: 1 16. 5 kg =

DIF:

Application

REF: Converting within the Metric System

DIF:

Application

REF: Converting within the Metric System

Application

REF: Converting within the Metric System

ANS: 5,000 g 5,000 1 kg = 1,000 g

x = 5,000 g PTS: 1 17. 2 L =

ANS: 2,000 mL 2,000 1 L = 1,000 mL

x = 2,000 mL PTS: 1

DIF:

18. 32 mcg =

ANS: 0.032 mg 0.032 1 mg = 1,000 mcg

x = 0.032 mg

PTS: 1 19. 24 in =

DIF:

Application

REF: Converting within the Metric System

Application

REF: Converting between Systems of Measurement

Application

REF: Converting within the Metric System

ANS: 60 60 cm 1 in = 2.5 cm 24

2.5 = 60 cm

PTS: 1 20. 0.56 mcg =

DIF: mg

ANS: 0.00056 0.00056 mg 1 mg = 1,000 mcg

PTS: 1

DIF:

Solve the following problems using conversions as needed. 21. A patient’s lunch consisted of the following fluids: 6 ounces of soup 8 ounces of milk 6 ounces of gelatin 4 ounces of pudding Calculate the patient’s total fluid intake in ounces. Convert to mL and to L. oz mL, L ANS: 24, 720, 0.72 1 oz = 30 mL 24 oz, 720 mL, 0.72 L 24 oz = 24  30 = 720 mL 24 oz = 720 ÷ 1,000 = 0.72 L PTS: 1

DIF:

Analysis

22. The total fluid intake of the below is

REF: Converting between Systems of Measurement mL.

1 ounce = 30 mL coffee ginger ale water broth

3 ounces 10 ounces 6 ounces 4 ounces

ANS: 690 mL 690 coffee ginger ale water chicken broth

3 oz = 90 mL 10 oz = 300 mL 6 oz = 180 mL 4 oz = 120 mL Intake = 690 mL

PTS: 1

DIF:

Application

REF: Converting between Systems of Measurement

23. The patient is to receive 5 mL of a drug, which is the equivalent of

teaspoons.

ANS: 1 1t 1 teaspoon (t) = 5 mL PTS: 1

DIF:

Application

REF: Converting between Systems of Measurement

24. At an annual physical, a patient weighs 198 pounds, which is the equivalent of

kilograms.

ANS: 90 90 kg 1 kg = 2.2 lb 198

2.2 = 90 kg

PTS: 1

DIF:

Application

REF: Converting between Systems of Measurement

25. A newborn infant is 22 inches long. His length is ANS: 55 55 cm 1 in = 2.5 cm 22

2.5 = 55 cm

cm.

PTS: 1

DIF:

Application

REF: Converting between Systems of Measurement

26. A newborn infant is 50 cm long. Her length is

inches.

ANS: 20 20 in 1 in = 2.5 cm 50

2.5 = 20 in

PTS: 1

DIF:

Application

REF: Converting between Systems of Measurement

Chapter 5—Conversions for Other Clinical Applications: Time and Temperature SHORT ANSWER Complete the following questions by converting between traditional time and international time. 1. Convert 10:45 AM to international time. ANS: 1045 PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 2. Convert 2:30 PM to international time. ANS: 1430 PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 3. Convert 8:00 AM to international time. ANS: 0800 PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 4. Convert 4:50 PM to international time. ANS: 1650 PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 5. Convert 12:15 PM to international time. ANS: 1215 PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 6. Convert 12:25 AM to international time. ANS: 0025 PTS: 1

DIF:

Comprehension

REF: Converting between Traditional and International Time 7. Convert 1825 to traditional time. ANS: 6:25 PM PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 8. Convert 0450 to traditional time. ANS: 4:50 AM PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 9. Convert 1525 to traditional time. ANS: 3:25 PM PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 10. Convert 1215 to traditional time. ANS: 12:15 PM PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 11. Convert 2220 to traditional time. ANS: 10:20 PM PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 12. Convert 1000 to traditional time. ANS: 10:00 AM PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time Convert between international and traditional time or between Fahrenheit and Celsius temperatures as requested.

13. A patient’s outpatient surgery is scheduled to begin at 1500. The patient is to be instructed to register at the outpatient surgery desk 2 hours before the scheduled time for the surgery. Using traditional time, state the time at which the patient should arrive for registration. ANS: 1500 = 3:00 PM Two hours before 3:00 PM is 1:00 PM PTS: 1 DIF: Application REF: Converting between Traditional and International Time 14. A patient’s outpatient surgery is scheduled to begin at 1500. The physician estimates that the patient will be in the surgery room for an hour and a half, and then in the recovery room for an hour. After that, the family may visit with the patient. At what time would the family members expect to be able to visit with the patient? Answer using traditional time. ANS: 1 hr 30 min in surgery + 1 hr in recovery room = 2 hours, 30 minutes. 3:00 PM + 2 hours, 30 minutes = 5:30 PM PTS: 1 DIF: Application REF: Converting between Traditional and International Time 15. A nurse who was assisting with the delivery of a baby noticed that the child was delivered at 12:10 PM. How should she note that time in the medical records if she is supposed to report the time using international time? ANS: 12:10 PM = 1210 PTS: 1 DIF: Application REF: Converting between Traditional and International Time 16. The emergency room nurse administered a medication to a patient at 3:25 AM. He is supposed to record the time using international time. What should he record as the time of administration? ANS: 3:25 AM = 0325 PTS: 1 DIF: Application REF: Converting between Traditional and International Time 17. A patient arrived in the emergency room with a fever of 38.5 C, which was reduced to 37.8 C by the time she was admitted to a hospital room. Change those temperatures to Fahrenheit temperatures. ANS:

PTS: 1

DIF:

Application

REF: Converting between Celsius and Fahrenheit

18. A mother called the pediatrician’s office, reporting that her infant son had a temperature of 102.6 F. The nurse is to record the information as a Celsius temperature. What should the nurse write down as the temperature reported by the mother? ANS:

PTS: 1

DIF:

Application

REF: Converting between Celsius and Fahrenheit

19. Convert 8:25 PM to international time. ANS: 2025 PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 20. Convert 7:45 AM to international time. ANS: 0745 PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 21. Convert 1:16 PM to international time. ANS: 1316 PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 22. Convert 11:20 AM to international time. ANS: 1120 PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 23. Convert 1945 to traditional time. ANS: 7:45 PM PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 24. Convert 2320 to traditional time. ANS:

11:20 PM PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 25. Convert 0915 to traditional time. ANS: 9:15 AM PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 26. Convert 1152 to traditional time. ANS: 11:52 AM PTS: 1 DIF: Comprehension REF: Converting between Traditional and International Time 27. Convert between Fahrenheit and Celsius temperatures as requested. 100 F ANS: 100 F =

= 37.8 C

PTS: 1

DIF:

Application

REF: Converting between Celsius and Fahrenheit

28. Convert between Fahrenheit and Celsius temperatures as requested.

ANS:

PTS: 1

DIF:

Application

REF: Converting between Celsius and Fahrenheit

29. Convert between Fahrenheit and Celsius temperatures as requested.

ANS: PTS: 1

DIF:

Application

REF: Converting between Celsius and Fahrenheit

30. Convert between Fahrenheit and Celsius as requested.

ANS: PTS: 1

DIF:

Application

REF: Converting between Celsius and Fahrenheit

Chapter 6—Equipment Used in Dosage Measurement COMPLETION 1. The medicine cup calibrations indicate that 1 teaspoon is approximately

mL.

ANS: 5 mL 5 PTS: 1

DIF:

Knowledge

REF: Oral Administration

2. The medicine cup calibrations indicate that 1 tablespoon (1 T) is approximately

mL.

ANS: 15 mL 15 PTS: 1

DIF: Knowledge

REF: Oral Administration

SHORT ANSWER Draw an arrow to point to the volume that corresponds to the dose to be administered with the given equipment. 1. Administer 0.75 mL.

ANS:

PTS: 1

DIF:

2. Administer 1.2 mL.

ANS:

Knowledge

REF: Parenteral Administration

PTS: 1

DIF:

Knowledge

REF: Parenteral Administration

Knowledge

REF: Parenteral Administration

Knowledge

REF: Parenteral Administration

3. Administer 0.08 mL.

ANS:

PTS: 1

DIF:

4. Administer 15 units.

ANS:

PTS: 1

DIF:

5. Administer 68 units.

ANS:

PTS: 1

DIF:

Knowledge

REF: Parenteral Administration

Knowledge

REF: Parenteral Administration

Knowledge

REF: Parenteral Administration

6. Administer 36 units.

ANS:

PTS: 1

DIF:

7. Administer 4.6 mL.

ANS:

PTS: 1

DIF:

8. Administer 17 mL.

ANS:

PTS: 1

DIF:

Knowledge

REF: Parenteral Administration

Knowledge

REF: Oral Administration

9. Administer 2 t.

ANS:

PTS: 1

DIF:

10. Administer 0.36 mL.

ANS:

PTS: 1

DIF:

Knowledge

REF: Parenteral Administration

Knowledge

REF: Parenteral Administration

Knowledge

REF: Parenteral Administration

11. Administer 0.75 mL.

ANS:

PTS: 1

DIF:

12. Administer 1.6 mL.

ANS:

PTS: 1 13. Administer 2.9 mL.

DIF:

ANS:

PTS: 1

DIF:

Knowledge

REF: Parenteral Administration

Knowledge

REF: Parenteral Administration

Knowledge

REF: Parenteral Administration

14. Administer 4.2 mL.

ANS:

PTS: 1

DIF:

15. Administer 3.8 mL.

ANS:

PTS: 1 16. Administer 5.6 mL.

DIF:

ANS:

PTS: 1

DIF:

Knowledge

REF: Parenteral Administration

Knowledge

REF: Parenteral Administration

17. Administer 15 mL.

ANS:

PTS: 1

DIF:

18. Administer 12 units of insulin.

ANS:

PTS: 1

DIF:

Knowledge

REF: Parenteral Administration

19. Administer 80 units of insulin.

ANS:

PTS: 1

DIF:

Knowledge

REF: Parenteral Administration

20. Can you measure 1.45 mL in a single tuberculin syringe? Explain. ANS: No. A single, tuberculin syringe has a maximum capacity of only 1 mL. PTS: 1

DIF:

Application

REF: Parenteral Administration

21. How would you measure 2.44 mL in a 3 mL syringe? ANS: Round to 2.4 mL and measure 2.4 mL on the syringe. PTS: 1

DIF:

Application

REF: Parenteral Administration

22. In which syringe should 0.32 mL of a medication solution be measured? ANS: The medication can be measured and administered with a 1 mL (tuberculin) syringe.

PTS: 1

DIF:

Application

REF: Parenteral Administration

23. Is it considered safe practice to exchange packaged droppers? ANS: No, it is not considered safe practice because drop size varies from one dropper to another. PTS: 1

DIF:

Application

REF: Oral Administration

24. Will using a medicine cup to measure a liquid medication always give you an accurate amount of medication? ANS: No, medicine cups only provide approximate measures. PTS: 1

DIF:

Application

REF: Oral Administration

25. Can insulin syringes be used to measure any medication for parenteral use? ANS: No, insulin syringes can only be used for the measurement and administration of insulin. PTS: 1

DIF:

Application

REF: Parenteral Administration

26. What are some examples for use of a 1 mL (tuberculin) syringe? ANS: The 1 mL syringe can be used to measure and administer allergen extract, vaccines, and medication for children. PTS: 1

DIF:

Application

REF: Parenteral Administration

27. Can the single-dose, prefilled syringe cartridge be used more than once? ANS: No, a single-dose, prefilled syringe cartridge can be used only once and then must be discarded. PTS: 1

DIF:

Application

REF: Parenteral Administration

Chapter 7—Interpreting Drug Orders SHORT ANSWER Answer the following questions by supplying either the medical abbreviation or the interpretation of the medical abbreviation. 1. q.i.d. ANS: four times per day PTS: 1

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

2. p.c. ANS: after meals PTS: 1 3. t.i.d. ANS: three times a day PTS: 1 4. ANS: with PTS: 1 5. p.o. ANS: orally PTS: 1 6. q.4h ANS: every four hours PTS: 1 7. before ANS:

PTS: 1

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

8. nothing by mouth ANS: NPO PTS: 1 9. gtt ANS: drops PTS: 1 10. lytes ANS: electrolytes PTS: 1 11. when necessary ANS: p.r.n. PTS: 1 12. immediately ANS: stat PTS: 1 13. b.i.d. ANS: two times a day PTS: 1 14. min. ANS: minute PTS: 1 15. h

ANS: hour PTS: 1

DIF:

Knowledge

REF: Medical Abbreviations

DIF:

Knowledge

REF: Medical Abbreviations

DIF:

Knowledge

REF: Medical Abbreviations

DIF:

Knowledge

REF: Medical Abbreviations

DIF:

Knowledge

REF: Medical Abbreviations

DIF:

Knowledge

REF: Medical Abbreviations

DIF:

Knowledge

REF: Medical Abbreviations

DIF:

Knowledge

REF: Medical Abbreviations

16. q.h ANS: every hour PTS: 1 17. q.12 h ANS: every twelve hours PTS: 1 18. capsule ANS: cap PTS: 1 19. intramuscular ANS: IM PTS: 1 20. intradermal ANS: ID PTS: 1 21. per rectum ANS: pr PTS: 1 22. tablet ANS: tab PTS: 1

23. q ANS: every PTS: 1

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

DIF: Knowledge

REF: Medical Abbreviations

24. qs ANS: quantity sufficient PTS: 1 25. aq ANS: water PTS: 1 26. GT ANS: gastrostomy tube PTS: 1 27. NG ANS: nasogastric tube PTS: 1 28. noct ANS: night PTS: 1 29. et ANS: and PTS: 1 30. IV PB ANS: intravenous piggyback

PTS: 1

DIF:

Knowledge

REF: Medical Abbreviations

Interpret the following drug orders or write drug orders using correct medical abbreviations based on the supplied information. The drug orders are presented for practice only, and actual prescribed dosages will vary according to a patient’s age, condition, reaction, additional medications, and other factors. 31. Phenergan 25 mg IM q. 6h p.r.n., nausea. ANS: Give Phenergan 25 mg intramuscularly every 6 hours as necessary for nausea. PTS: 1

DIF:

Comprehension

32. codeine gr

p.o. q.4h p.r.n., pain.

REF: The Drug Order

ANS: Give

grain of codeine orally every four hours as needed for pain.

PTS: 1

DIF:

Comprehension

REF: The Drug Order

33. potassium chloride 40 mEq p.o. b.i.d. in 4 oz juice. ANS: Give 40 milliequivalents of potassium chloride orally, twice per day, in four ounces of juice. PTS: 1

DIF:

Comprehension

REF: The Drug Order

34. Demerol 25 mg IM q.6h p.r.n., pain. ANS: Give 25 mg of Demerol intramuscularly every 6 hours as needed for pain. PTS: 1

DIF:

Comprehension

REF: The Drug Order

35. Amoxicillin 500 mg p.o. t.i.d. ANS: Give 500 mg Amoxicillin orally three times per day. PTS: 1

DIF:

Comprehension

REF: The Drug Order

36. Morphine Sulphate 2 mg IV q.2h p.r.n., pain. ANS: Give Morphine Sulphate 2 mg intravenously every 2 hours as needed for pain. PTS: 1

DIF:

Comprehension

REF: The Drug Order

37. Give Lasix 20 mg orally twice a day. ANS: Lasix 20 mg p.o. b.i.d. PTS: 1

DIF:

Comprehension

REF: The Drug Order

38. Give Prednisone 25 milligrams orally once daily. ANS: Prednisone 25 mg p.o. daily. PTS: 1

DIF:

Comprehension

REF: The Drug Order

39. Tylenol suppository 325 mg p.r q. 6h p.r.n, for temperature of 101F or higher. ANS: Give Tylenol 325 milligram suppository per rectum every 6 hours as needed for a temperature of 101F or higher. PTS: 1

DIF:

Comprehension

REF: The Drug Order

Chapter 8—Understanding Drug Labels SHORT ANSWER Identify the following, using the given label.

Used with permission from Pfizer Inc.

1. The name of the manufacturer is

ANS: Pfizer Inc. PTS: 1

DIF:

Comprehension

2. The form of the drug is

REF: Name of the Manufacturer .

ANS: Caplets caplets PTS: 1

DIF:

Comprehension

Identify the following, using the given label.

Used with permission from Pfizer Inc.

REF: Form

3. The route of administration is

ANS: I.V. PTS: 1

DIF:

Comprehension

4. The brand name of the drug is

REF: Administration Route .

ANS: Zithromax PTS: 1

DIF:

Comprehension

REF: Brand and Generic Name

5. What are the label alerts? ANS: Must be further diluted before use. PTS: 1

DIF: Comprehension

REF: Label Alerts

Identify the following, using the given label.

Label courtesy of KV Pharmaceutical Co., St., Louis, Missouri.

6. Manufacturer: ANS: Ethex PTS: 1

DIF:

Comprehension

REF: Name of the Manufacturer

DIF:

Comprehension

REF: Brand and Generic Name

7. Brand name: ANS: none, generic drug PTS: 1 8. Generic name:

ANS: nitroglycerin PTS: 1

DIF:

Comprehension

REF: Brand and Generic Name

DIF:

Comprehension

REF: Dosage Strength

DIF:

Comprehension

REF: Form

DIF:

Comprehension

REF: Administration Route

DIF:

Comprehension

REF: National Drug Code (NDC)

DIF:

Comprehension

REF: Bar Code Symbols

Comprehension

REF: Total Volume

9. Dosage strength: ANS: 6.5 mg per capsule PTS: 1 10. Form: ANS: capsules PTS: 1 11. Administration route: ANS: oral administration PTS: 1

12. National Drug Code number: ANS: NDC 58177-005-04 PTS: 1 13. UPC code bars: ANS: 3-58177-005-04-6 PTS: 1

14. Total number of capsules: ANS: 100 capsules PTS: 1

DIF:

Identify the following, using the given label.

Used with permission from Aventis Pharmaceuticals.

15. Lot number: ANS: Lot BA799 PTS: 1

DIF:

Comprehension

REF: Lot or Control Number

DIF:

Comprehension

REF: Expiration Date

16. Expiration date: ANS: 08/xx (Aug 20xx) PTS: 1

Identify the following, using the given label.

17. The supply dosage is

g per

mL.

ANS: 2% = 2 g per 100 mL PTS: 1 18. The supply dosage is ANS:

DIF:

Application

REF: Supply Dosage

mg per mL.

PTS: 1

DIF:

Application

REF: Supply Dosage

Chapter 9—Preventing Medication Errors SHORT ANSWER Complete the following based upon the directions. The problems and drug orders are presented for practice only, and actual prescribed dosages will vary according to a patient’s age, condition, reaction, additional medications, and other factors. 1. Correct the medical notation of the following order. Heparin 1,400 u/h. ANS: Heparin 1,400 units/h. PTS: 1

DIF:

Knowledge

REF: Transcription

2. Correct the medical notation of the following order. MS 4 mg IV. ANS: Morphine sulfate 4 mg IV. PTS: 1

DIF:

Comprehension

REF: Transcription

3. Correct the medical notation of the following order. Lanoxin .125 mg q.o.d. ANS: Lanoxin 0.125 mg every other day. PTS: 1

DIF:

Comprehension

REF: Transcription

4. Correct the medical notation of the following order. Regular insulin 7.0 u every AM. ANS: Regular insulin 7 units every AM. PTS: 1

DIF:

Comprehension

REF: Transcription

5. Correct the medical notation of the following order. Demerol 75.00 mg IM as needed for pain. ANS: Demerol 75 mg IM p.r.n., pain. PTS: 1

DIF:

Comprehension

REF: Transcription

6. When receiving verbal orders, the nurse should the order to ensure its accuracy.

and

ANS: When receiving verbal orders, the nurse should repeat and verify the order to ensure its accuracy. PTS: 1

DIF:

Comprehension

REF: Verbal Orders

7. Who is legally responsible for patient safety and any medications errors that may occur? ANS: The person administering the medication is legally responsible for patient safety and any medication errors that may occur. PTS: 1 DIF: Comprehension REF: Safe Medication Administration 8. Identify the six rights of medication administration. ANS: Right patient Right drug Right dose Right time Right route Right documentation PTS: 1

DIF:

Knowledge

REF: Safe Medication Administration

9. The nurse should check the medication label how many times before administering the drug? ANS: 3 three PTS: 1

DIF:

Knowledge

REF: Right Drug

10. Identify the error in the following medical order. Dilacor XR 240 mg q.d. per nasogastric tube. ANS: This is an extended release medication and should not be crushed or dissolved. PTS: 1

DIF:

Comprehension

11. Correct the medical notation of the following order. Lasix 40.0 mg IV q.d. ANS: Lasix 40 mg IV daily.

REF: Right Route

PTS: 1

DIF:

Comprehension

REF: Transcription

12. Identify how the “right drug” is maintained by the nurse. ANS: The “right drug” is maintained by checking the medication label: 1. on first contact with the drug 2. prior to measuring the drug 3. after obtaining the drug, just prior to administration PTS: 1

DIF:

Application

REF: Right Drug

13. Documentation of medication administration should occur when? ANS: Documentation should occur after the medication administration. PTS: 1

DIF:

Knowledge

REF: Right Documentation

14. What is one of the “main causes” of medication errors? ANS: Incorrect transcription of the original prescriber’s order. PTS: 1

DIF:

Knowledge

REF: Transcription

15. What list was written in an attempt to avoid transcription errors? ANS: The Joint Commission Official “Do Not Use” list of Medical Abbreviations PTS: 1

DIF:

Knowledge

REF: Transcription

16. According to The Joint Commission Official “Do Not Use” List of Medical Abbreviations, how should the commonly used abbreviation, Q.D. now be written? ANS: Write “daily.” PTS: 1

DIF:

Comprehension

REF: Transcription

17. According to The Joint Commission Official “Do Not Use” List of Medical Abbreviations, how should the abbreviation IU, now be written? ANS: Write “International Unit.” PTS: 1

DIF:

Comprehension

REF: Transcription

18. According to The Joint Commission Official “Do Not Use” List of Medical Abbreviations, why should the RN not write a trailing zero on a medication dose? ANS:

The decimal point may be missed. PTS: 1

DIF:

Comprehension

REF: Transcription

19. Correct the medical notation of the following order. Fosamax 70 mg q.d. ANS: Fosamax 70 mg daily. PTS: 1

DIF:

Comprehension

REF: Transcription

20. Correct the medical notation of the following order. NPH Insulin 45.0 u SC every AM. ANS: NPH Insulin 45 units SC every AM. PTS: 1

DIF:

Comprehension

REF: Transcription

21. Correct the medical notation of the following order. Heparin 1,000 u SC q.d. ANS: Heparin 1,000 units SC daily. PTS: 1

DIF:

Comprehension

REF: Transcription

22. Correct the medical notation of the following order. Valium 2.0 mg p.o., daily, p.r.n., anxiety. ANS: Valium 2 mg p.o., p.r.n, anxiety. PTS: 1

DIF:

Comprehension

REF: Transcription

23. Do registered nurses have the legal authority to write patient orders and prescriptions? ANS: No, only those licensed health care providers who have the authority by their states to write prescriptions and orders are permitted to do so. Examples include a medical doctor (MD), nurse practitioners (NP), physician’s assistants (PA), a dentist (DDS), an osteopathic doctor (DO), and a podiatrist (DPM). PTS: 1

DIF:

Comprehension

REF: Prescription

24. What reference should a nurse use when validating the safety of the medication as ordered and transcribed? ANS:

The nurse should refer to a reputable drug reference resource to validate the safety of ordered and transcribed medications. PTS: 1

DIF:

Comprehension

REF: Prescription

25. How many ways does The Joint Commission require a patient to be uniquely identified to ensure the safe administration of medications. ANS: The Joint Commission requires that patients be identified with at least two unique identifiers such as name and date of birth, or name and patient ID number. It may not be the room number. PTS: 1

DIF:

Comprehension

REF: Right Patient

26. Which step in the administration of medications often leads to overmedication of the patient? ANS: The last step in the procedure for medication administration is documentation. Often fatigue and time constraints are factors that may contribute to failure to document that a medication has been given. PTS: 1

DIF:

Comprehension

REF: Right Documentation

Chapter 10—Oral Dosage of Drugs PROBLEM Compute the amount of medication you will give to administer one dose of the following medication orders. Assume all tablets are scored, when necessary. The problems and drug orders are presented for practice only, and actual prescribed dosages will vary according to a patient’s age, condition, reaction, additional medications, and other factors. 1. Order: Supply: Give:

furosemide 80 mg p.o. b.i.d. Bottle containing 50 tablets of Lasix (furosemide), 80 mg per tablet tablet(s)

ANS:

PTS: 1

DIF:

Comprehension

REF: Tablets and Capsules

2. Order: Supply: Give:

tamoxifen 0.02 g p.o. b.i.d., morning and evening Nolvadex (tamoxifen) 20 mg per tablet tablet(s)

ANS: 1 g = 1,000 mg

PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

3. Order: Supply: Give: ANS:

Depakene 375 mg p.o. b.i.d. Depakene 250 mg/5 mL mL or

teaspoons

PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

4. Order: Supply: Give:

Amoxil 0.375 g p.o. q.8h 80 mL bottle of reconstituted Amoxil oral suspension, 125 mg/5 mL mL or tablespoon

ANS: 1,000 mg = 1 g

PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

5. Order: Supply: Give:

cefalcor 0.3 g p.o. q.8h Celcor (cefalcor) reconstituted oral suspension, 375 mg per 5 mL mL

ANS:

PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

6. Order: Supply: Give:

erythromycin ethylsuccinate 800 mg p.o. q.12h E.E.S. 400 (erythromycin ethylsuccinate) 400 mg per tablet tablet(s)

ANS:

PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

7. Order: Supply: Give:

Augmentin 0.5 g p.o. q.8h 75 mL bottle or reconstituted Augmentin, 250 mg/5 mL mL or teaspoons

ANS: 1 g = 1,000 mg

PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

8. Order: Supply: Give:

Klonopin 500 mcg p.o. t.i.d. Bottle of 100 tablets of Klonopin, 0.5 mg per tablet tablet(s)

ANS:

PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

9. Order: Supply: Give: ANS:

pediatric dose: Biaxin 100 mg p.o. q.12h 100 mL of reconstituted Biaxin, 125 mg per 5 mL mL

PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

10. Order: Supply: Give:

Axid 0.15 g p.o. b.i.d. Bottle containing 60 capsules of Axid, 150 mg per capsule capsule(s)

ANS:

PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

11. Order: Supply: Give:

Prozac 40 mg p.o. b.i.d., morning and noon Prozac 20 mg per tablet tablet(s)

ANS:

PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

12. Order: Supply: Give: ANS:

hydrochlorothiazide 50 mg p.o. b.i.d. hydrochlorothiazide 100 mg tablets tab(s)

PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

13. Decide which supply you would select and enter the number of tablets you would give. Order: codeine gr p.o. q.4h p.r.n., pain Supply: 15 mg, 30 mg, and 60 mg tablets Give: Select mg tablets, and give tablet(s). ANS:

. PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

14. Order: Supply: Give:

Amoxil suspension 375 mg p.o. q.6h Amoxil suspension 250 mg/5mL mL

ANS:

PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

15. Order: Supply: Give: ANS:

Keflex 0.375 g p.o. b.i.d. Reconstituted Keflex oral suspension, 250 mg/5mL teaspoons

PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

16. Order: Supply: Give:

Allopurinol 0.2 g p.o. daily Bottle containing 200 tablets Zyloprim (Allopurinol) 100 mg per tablet tablet(s)

ANS: 1 g = 1,000 mg

X = 200

X = 2 tablets PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

17. Order: Supply: Give: ANS:

Mycostatin 400,000 units p.o. swish and swallow q.6h t.i.d. Bottle containing 473 mL Mycostatin oral suspension, 100,000 units per mL mL

X = 4 mL PTS: 1

DIF:

Application

REF: Oral Liquids

18. Order: Supply: Give:

Keflex 0.5 g p.o. b.i.d for 7 days Bottle containing Keflex 500 mg per capsule, 14 capsules capsule(s)

ANS: 1 g = 1,000 mg

X = 500 mg

X = 1 capsule PTS: 1

DIF:

Application

REF: Three-Step Approach to Dosage Calculations

19. Order: Supply: Give:

Tylenol 325 mg p.o. q.6h p.r.n.for temperature of 101°F or above Bottle containing 50 tablets of Tylenol 325 mg per tablet tablet(s)

ANS:

X = 1 tablet PTS: 1

DIF:

Comprehension

REF: Tablets and Capsules

20. Order: Supply: Give:

Synthroid 12.5 mcg p.o. daily Bottle containing 100 scored tablets of Synthroid, 25 mcg per tablet tablet(s)

ANS:

X = 0.5 tablet PTS: 1 21.

DIF:

Comprehension

REF: Tablets and Comprehension

Order: Supply: Give:

Potassium Chloride 30 mEq p.o. b.i.d Package containing 15 mL of Potassium Chloride Oral Solution 10%, 20 mEq per 15 mL. mL

ANS:

X = 20 mL PTS: 1

DIF:

Application

REF: Oral Liquids

22. Order: Label: Give:

Demerol syrup 100 mg p.o. q.6h p.r.n. pain Demerol syrup 50 mg per 5 mL mL

ANS:

X = 10 mL PTS: 1

DIF:

Application

REF: Oral Liquids

23. Order: Supply: Give:

Lasix 80 mg p.o. daily Lasix 40 mg tablets tablet(s)

ANS:

X=2 PTS: 1

DIF:

Comprehension

REF: Tablets and Capsules

24. Is there enough medication in a 15 mL package of Potassium Chloride Oral Solution 10%, 20 mEq per 15 mL, to fulfill an order of 20 mL? Explain. ANS: No, there is not enough medication in one package. The nurse would need to use some medication from another package too.

PTS: 1

DIF:

Application

REF: Oral Liquids

Chapter 11—Parenteral Dosage of Drugs PROBLEM Compute the amount of medication that will be given to administer one dose of the following medication orders. Round all parenteral administration orders that are over 1 mL to one decimal place. Round all parenteral administration orders under 1 mL to two decimal places. Do not include zeros at the end of decimal numbers. The problems and drug orders are presented for practice only, and actual prescribed dosages will vary according to a patient’s age, condition, reaction, additional medications, and other factors. 1. Order: Supply: Give:

penicillin G procaine 1,200,000 units IM q.o.d. penicillin G procaine 600,000 units per mL mL

ANS:

PTS: 1

DIF:

Comprehension

REF: Injectable Solutions

2. Order: Supply: Give:

Prostigmin 250 mcg subcut C q.6h Prostigmin 0.25 mg/mL mL

ANS:

PTS: 1

DIF:

Application

REF: Injectable Solutions

3. Order: Supply: Give: ANS:

Demerol 75 mg IM q.4h p.r.n., pain Demerol 50 mg/mL mL

PTS: 1

DIF:

Comprehension

REF: Injectable Solutions

4. Order: Supply: Give:

diazepam 5 mg IM q.4h p.r.n., anxiety Valium (diazepam) 10 mg per 2 mL mL

ANS:

PTS: 1

DIF:

Comprehension

REF: Injectable Solutions

5. Order: Supply: Give:

diphenhydramine 15 mg IM stat Benadryl (diphenhydramine) 10 mg/mL mL

ANS:

PTS: 1

DIF:

Comprehension

REF: Injectable Solutions

6. Order: Supply: Give:

Valium 3 mg IM q.6h p.r.n., pain Valium 10 mg/2 mL mL

ANS:

PTS: 1

DIF:

Comprehension

7. Order: Supply: Give: ANS:

penicillin G potassium 400,000 units IM q.i.d. penicillin G potassium 500,000 units per 2 mL mL

REF: Injectable Solutions

PTS: 1

DIF:

Comprehension

REF: Injectable Solutions

8. Order: Supply: Give:

heparin 3,000 units subcut b.i.d. heparin 20,000 units/mL mL

ANS:

PTS: 1

DIF:

Comprehension

REF: Heparin

9. Order: Supply: Give:

Librium 30 mg IM q.6h p.r.n., anxiety Librium 100 mg/2 mL mL

ANS:

PTS: 1

DIF:

Comprehension

REF: Injectable Solutions

10. Order: Supply: Give:

Cleocin 0.3 g IM q.i.d. Cleocin 300 mg per 2 mL mL

ANS:

PTS: 1

DIF:

Comprehension

11. Order: Supply: Give:

morphine sulfate 6 mg IM q.4h p.r.n., pain morphine sulfate 10 mg/mL mL

REF: Injectable Solutions

ANS:

PTS: 1

DIF:

Comprehension

REF: Injectable Solutions

12. Order: Supply: Give:

Terramycin 0.1 g IM q.d. Terramycin 100 mg/mL mL

ANS:

PTS: 1

DIF:

Comprehension

REF: Injectable Solutions

13. Order: Supply: Give:

meperidine hydrochloride 25 mg IM q.4h p.r.n., pain Demerol (meperidine HCl) 50 mg/mL mL

ANS:

PTS: 1

DIF:

Comprehension

REF: Injectable Solutions

14. Order: Supply: Give:

Tigan 0.1 g IM q.6h p.r.n., nausea Tigan 100 mg/2 mL mL

ANS:

PTS: 1

DIF:

Comprehension

15. Order:

Vistaril 50 mg IM stat

REF: Injectable Solutions

Supply: Give:

Multidose vial labeled Vistaril 50 mg per mL mL

ANS:

X = 1 mL PTS: 1

DIF:

Comprehension

REF: Injectable Solutions

16. Ordered: Supply: Give:

Demerol 75 mg IM q.6h p.r.n, pain Meperidine HCl Injection 100 mg per mL mL

ANS:

X = 0.75 mL PTS: 1

DIF:

Comprehension

REF: Injectable Solutions

17. Ordered: Supply: Give:

Heparin 5,000 units subcut b.i.d Multidose vial of 4 mL of heparin sodium injection 10,000 units/mL mL

ANS:

X = 0.5 mL PTS: 1

DIF:

Comprehension

REF: Heparin

18. Ordered: Supply: Give:

Dexamethasone 2 mg IM q.12h Dexamethasone sodium phosphate 4 mg/ml mL

ANS:

X = 0.5 mL PTS: 1

DIF:

Comprehension

19. Ordered:

Morphine 30 mg IM q.6h p.r.n., pain

REF: Injectable Solutions

Supply: Give:

Morphine 15 mg per mL mL

ANS:

X = 2 mL PTS: 1

DIF:

Comprehension

Ordered: Supply: Give:

Dilantin 500 mg IM stat Dilantin 250 mg/5 mL mL

REF: Injectable Solutions

20.

ANS:

X = 10 mL PTS: 1

DIF:

Comprehension

REF: Injectable Solutions

21. Ordered: Supply: Give:

Depo-Provera 400 mg IM every 3 months Depo-Provera injection 400 mg per mL mL

ANS:

X = 1 mL PTS: 1

DIF:

Comprehension

REF: Injectable Solutions

22. Ordered: Supply: Give:

Vistaril 25 mg IM q. 4h p.r.n, nausea Vistaril 50 mg/mL, multidose vial of 10 mL mL

ANS:

X = 0.5 mL PTS: 1

DIF:

Comprehension

REF: Injectable Solutions

23. How many doses of Heparin 5,000 units are available in a multidose vial of 4 mL heparin sodium injection 10,000 units/mL? ANS: 8 doses PTS: 1

DIF:

Application

REF: Heparin

24. How many doses of Vistaril 25 mg IM are available in a 10 mL multidose vial of Vistaril 50 mg/mL? ANS: 20 doses are available PTS: 1

DIF:

Application

REF: Injectable Solutions

Chapter 12—Reconstitution of Solutions PROBLEM Compute the amount of medication that will be given to administer one dose of the following medication orders by using a proportion to obtain your answers. Round all parenteral administration orders that are over 1 mL to one decimal place. Round all parenteral administration orders under 1 mL to two decimal places. Do not include zeros at the end of decimal numbers. The problems and drug orders are presented for practice only, and actual prescribed dosages will vary according to a patient’s age, condition, reaction, additional medications, and other factors. 1. The physician orders 150,000 units of penicillin IM x one dose. You have a 10 mL vial of powder labeled penicillin 500,000 units. Instructions indicate to add 4.8 mL sterile saline or sterile water to give 100,000 units per mL. How many mL will be administered? ANS:

PTS: 1

DIF:

Application

REF: Single-Strength Solution

2. Order: Supply: Directions: Give:

Methotrexate 15 mg IM daily Methotrexate 1 gram vial Reconstitute with 2 mL of normal saline to yield 2.5 mg/mL mL

ANS:

PTS: 1

DIF:

Application

REF: Single-Strength Solution

3. Order: Supply: Give: ANS:

Protamine sulfate 25 mg IV x one dose Protamine sulfate 50 mg, reconstitute with 5 mL to obtain 10 mg/mL mL.

PTS: 1

DIF:

Application

REF: Single-Strength Solution

4. Order: Supply: Give:

Rifampin 600 mg daily IV Rifampin 600 mg, dilute with 10 mL of sterile water to yield 60 mg/mL mL

ANS:

PTS: 1

DIF:

Application

REF: Single-Strength Solution

5. Order: Supply: Give:

Mandol 500 mg IM Mandol 1 gram, reconstitute with 3 mL sterile water to yield 285 mg/mL mL

ANS:

PTS: 1

DIF:

Application

REF: Single-Strength Solution

6. Order: Supply: Give:

Cefazolin 1,000 mg IV x one dose Cefazolin 1gram, reconstitute with 3.7 mL to yield 250 mg/mL mL

ANS:

PTS: 1

DIF:

Application

REF: Single-Strength Solution

7. Order: Supply: Give:

Claforan 2,000 mg IV every 8 hours Claforan 2 gram, dilute with 10 mL to yield 180 mg/m mL

ANS:

PTS: 1

DIF:

Application

REF: Single-Strength Solution

8. Order: Supply: Directions: Give:

Piperacillin 2 g IV hour prior to surgery Piperacillin 4 g vial Reconstitute with 2 mL of normal saline to yield 2 g per mL. mL

ANS:

X = 1 mL PTS: 1

DIF:

Application

REF: Single-Strength Solution

9. Order: Supply: Directions: Give:

Solu-Medrol 75 mg IM b.i.d. Multi-dose vial of Solu-Medrol 500 mg. Reconstitute with 8 mL of bacteriostatic water to yield 125 mg/2 mL mL

ANS:

125X = 150 X = 1.2 mL PTS: 1

DIF:

Application

REF: Single-Strength Solution

10. Order: Supply: Directions: Give:

Ceftazadine 1.5 g IV q.12 h for 5 days Ceftazadine 2 g vial Reconstitute with 2 mL NS to yield 1g/mL mL

ANS:

X = 1.5 mL PTS: 1

DIF:

Application

REF: Single-Strength Solution

11. Order: Supply: Directions: Give: ANS:

Ancef 250 mg IV q.8h Ancef 1 g Reconstitute with 5 mL NS to yield 125 mg/mL mL

125X = 625 X = 5 mL PTS: 1

DIF:

Application

REF: Single-Strength Solution

12. Order: Supply: Directions: Give:

Librium 50 mg IM 3 hours prior to surgery Ampule Librium 100 mg Reconstitute with 1 mL NS to yield 100 mg/2mL mL

ANS:

X = 1 mL PTS: 1

DIF:

Application

REF: Single-Strength Solution

13. a. Order: Supply: Directions: Give:

Oxacillin 500 mg IV q. 6h Oxacillin 2 g, multi-dose vial Reconstitute with 10 mL diluent to yield 250 mg/mL, total volume 120 mL mL

How many total doses are available for patient use?

There will be sufficient Oxacillin for how many days?

ANS: a.

250X = 2,500 X = 10 mL b.

12 doses

3 days

PTS: 1

DIF:

Analysis

REF: Single-Strength Solution

Chapter 13—Pediatric and Adult Dosages Based on Body Weight PROBLEM Compute the amount of medication that will be given to administer one dose of the following medication orders using the ratio-proportion method to obtain your answers. Assume all tablets are scored, when necessary. Round all parenteral administration orders that are over 1 mL to one decimal place. Round all parenteral administration orders under 1 mL to two decimal places. Do not include zeros at the end of decimal numbers. The problems and drug orders are presented for practice only, and actual prescribed dosages will vary according to a patient’s age, condition, reaction, additional medications, and other factors. 1. Order: Supply: Give:

Axid 0.3 g p.o. at h.s. Axid 150 mg capsules capsules

ANS: Equivalent 1g = 1,000 mg

X = 1,000 0.3 X = 300 mg

X capsules = 150X = 300 X = 2 capsules PTS: 1

DIF:

Application

REF: Using Ratio-Proportion To Calculate Dosages

2. Order: Supply: Give:

Dilantin 25 mg p.o. t.i.d. Dilantin chewable 50 mg tablets tablet(s)

ANS: X tablets = 50X = 25

PTS: 1

tablet

DIF:

Comprehension

REF: Using Ratio-Proportion To Calculate Dosages 3. Order: Amoxil 125 mg p.o. q.8h Supply: Bottle of Amoxil (powdered medication) with the instructions to add 12 mL of water to obtain a pediatric oral suspension of 50 mg/mL Give: mL ANS: X mL = 50X = 125 X = 2.5 mL PTS: 1

DIF:

Application

REF: Using Ratio-Proportion To Calculate Dosages

4. Order: Supply: Give:

Amoxil 0.25 g p.o. q.8h 80 mL bottle of reconstituted Amoxil oral suspension, 125 mg/5 mL mL or teaspoons

ANS: Equivalent 1 g = 1,000 mg

X = 1,000 0.25 X = 250 mg

X mL = 125X = 5 250 125X = 1,250 X = 10 mL 10 mL = 10 5 = 2 teaspoons PTS: 1

DIF:

Application

REF: Using Ratio-Proportion To Calculate Dosages

5. Order: Supply: Give:

Augmentin 375 mg p.o. q.8h 75 mL bottle of reconstituted Augmentin, 250 mg/5 mL mL

ANS: X mL = 250X = 375

250X = 1,875 X = 7.5 mL PTS: 1 DIF: Comprehension REF: Using Ratio-Proportion To Calculate Dosages 6. Order: Supply: Give:

Biaxin 500 mg p.o. q.12h Biaxin oral suspension, reconstituted to 250 mg per 5 mL mL or teaspoons

ANS: X mL = 250X = 5 500 250X = 2,500 X = 10 mL 10 mL = 10

5=2 2 teaspoons

PTS: 1 DIF: Comprehension REF: Using Ratio-Proportion To Calculate Dosages 7. Order: Supply: Give:

Ceclor 300 mg p.o. q.8h Ceclor reconstituted oral suspension, 375 mg/5 mL mL

ANS: X mL = 375X = 300 5 375X = 1,500 X = 4 mL PTS: 1 DIF: Comprehension REF: Using Ratio-Proportion To Calculate Dosages 8. Order: Supply: Give:

Klonopin 500 mcg p.o. t.i.d. Bottle of 100 tablets of Klonopin, 0.5 mg per tablet tablet(s)

ANS: Equivalent = 1 mg = 1,000 mcg

1,000X = 500 X = 0.5 mg

0.5X = 0.5 X = 1 tablet PTS: 1

DIF:

Application

REF: Using Ratio-Proportion To Calculate Dosages

9. Order: Supply: Give:

vitamin B12 100,000 units IM q.d. for 3 days 2 mL vial of vitamin B12 with 50,000 units/mL mL

ANS: X mL = 50,000X = 100,000 X = 2 mL PTS: 1

DIF:

Application

REF: Using Ratio-Proportion To Calculate Dosages

10. Order: Supply: Give:

thiamine HCl 20 mg IM t.i.d. 10 mL multiple dose vial of vitamin B1 (thiamine HCl) 100 mg/mL mL

ANS: X mL= 100X = 20 X = 0.2 mL PTS: 1 DIF: Comprehension REF: Using Ratio-Proportion To Calculate Dosages 11. Order: ascorbic acid 150 mg IM q.d. Supply: 2 mL ampule of vitamin C (ascorbic acid) 250 mg/mL Give: mL ANS: X mL = 250X = 150 X = 0.6 mL PTS: 1

DIF:

Comprehension

REF: Using Ratio-Proportion To Calculate Dosages 12. Order: Supply: Give:

heparin 7,500 units SC q.8h heparin 10,000 units/mL mL

ANS: X mL = 10,000X = 7,500 X = 0.75 mL PTS: 1 DIF: Comprehension REF: Using Ratio-Proportion To Calculate Dosages 13. Order: Supply: Give:

prednisolone acetate 35 mg IM q.d. 10 mL multiple dose vial of prednisolone acetate with a supply dosage of 50 mg/mL mL

ANS: X mL= 50X = 35 X = 0.7 mL PTS: 1 DIF: Comprehension REF: Using Ratio-Proportion To Calculate Dosages 14. Order: Supply: Give:

methylprednisolone acetate 100 mg IM once per week methylprednisolone acetate suspension, 80 mg/mL mL

ANS: X mL = 80X = 100 X = 1.25 = 1.3 mL PTS: 1 DIF: Comprehension REF: Using Ratio-Proportion To Calculate Dosages Compute the amount of medication that will be given to administer one dose of the following medication orders using the Dimensional Analysis method to obtain your answers.

Assume all tablets are scored, when necessary. Round all parenteral administration orders that are over 1 mL to one decimal place. Round all parenteral administration orders under 1 mL to two decimal places. Do not include zeros at the end of decimal numbers. The problems and drug orders are presented for practice only, and actual prescribed dosages will vary according to a patient’s age, condition, reaction, additional medications, and other factors. 15. Order: Supply: Give:

Ceclor 0.375 g po. q.8h Ceclor oral suspension 125 mg/5mL mL

ANS: X mL =

15 mL Ceclor

PTS: 1

DIF:

Application

REF: Using Dimensional Analysis To Calculate Dosages

16. Order: Supply: Give:

Vistaril 0.1 g p.o. t.i.d Vistaril oral suspension 25 mg/5mL mL

ANS: X mL =

20 mL

PTS: 1

DIF:

Application

REF: Using Dimensional Analysis To Calculate Dosages

17. Order: Supply: Give:

Haldol 3 mg IM q. 8h Haldol 5 mg/mL injectable; 20 mL multidose vial mL

ANS: X mL =

0.6 mL

PTS: 1 DIF: Comprehension REF: Using Dimensional Analysis To Calculate Dosages 18. Order: Supply: Give:

Pepcid 20 mg p.o. q.hs Famotidine 10 mg chewable tablets tablets

ANS: X chewable tablets = PTS: 1

2 tablets DIF:

Comprehension

REF: Using Dimensional Analysis To Calculate Dosages 19. Order: Supply: Give:

Synthroid 50 mcg p.o. daily levothyroxine 0.025 mg tablets tablets

ANS: X tablets =

= 2 tablets

PTS: 1 DIF: Comprehension REF: Using Dimensional Analysis To Calculate Dosages 20. Order: Supply: Give:

Augmentin 875 mg p.o. q.12 Augmentin oral suspension 400 mg/5mL, 20 mL bottle mL

ANS: X mL = PTS: 1

8.75 or 8.8 mL DIF:

Application

REF: Using Dimensional Analysis To Calculate Dosages

21. Order: acyclovir 0.8 g p.o. q.4h Supply: acyclovir 400 mg tablets Give: tablets ANS: X tablets = PTS: 1

= 2 tablets DIF:

Application

REF: Using Dimensional Analysis To Calculate Dosages

Chapter 14—Alternative Dosage Calculation Methods: Ratio-Proportion and Dimensional Analysis PROBLEM Compute the requested information. Round all parenteral administration orders that are over 1 mL to one decimal place. Round all parenteral administration orders under 1 mL to two decimal places. Do not include zeros at the end of decimal numbers. The problems and drug orders are presented for practice only, and actual prescribed dosages will vary according to a patient’s age, condition, reaction, additional medications, and other factors. Use the following information about a child and his order to compute answers. A pediatrician has ordered ampicillin 50 mg/kg/day p.o. divided q.6h for a child who weighs 44 lb. 1. How many kilograms does the child weigh?

ANS:

PTS: 1 DIF: Comprehension REF: Converting Pounds to Kilograms 2. How many milligrams should the child receive per day?

ANS: per day, 20 kg PTS: 1 DIF: Comprehension REF: Total Daily Dosage Range per Kilogram 3. How many milligrams should the child receive per dose?

ANS: q.6h every 6 hours, which is given 4 times per day.

PTS: 1 DIF: Comprehension REF: Routine or Round-the-Clock Drugs 4. The pharmacy has supplied reconstituted ampicillin, with a supply dosage of 500 mg/5 mL. How many milliliters should be given per q.6h dose? mL ANS:

PTS: 1 DIF: Comprehension REF: Routine or Round-the-Clock Drugs 5. How many teaspoons should the child’s parent administer per dose?

ANS:

PTS: 1 DIF: Comprehension REF: Routine or Round-the-Clock Drugs Use the following information about a child and her order to compute answers. Mandy, a child who weighs 15 kilograms, is to be given amoxicillin. The recommended dosage of amoxicillin for children is 20 to 40 mg/kg/day p.o. in equally divided doses administered q.8h. 6. What is the recommended range of milligrams of medication for this child per day? minimum:

maximum:

ANS: per day, minimum per day, maximum

PTS: 1

DIF:

Application

REF: Drugs with Maximum Daily Allowance

7. What is the recommended range of milligrams of medication for this child per q.8h dose? minimum:

maximum:

ANS: q.8h every 8 hours, which is given 3 times per day. per day minimum

per day maximum

PTS: 1

DIF:

Application

REF: Daily-Dosage-Range Drugs

8. The pediatrician has ordered amoxicillin 125 mg p.o. q.8h for Mandy. The available supply of amoxicillin is 125 mg/5 mL.

Is her order within the recommended range for this medication? (yes/no) If so, how many mL of amoxicillin should be given per q.8h administration?

ANS: Yes, 125 mg per dose is within 100 mg to 200 mg per dose.

PTS: 1

DIF:

Application

REF: Daily-Dosage-Range Drugs

9. How many teaspoonfuls of amoxicillin should be given per q.8h administration?

ANS: 5 mL 1 t PTS: 1 DIF: Comprehension REF: Routine or Round-the-Clock Drugs Use the following information about a child and his order to compute answers. The recommended dosage of Rocephin is 50 to 100 mg/kg/day divided into two equal doses. The physician has ordered Rocephin 200 mg IM b.i.d. for a child who weighs 5000 g. The Rocephin vial contains 1 g of medication that must be reconstituted with 3.6 mL of diluent to yield 1 g/4 mL. 10. Compute the recommended minimum and maximum amount of milligrams that the child should receive per day. minimum: mg maximum: mg ANS: per day, minimum per day, maximum

PTS: 1

DIF:

Application

REF: Daily-Dosage-Range Drugs

11. Compute the recommended minimum and maximum amount of milligrams that the child should receive per dose. minimum: mg maximum: mg ANS: per dose, minimum

per dose, maximum

PTS: 1

DIF:

Application

REF: Daily-Dosage-Range Drugs

12. Is the order within the recommended range? (yes/no) If so, compute the number of milliliters of Rocephin that should be administered per dose. mL. ANS: Yes, the ordered amount of 200 mg per dose, b.i.d. is within the recommended range of 125 mg to 250 mg per dose, given twice per day.

PTS: 1

DIF:

Application

REF: Daily-Dosage-Range Drugs

A pediatrician ordered Demerol 1 mg/kg/day p.o., divided q.4h p.r.n. for a child who weighs 33 lb. 13. How many kilograms does this child weigh? ANS:

X = 15 kg PTS: 1 DIF: Comprehension REF: Converting Pounds to Kilograms 14. How many milligrams of Demerol should this child receive per day? ANS: per day, 15 kg

1 mg/kg = 15 mg

PTS: 1 DIF: Comprehension REF: Routine or Round-the-Clock Drugs 15. How many milligrams of Demerol should the child receive per dose? ANS: per dose, q. 4h p.r.n. = every 4 hours, which is given 6 times per day.

2.5 mg per dose PTS: 1

DIF:

Comprehension

REF: Single-Dosage Drugs

A pediatrician ordered Augmentin 30 mg/kg/day divided into q. 8h doses for a child who weighs 66 lbs. 16. How many kilograms does the child weigh? ANS:

X = 30 kg PTS: 1 DIF: Comprehension REF: Converting Pounds to Kilograms 17. How many milligrams should the child receive per day? ANS: per day, 30 kg

30 mg/kg = 900 mg

PTS: 1 DIF: Comprehension REF: Routine or Round-the-Clock Drugs 18. How many milligrams should the child receive per dose? ANS: q. 8h = every 8 hours, which is given 3 times per day

300 mg per dose PTS: 1 DIF: Comprehension REF: Routine or Round-the-Clock Drugs 19. Using the following information about a child and her medication order to complete answers. A 6-year-old child weighing 25 kg has a staph infection and the provider has ordered penicillin. The recommended dose of penicillin for children is 25 to 50 mg/kg/day p.o. in equally divided doses administered q.6h. What is the recommended range of milligrams of medication for this child per day? Minimum

Maximum

ANS: per day, minimum 25 kg

25 mg/kg = 625 mg

per day, maximum 25 kg

50 mg/kg = 1,250 mg

PTS: 1

DIF:

Application

REF: Daily-Dosage-Range Drugs

The following order was written for a child weighing 66 lb. Order: Morphine 0.2 mg/kg p.o. q. 6h p.r.n, pain. 20. How many kilograms does this child weigh? ANS:

X = 30 kg PTS: 1 DIF: Comprehension REF: Converting Pounds to Kilograms 21. How many milligrams should the child receive per day? ANS: 0.2 mg/kg

30 kg = 6 mg

PTS: 1 DIF: Comprehension REF: Drugs with Maximum Daily Allowance 22. How many milligrams should the child receive per dose? ANS: per dose, q. 6h p.r.n. = every six hours, which is given 4 times per day.

1.5 mg PTS: 1

DIF:

Comprehension

REF: Single-Dosage Drugs

23. The recommended dose of this medication for this child is 0.2 mg-5 mg/kg per q. 4-6 h. Is the dose mentioned above in the recommended range and therefore safe to administer? ANS: Yes, the ordered amount of 1.5 mg per dose q.6h is within the recommended range and is therefore safe to administer. PTS: 1

DIF:

Application

REF: Daily-Dosage-Range Drugs

The pediatrician orders Dicloxacillin 62.5 mg p.o. q. 6h for a child with a staph infection. The child weighs 77 lb. The drug reference recommends a dose of 12.5-50 mg/kg in divided doses of q. 6h for a child 40 kg, with a maximum of 4 g per day. 24. How many kilograms does this child weigh? ANS:

X = 35 lbs PTS: 1 DIF: Comprehension REF: Converting Pounds to Kilograms 25. Calculate the minimum recommended dosage. ANS: minimum = 12.5 mg/kg/day

35 kg = 437.5 mg/day

minimum mg/dose = 437.5

4 doses = 109.4 mg

PTS: 1

Application

DIF:

REF: Daily-Dosage-Range Drugs

26. Calculate the maximum recommended dose. ANS: maximum mg/kg/day = 50 mg/kg/day

35 kg = 1,750 mg/day

maximum mg/dose = 1750

4 doses = 437.5 mg

PTS: 1

Application

DIF:

REF: Daily-Dosage-Range Drugs

27. Is this order within the recommended range for this child? ANS: No, the order of 62.5 mg q.6h is not within the recommended range of 109.4 mg to 437.5 mg. PTS: 1

DIF:

Application

REF: Underdosage

28. What action should be taken by the nurse if a drug order is unsafe? ANS: The nurse should contact the prescriber to discuss the order. PTS: 1

DIF:

Comprehension

REF: Underdosage

Chapter 15—Intravenous Solutions, Equipment, and Calculations MULTIPLE CHOICE 1. A patient’s order for IV fluid states that NS is to be infused. Which of the following IV fluids should be given? A. 0.9% Sodium Chloride C. 0.225% Sodium Chloride B. 0.45% Sodium Chloride D. 5% Dextrose ANS: A

PTS: 1

DIF: Knowledge

REF: Solution Strength

2. A patient’s order for IV fluid states the D5W is to be infused. Which of the following IV fluids should be given? A. 5% Dextrose with Normal Saline B. 5% Dextrose with Lactated Ringer’s Solution C. 5% Dextrose with 0.45% Sodium Chloride D. 5% Dextrose ANS: D PTS: 1 REF: Solution Strength

DIF: Comprehension

3. A patient’s order for IV fluid states that D5NS is to be infused. Which of the following IV fluids should be given? A. 5% Dextrose B. 0.9% Sodium Chloride C. 5% Dextrose with 0.9% Sodium Chloride D. Lactated Ringer’s Solution ANS: C PTS: 1 REF: Solution Strength

DIF: Comprehension

4. A patient’s order for IV fluid states that D5LR is to be infused. Which of the following IV fluids should be given? A. 5% Dextrose with Lactated Ringer’s Solution B. 5% Dextrose and 0.45% Sodium Chloride with 20 mEq KCl/L C. 5% Dextrose with 0.225% Sodium Chloride D. 0.45% Sodium Chloride ANS: A PTS: 1 REF: Solution Strength

DIF: Comprehension

5. What is the ratio of the weight of dextrose to the volume of IV fluid in D5W? A. 5 grams of dextrose to 1 liter of IV fluid B. 5 milligrams of dextrose to 1 milliliter of IV fluid C. 5 milligrams of dextrose to 1 liter of IV fluid D. 5 grams of dextrose to 100 mL of IV fluid ANS: D PTS: 1 REF: Solution Strength

DIF: Comprehension

6. What is the ratio of the weight of sodium chloride to the volume of IV fluid in NS? A. 0.9 grams of sodium chloride to 100 mL of IV fluid B. 0.009 grams of sodium chloride to 1 milliliter of IV fluid C. 0.9 grams of sodium chloride to 1 liter of IV fluid

D. 0.9 milligrams of sodium chloride to 100 mL of IV fluid ANS: A PTS: 1 REF: Solution Strength

DIF: Comprehension

7. A patient’s order for IV fluid states that LR is to be infused. Which of the following IV fluids should be given? A. Lactated Ringer’s Solution B. 5% Dextrose with Lactated Ringer’s Solution C. 0.9% Sodium Chloride D. 5% Dextrose ANS: A PTS: 1 REF: Solution Strength

DIF: Comprehension

8. A patient’s order for IV fluid states that D5 NS with 20 KCL is to be infused. Which of the following IV fluids should be given to the patient? A. 0.9% Sodium Chloride B. 5% Dextrose and 0.45% Sodium Chloride with 20 mEq of KCL/L C. 5% Dextrose with 0.225% Sodium Chloride with 20 mEq KCL/L D. 5% Dextrose ANS: B PTS: 1 REF: Solution Strength

DIF: Comprehension

PROBLEM Calculate the weight of solutes in the following IV solutions, and identify the solutes. 1. 1 liter of D5W contains

(weight)

(solute)

ANS: D5W = 5% dextrose = 5 g dextrose per 100 mL of solution

1 liter of D5W contains 50 g of dextrose. PTS: 1 DIF: Application REF: Calculating Components of IV Solutions When Expressed as a Percent 2. 1 liter of NS contains

of (weight)

. (solute)

ANS: NS = 0.9% sodium chloride = 0.9 g sodium chloride per 100 mL of solution

1 liter of NS contains 9 g of sodium chloride. PTS: 1 DIF: Application REF: Calculating Components of IV Solutions When Expressed as a Percent

3. 500 mL of D5 NS contains

of (weight)

. (solute)

ANS: D5 = Dextrose 5% = 5 g Dextrose per 100 mL

100X = 2,500

X = 25 g Dextrose PTS: 1 DIF: Application REF: Calculating Components of IV Solutions When Expressed as a Percent The following IV orders will be regulated by electronic infusion devices. Calculate the flow rates of the IV fluids in mL/h. The problems and drug orders are presented for practice only, and actual prescribed dosages will vary according to a patient’s age, condition, reaction, additional medications, and other factors. 4. 1200 mL D10W IV to infuse in 10 hours by infusion pump ANS:

PTS: 1 DIF: Application REF: Calculating Flow Rates for Infusion Pumps in mL/h

Flow rate:

mL/h

5. 2 L D5W IV to infuse in 24 hours by infusion pump

Flow rate:

mL/h

ANS: 2 L = 2,000 mL

PTS: 1 DIF: Application REF: Calculating Flow Rates for Infusion Pumps in mL/h 6. 1 L D5 NS IV to infusion 20 hours by controller

Flow rate:

mL/h

ANS:

PTS: 1 DIF: Application REF: Calculating Flow Rates for Infusion Pumps in mL/h 7. 30 mL D5W with antibiotic IV to infuse in 20 minutes by infusion pump

Flow rate:

mL/h

ANS:

PTS: 1 DIF: Application REF: Calculating Flow Rates for Infusion Pumps in mL/h 8. Calculate the IV flow rate for 50 mL NS to infuse by infusion pump over 20 minutes mL/h ANS:

20X = 3,000

X = 150 mL/h

Flow rate:

PTS: 1 DIF: Application REF: Calculating Flow Rates for Infusion Pumps in mL/h 9. Calculate the IV flow rate for 250 mL to infuse by infusion pump over two hours mL/h

Flow rate:

ANS:

PTS: 1 DIF: Application REF: Calculating Flow Rates for Infusion Pumps in mL/h The following IV orders will be regulated manually. Calculate the flow rate of the IV fluid in gtt/min. 10. 1 L NS IV to infuse in 10 hours The drop factor is 10 gtt/mL.

Flow rate:

gtt/min

ANS:

PTS: 1 DIF: Application REF: Calculating Flow Rates for Manually Regulated IVs in gtt/min - Shortcut Method 11. 1000 mL D5W IV to infuse in 8 hours The drop factor is 20 gtt/mL. Flow rate:

gtt/min

ANS:

PTS: 1 DIF: Application REF: Calculating Flow Rates for Manually Regulated IVs in gtt/min - Shortcut Method 12. 1 L NS IV to infuse in 10 hours The drop factor is 10 gtt/mL. ANS:

Flow rate:

gtt/min

PTS: 1 DIF: Application REF: Calculating Flow Rates for Manually Regulated IVs in gtt/min - Shortcut Method 13. 50 mL NS with antibiotic IV to infuse in 20 minutes The drop factor is 20 gtt/mL. Flow rate:

gtt/min

ANS:

PTS: 1 DIF: Application REF: Calculating Flow Rates for Manually Regulated IVs in gtt/min - Formula Method 14. Calculate the IV flow rate for 1,000 mL D5NS hours. The IV is to be manually regulated. The drop factor is 10 gtt/min.

Flow rate:

gtt/min to infuse over 10

ANS: C=R

16.6 = 17 gtt/min PTS: 1 DIF: Application REF: Calculating Flow Rates for Manually Regulated IVs in gtt/min - Formula Method

15. Calculate the IV flow rate for 500 mL D5 NS hours. The IV is to be manually regulated. The drop factor is 15 gtt/min. ANS: 125 mL/h

= gtt/min

Flow rate:

gtt/min to infuse over 4

31.25 = 31 gtt/min PTS: 1 DIF: Application REF: Calculating Flow Rates for Manually Regulated IVs in gtt/min - Shortcut Method 16. Calculate the IV flow rate for 100 mL NS with an to infuse in 30 minutes. The IV will be manually regulated. The drop factor is 20 gtt/min.

Flow rate:

gtt/min antibiotic added

ANS:

PTS: 1 DIF: Application REF: Calculating Flow Rates for Manually Regulated IVs in gtt/min - Formula Method 17. Calculate the IV flow rate for 1 L LR to infuse IV is to be manually regulated. The drop factor is 10 gtt/min.

Flow rate:

gtt/min over 8 hours. The

ANS:

PTS: 1 DIF: Application REF: Calculating Flow Rates for Manually Regulated IVs in gtt/min - Formula Method A patient’s IV flow needs to be checked frequently so that any adjustments in rate will be small. The allowable percent of change varies according to the institution’s policy, patient’s condition, and other factors. For this problem set only, assume that the patient’s flow rate may be reset if the maximum variation from the physician’s order is not more than 25%. Compute the percent of variation before resetting IV flow rates, and indicate either the new flow rate you will set or the appropriate action you will take. The following IV order will be regulated manually. 1,000 mL D5W IV to infuse in 8 hours The drop factor is 15 gtt/mL. 18. Calculate the flow rate of the IV fluid in gtt/min. ANS:

Flow rate:

gtt/min

PTS: 1 DIF: Application REF: Calculating Flow Rates for Manually Regulated IVs in gtt/min 19. After 6 hours, 200 mL of IV fluid remains. If necessary and if allowable, reset the IV so that it is completed on time. What would the adjusted rate have to be?

Adjusted rate, is allowable:

gtt/min

ANS:

PTS: 1

DIF:

Analysis

REF: Adjusting IV Flow Rate

20.20. Compute the percent of change in the flow rate. According to guidelines given, is the new rate allowable? (yes/no)

ANS:

The flow rate would be decreased by 19.6% or about 20%. Yes, if guidelines may be followed for this patient. PTS: 1

DIF:

Application

21. 1,000 mL D5W IV to infuse at 25 gtt/min

REF: Adjusting IV Flow Rate

The drop factor is 15 gtt/mL. Flow rate:

mL/h

Total infusion time:

hours

ANS: T is the unknown quantity

PTS: 1

DIF:

Analysis

REF: Calculating Infusion Time and Volume

Chapter 16—Body Surface Area and Advanced Pediatric Calculations PROBLEM The following problems and drug orders are presented for practice only, and actual prescribed dosages will vary according to a patient’s age, condition, reaction, additional medication, and other factors. Determine the BSA for each of the following children using the BSA nomogram. Include two decimal places with your answers. 1. Miguel, who is a normally proportioned child, weighing 7.5 lb.

BSA =

ANS: 0.23 m2 PTS: 1

DIF:

Comprehension

REF: BSA Nomogram

2. Heidi, who is a normally proportioned child, weighing 20 kg.

BSA =

ANS: 20 kg = 44 lb BSA = 0.80 m2 PTS: 1

DIF: Comprehension

3. Marcus, who weighs 9 kg and is 50 inches tall.

REF: BSA Nomogram m2

BSA =

ANS: 0.54 m2 PTS: 1

DIF:

Comprehension

4. Tonya, who is 80 cm tall and weighs 20 kg.

REF: BSA Nomogram BSA =

ANS: 0.70 m2 PTS: 1

DIF:

Comprehension

REF: BSA Nomogram

Determine the BSA for each of the following children using the BSA computation formulas given in the textbook. Include two decimal places with your answers. 5. Alicia, who weighs 15 kg and is 90 cm tall.

BSA =

ANS:

PTS: 1

DIF:

Application

REF: BSA Formula

6. Tommy, who is 35 inches tall and weighs 40 lb.

BSA =

ANS:

PTS: 1

DIF:

Application

REF: BSA Nomogram

7. Allison, who measures 56 inches tall and weighs 68 lb.

BSA =

ANS: Household BSA (m ) = PTS: 1

DIF:

Application

REF: BSA Nomogram

8. Kevin, who measures 61 inches tall and weighs 84 lb.

BSA =

ANS: Household BSA (m ) = PTS: 1

DIF:

m Application

REF: BSA Nomogram

Compute the answers to the following questions, which are based on the child’s BSA, using the following information about the child and her order. The usual adult dose of Rocephin is 0.5 g IM per dose, administered b.i.d. The child is to be given the medication based on her BSA and the usual adult dose. Her BSA is 0.51 m2. 9. How many milligrams of Rocephin should she receive per dose?

ANS:

PTS: 1

DIF:

Application

REF: BSA Dosage Calculation

10. The supply of Rocephin is reconstituted to 250 mg/mL. How many milliliters of Rocephin should she receive per administration? ANS:

PTS: 1

DIF:

Application

REF: BSA Dosage Calculation

Compute the answers to the following questions, which are based on the child’s BSA, using the following information about the child and his order. Jimmy, whose BSA is 0.45 m2, is to receive Oncovin 2 mg/m2 IV once per week. The supply dosage available is 5 mg/mL. 11. How many milligrams of Oncovin should he receive per administration?

ANS:

PTS: 1

DIF:

Application

REF: BSA Dosage Calculation

12. How many milliliters should be administered per dose?

ANS:

PTS: 1

DIF:

Application

REF: BSA Dosage Calculation

Compute the daily rate of pediatric maintenance fluids for the following children, using the following guidelines: 100 mL/kg/day for the first 10 kg of body weight 50 mL/kg/day for the next 10 kg of body weight 20 mL/kg/day for each kg above 20 kg of body weight 13. Maggie, who weighs 13 kg.

mL/day

ANS:

PTS: 1 DIF: Application REF: Calculation of Daily Volume for Maintenance Fluid 14. Reggie who weighs 24 kg. ANS:

mL/day

PTS: 1 DIF: Application REF: Calculation of Daily Volume for Maintenance Fluid 15. Jessie, who weighs 40 lb.

mL/day

ANS:

Note: If 18 kg is used instead of 18.2 kg, the answer is 1400 mL per day. PTS: 1 DIF: Application REF: Calculation of Daily Volume for Maintenance Fluid 16. Lisa, who weighs 11 kg.

mL/day

ANS:

PTS: 1 DIF: Application REF: Calculation of Daily Volume for Maintenance Fluid 17. What is the hourly rate for an IV of 1050 mL to be run over 24 hours? ANS: or 44 mL/h PTS: 1 DIF: Application REF: Calculation of Daily Volume for Maintenance Fluid 18. Matt, who measures 177.5 cm tall and weighs 81.8 kg. ANS: Metric BSA (m ) =

BSA =

PTS: 1

DIF:

Application

REF: BSA Formula

Compute the answers to the following questions, which are based on the child’s BSA, using the following information about the child and her order. Sally, whose BSA is 1.25 m , is to receive acyclovir 600 mg p.o. q.i.d. The drug reference guide recommends 500 mg/m q. 8h. The supply dosage available is 800mg/2mL. 19. How many milligrams of acyclovir should she receive per administration? mg ANS: mg/m PTS: 1

m = 500 mg/m

1.25 m = 625 mg

DIF:

Application

REF: BSA Dosage Calculation

20. How many milliliters should be administered per dose? ANS:

X = 1.56 mL = 1.6 mL PTS: 1

DIF:

Application

REF: BSA Dosage Calculation

21. Is this considered a safe dose? If not, what should the nurse do? ANS: No. The ordered dosage of 600 mg q.i.d is too low. The nurse should contact and confer with the prescriber. PTS: 1

DIF:

Application

REF: BSA Dosage Calculation

The recommended oral dosage for succimer is 350 mg/m q. 8h. This has been ordered for a child measuring 54 inches tall and weighing 73 lb. 22. What is the child’s BSA m ? ANS: Household BSA (m ) = PTS: 1

DIF:

Application

REF: BSA Dosage Calculation

23. Calculate the safe dosage for this child. ANS: mg/m

m = 350 mg/m

1.12 m = 392 mg

PTS: 1

DIF:

Application

REF: BSA Dosage Calculation

24. Is this considered a safe dose? If not, what should the nurse do? ANS: No, this is not a safe dose. It is more than the recommended dose and the nurse should confer with the prescriber. PTS: 1

DIF:

Application

REF: BSA Dosage Calculation

Kevin, a 5-year-old with herpes simplex, is measured at 42 inches tall and weighs 43 lb. The pediatrician prescribes ritonavir 200 mg p.o. b.i.d. The drug reference recommends the dose of 250 mg/m b.i.d for a child. 25. What is Kevin’s BSA? ANS: Household BSA (m ) = PTS: 1

DIF:

Application

REF: BSA Dosage Calculation

26. Calculate the recommended dose.

ANS: mg/m

m = 250 mg/m

PTS: 1

DIF:

0.76 m = 190 mg Application

REF: BSA Dosage Calculation

27. Is this a safe dose? If not, what should the nurse do? ANS: No, this is not a safe dose. The ordered dose of 200 mg is slightly high. The nurse should call the prescriber and confer about the order. PTS: 1

DIF:

Application

REF: BSA Dosage Calculation

An adult with Promyelocytic Leukemia is measured at 165 cm tall and weighs 56.8 kg. The physician ordered tretinoin 50 mg po b.i.d. The drug reference recommends 45 mg/m b.i.d. 28. Calculate the BSA for this adult. ANS: Metric BSA (m ) = PTS: 1 29. Calculate the dose. ANS:

DIF:

Application

REF: BSA Dosage Calculation

mg/m PTS: 1

m = 45mg/m DIF:

1.6 mg = 72 mg Application

REF: BSA Dosage Calculation

30. Is this a safe dose? If not, what should the nurse do? ANS: No, this is not a safe dose. The ordered dose of 50 mg is too low. The nurse should call the prescriber and confer about the medication. PTS: 1

DIF:

Application

REF: BSA Dosage Calculation

Chapter 17—Advanced Adult Intravenous Calculations PROBLEM Complete the following advanced IV calculations. The problems and drug orders are presented for practice only, and actual prescribed dosages will vary according to a patient’s age, condition, reaction, additional medications, and other factors. 1. 1 L D5W with 10,000 units heparin to infuse at 1000 units/h The drop factor is 20 gtt/mL. Flow rate:

gtt/min

ANS:

PTS: 1

DIF:

Application

REF: IV Medication Ordered per Minute

2. 1,000 mL NS with 10,000 units heparin to infuse at 750 units/h The drop factor is 12 gtt/mL. Flow rate:

gtt/min

ANS:

PTS: 1

DIF:

Application

REF: IV Medication Ordered per Minute

3. One of your patients has an IV that is flowing at a rate of 10 gtt/min. The IV bag contains a solution of 500 mL NS with 20,000 units of heparin. The drop factor is 15 gtt/mL. How many units is the patient receiving per 24 hours?

units/24h

ANS:

Patient is receiving 40 mL/hour.

The patient is receiving 38,400 units/24 h. PTS: 1

DIF:

Analysis

REF: Limiting Infusion Volumes

Compute the answers to the following questions based on this information. 4. Order:

Pepcid 20 mg added to 100 mL D5W IV in 30 min q.12h An infusion pump will be used. Supply: Pepcid 10 mg/mL Compute the volume of Pepcid to be added to the 100 mL D5W. Compute the flow rate. Pepcid: ANS:

Flow rate:

mL/h

200 mL/60 min PTS: 1

200 mL/h DIF:

Application

REF: Limiting Infusion Volumes

Compute the answers to the following questions based on this information. A critical care patient who weighs 80 kg has an order for 10 mcg/kg/min of dobutamine to be administered IV and regulated by an electronic pump. The supply of dobutamine is 500 mg in 250 mL of D5W. 5. Compute the number of micrograms and the number of milligrams per minute that the patient will receive. micrograms per minute:

milligrams per minute:

ANS:

Per minute, The patient will receive 800 mcg/min or 0.8 mg/min. PTS: 1

DIF:

Application

REF: IV Medication Ordered per Minute

6. Compute the volume of milliliters infused per minute. ANS:

There are 2 mg/mL or 2,000 mcg/mL of medication supply.

mL/min

800 mcg of dobutamine are in 0.4 mL of IV solution. 800 mcg/min is delivered by a rate of 0.4 mL/min. PTS: 1

DIF:

Application

REF: IV Medication Ordered per Minute

7. Compute the flow rate in mL/h.

mL/h

ANS:

PTS: 1

DIF:

Application

REF: IV Medication Ordered per Minute

Compute the answers to the following questions based on this information. A patient’s IV fluids are to be limited. His continuous IV order is for 2,000 mL of NS every 24 hours. He is to receive an IV PB of 150 mg of netromycin in 100 mL NS infused in 2 hours, every 8 hours. His IV flow rate is controlled by an infusion pump. Answer the following questions about his IV PB. 8. What is the flow rate of his IV PB?

mL/h

ANS:

PTS: 1

DIF:

Application

REF: Limiting Infusion Volumes

9. How many milliliters per day flow for his IV PB?

mL/day

ANS: 100 mL every 8 hours is 100 mL three times per day.

PTS: 1

DIF:

Application

REF: Limiting Infusion Volumes

10. How many hours per day does his IV PB flow? ANS:

PTS: 1

DIF:

Application

REF: Limiting Infusion Volumes

11. Answer the following questions about his continuous IV. How many milliliters per day will he receive with his regular IV? How many hours will his continuous IV flow per 24 hours? What will his regular IV flow rate be, in mL/hour?

mL/day hours/day mL/h

ANS:

Flow rate: 71 mL/h PTS: 1

DIF:

Analysis

REF: Limiting Infusion Volumes

The following questions refer to your patient who is on IV heparin therapy according to the “Standard Weight Based Heparin Protocol” noted below. The patient weighs 144 pounds. On admission, the patient’s APTT is 30 seconds. You initiate IV heparin therapy at 1130 on 06/06/XX. Record your answers in the spaces below unless provided with the “Standard Weight Based Heparin Protocol Worksheet” by your instructor. Standard Weight Based Heparin Protocol For all patients on heparin drips: 1. Weight in kilograms. Required for order to be processed: kg 2. Heparin 25,000 units in 250 mL of 1/2 NS. Boluses to be given as 1000 units/mL. 3. APTT q.6h or 6 hours after rate change; q.d. after two consecutive therapeutic APTTs. 4. CBC initially and repeat every day(s). 5. Obtain APTT and PT/INR on day one prior to initiation of therapy. 6. Guaiac stool initially, then every day(s) until heparin discontinued. Notify if positive. 7. Neuro checks every hours while on heparin. Notify physician of any changes. 8. D/C APTT and CBC once heparin drip is discontinued unless otherwise ordered. 9. Notify physician of any bleeding problems. 10. Bolus with 80 U/kg. Start drip at 18 units/kg/h. Rebolus with 80 units/kg and increase rate by 4 units/kg/h 11. If APTT is  35 secs: 12. If APTT is 36–44 secs: Rebolus with 40 units/kg and increase rate by 2 units/kg/h 13. If APTT is 45–75 secs: Continue current rate 14. If APTT is 76–90 secs: Decrease rate by 2 units/kg/h

15. 12.

If APTT is  90 secs:

Hold heparin for 1 hour and decrease rate by 3 units/kg/h

What is the patient’s weight as measured in kilograms? (Round to the nearest 10 kg.) kg What does the protocol/sample order indicate for the standard bolus dosage of heparin for this patient? units/kg ANS:

PTS: 1 DIF: Application REF: Calculating IV Dosages and Flow Rates Using Clinical Protocols 13.

Calculate the dosage of heparin that should be administered for the bolus for this patient. units What does the protocol indicate as the required solution concentration (supply dosage) of heparin to use for the bolus? units/mL Calculate the dose volume of heparin that should be administered for the bolus for this patient. mL ANS:

PTS: 1 DIF: Application REF: Calculating IV Dosages and Flow Rates Using Clinical Protocols 14.

What does the protocol/sample order indicate for the initial infusion rate for this patient? units/kg/h Calculate the dosage of heparin this patient should receive each hour. units/h What does the protocol/sample orders indicate as the required solution concentration (supply dosage) of heparin to use for the initial infusion? units/mL

Calculate the heparin solution volume this patient should receive each hour to provide correct infusion for the patient’s weight. mL/h ANS:

PTS: 1 DIF: Application REF: Calculating IV Dosages and Flow Rates Using Clinical Protocols 15.

According to the protocol/sample order, how often should the patient’s APPT be checked? q.

At 1730, the patient’s APPT is 38 seconds. Rebolus with heparin units

(

mL).

How much should you change the infusion rate? increase or

decrease heparin

The new infusion rate will be heparin

units/h and

mL/h.

ANS: 6h

PTS: 1 DIF: Application REF: Calculating IV Dosages and Flow Rates Using Clinical Protocols 16.

At 2345, the patient’s APPT is 46 seconds. What should you do now? ANS: Maintain rate at 14 mL/h. PTS: 1

DIF:

Application

REF: IV Heparin Protocol

ml/h.

17.

At 0600 0n 06/07/XX, the patient’s APPT is 50 seconds. What should you do now? When should the APPT be checked again?

(hours) on

(date)

ANS: Maintain rate at 14 mL/h Recheck APPT at 0600 on 06/08/XX PTS: 1 18.

DIF:

Application

REF: IV Heparin Protocol

Order: 500 mL D5W with heparin 5000 units IV to infuse at 1000 units/h. The drop factor is 10 gtt/mL. Calculate the flow rate. Flow rate: gtt/min ANS:

5,000X = 500,000 X = 100 mL/h

16.6 = 17 gtt/min PTS: 1 DIF: Application REF: Calculating IV Dosages and Flow Rates Using Clinical Protocols 19.

Order: 1,000 mL D5W with heparin 20,000 units IV is to infuse at a rate of 750 units/h. The drop factor is 12 gtt/mL Calculate the flow rate. Flow rate: gtt/min ANS:

20,000X = 750,000 X = 37.5 mL

7.5 = 8 gtt/min PTS: 1 DIF: Application REF: Calculating IV Dosages and Flow Rates Using Clinical Protocols 20.

Order: Lidocaine 2 g IV in 1,000 mL D5W to infuse at a rate of 3 mg/min by infusion pump. Calculate the flow rate. Flow rate: gtt/min

ANS: Dose on hand = 2g = 2,000 mg

X = 1.5 mL/min

X = 90 mL/h PTS: 1 21.

DIF:

Application

REF: IV Medication Ordered per Minute

Order: Nitroglycerin 100 mg IV in 500 mL D5W to infuse at a rate of 30 mcg/min. Calculate the flow rate. Flow rate: gtt/min ANS: 1 mg = 1,000 mcg

X = 100,000 mcg

100,000 X=15,000 X = 0.15 mL/min

X = 9 mL/h PTS: 1

DIF:

Application

REF: Titrating IV Drugs

An ICU patient weighing 70 kg has an order for dobutamine 5 mcg/kg/min to be administered IV and regulated by infusion pump. The supply of dobutamine is 500 mg in 500 mL D5W. 22.

Compute the number of micrograms and the number of milligrams that the patient will receive. mcg/min

mg/min

ANS:

X = 350 mcg/min or 0.35 mg/min PTS: 1 23.

DIF:

Application

REF: Titrating IV Drugs

Based on an order for 350 mcg/min or 0.35 mg/min, compute the volume of mL infused per minute. ANS:

500X = 500 X = 1 mg/mL or 1,000 mcg/mL of medication supply

1,000X = 350 X = 0.35 mL 350 mcg of dobutamine are in 0.35 mL of IV solution and 350 mcg/min are delivered by a rate of 0.35 mL/min PTS: 1 24.

DIF:

Application

Compute the flow rate in ml/h.

REF: IV Medication Ordered per Minute

Flow rate

mL/h

ANS:

X = 21 mL

Flow rate =

21 mL/h

PTS: 1

DIF:

Application

REF: Titrating IV Drugs

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