1.
The doctor’s order reads, give Tylenol® grains X every 4 hours prn for pain. This
amount is equal to which of the following?
Answer: Two tablets at 325mg each
Explanation: Grains ten or X is equal to 650 mg, therefore two 325 mg tablets will be given.
2. The order reads: give 75mg of Metropolol Tartrate (Lopressor®). On hand you have
50mg tablets that are scored. How many tablets will you give the client?
The key to this question is the word "scored". Only medication that come in scored tablets can be
halved. Un-scored tablets may not have the same strength when halved. Therefore it is acceptable to
give one tablet of 50mg and a half of a 50mg tablet which will be equal to 25mg to equal the 75mg
that is prescribed. Also remember that this medication is a beta blocker, so it is important to take the
client's blood pressure prior to administering the medication. Doctors will usually specify the
parameters for administration, but good nursing judgment is critical. For instance, if the parameters
read, "do not give if systolic BP is < 100 or diastolic is < 60", and the client's BP reading is 103/69. It
would be wise in such a case to call the doctor to inquire whether or not to hold the medication. You
may also offer the client some fluids. Many times increasing the fluid intake will raise the BP to an
acceptable reading within an hour.
3.
The order reads: Give 0.5 mg of Ativan I.M. every 6 hours for agitation. The bottle reads; 2 mL
equals 2 mg. How many mL’s will you give the client?
Answer:
0.5 mL’s
Explanation:
Answer: using dimensional analysis the problem can be set up as follows:
What you need to what you have:
0.5mg x 2 mL/ 2 mg = 0.5 mL
4. The order reads: Give I.V. of 1000 cc’s 0.9 Normal Saline to run over 8 hours. If the
tubing is equal to15 gtts/mL what will be the drip rate per minute?
Answer:
31 gtts/min
Explanation:
Answer: [1000 cc/8hr] x [1hr/60min] x [15 gtts/mL] = 31.25 gtts/min = 31 gtts/min
Notice that the units cancel from numerator to denominator leaving drops per min. Also notice
the rounding rules. The two is in the tenths place, which is of course less than five, so the one in
the ones place stays unchanged.
5. If the above I.V. has infused 435 cc after four hours, what would be the new rate in gtts/min
for the I.V. to finish on time?
Answer:
35 gtts/min
Explanation: Answer: Only 435 cc’s or mL’s have infused after four hours. The question that
you need to ask yourself is how many milliliters should have actually infused? Since 1000 cc
have to infuse over 8 hours, then after 4 hours, 500 cc’s should have infused. However this is
not the case. Less than 500 cc’s have infused. Now calculate how many milliliters you have left
to infuse, which would be 500cc – 435 cc = 65 cc’s + 500 cc’s = 565 cc’s left to infuse over the
next 4 hours. Now recalculate the drip rate.
[565 cc/ 4hr] x [1hr/60min] x [15gtts/mL] = 35.31 gtts /min or rounding, 35 gtts/min
6. You are instructed to give 200,000 Units of Penicillin. The bottle reads as follows; 3 grams of
penicillin; dilute with 4 mL of sterile saline to yield 5 million units. How many mL’s will you
give the client?
Answer: 0.16 mL’s
Explanation:
Answer: First you must prepare the solution with the 4 mL of sterile saline to yield a 4
mL solution containing 5 million units of penicillin. Next you must determine how many
milliliters will yield 200,000 Units. To do this, it is best to use dimensional analysis.
[200,000 Units] x [4 mL/ 5,000,000 Units] = 0.16 mL
You would draw up exactly this amount of medication in a 3 mL syringe. It is not
supposed to be rounded up. This would yield 0.2 Units, which would translate into a
higher dosage of what was originally intended.
7. The order reads; give 0.5mg. The drug label reads 500 micrograms per 2 mL. How many
mL’s will you give?
Answer:
2 mL’s
Explanation:
Always start the problem with what you are ordered to give;
[0.5mg] x [1000 micrograms/1mg] x [2mL/500 micrograms] = 2 mL
8. The order reads: Give 70 mg of Zantac. On hand is Zantac 50 mg in non- scored tablets. You
would do which of the following?
Answer:
Have pharmacy send the correct amount.
Explanation:
Answer: the crucial term in this question is, “non- scored. Any non-scored
tablet cannot be divided into smaller dosages. Pharmaceutical companies do not
make non-scored tablets evenly distributed with medication. One half of a nonscored tablet could yield less than what the dosage specifies.
9. You are to give a dose of Lantus 10 Units at 2200 to a client whose blood
glucose level is 145. The client is concerned that this will drop their blood
sugar dramatically when it peaks at 2330 You tell the client which of the
following?
Answer:
You are empathetic to their concerns, and that while their blood sugar may
possibly drop some, Lantus has no pronounced peak time.
Explanation:
Answer: The best answer is C. Lantus® has no pronounced peak time, and
therefore will not cause a drop in blood glucose levels. The client’s blood
glucose level is 145, which is slightly above the normal range of 70-120. The
most important concept is to educate the client, allay the client’s fears and
encourage participation in their medication regime.
10. In the administration of a Duramorph® patch your first action after the five rights of
medication administration would be to..
Answer:
Remove the previous patch
Explanation:
Answer: Literature supports that the most important step is to first remove the
former patch on the client prior to administration of another narcotic pain
patch. Without this step, you could overmedicate the client. You do not
cleanse the skin with alcohol, nor are sterile gloves necessary to apply the
patch.