OAKLAND UNIVERSITY
SCHOOL OF NURSING
MEDICATION
ADMINISTRATION
MODULE A
Basic-BSN (Sophomore-Semester 2) and
Accelerated 2nd Degree (Semester 1)
Faculty:
Patricia Ketcham, MSN, RN
Sarah Newton, PhD, RN
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MEDICATION ADMINISTRATION EXAMINATION - MODULE A
Introduction
The purpose of the Medication Administration Examination (MAE) - Module A is to provide
students with direction and review for the MAE (Basic-BSN Sophomore-Semester 2 and ASDSemester 1), and it serves as a foundation for Modules B and C.
In most healthcare settings, the registered nurse (RN) is responsible for medication
administration. A critical component of safe medication administration is accurate dosage
calculation. RNs must be able to calculate patient medication dosages accurately and quickly,
verify that medications provided by the pharmacy have been correctly calculated, and safely
administer the medications that have been prescribed. Nursing students are expected to be able to
apply previously learned mathematical concepts to the process of dosage calculation and employ
effective critical thinking to ensure safe medication delivery.
Module Objectives
At the completion of this module, the student will be able to:
1. Convert dosages within and between measurement systems using metric, household, and
apothecary systems.
2. Correctly interpret medical abbreviations and medication orders.
3. Demonstrate correct calculation of oral and parenteral medication dosages.
4. Correctly calculate intravenous flow rates, intravenous piggyback infusion rates, and
duration of infusion.
Required Textbook
Pikar, G. D., & Abernethy, A. P. (2013). Dosage calculations (9th ed.). Clifton Park, NY:
Delmar, Cengage Learning. (ISBN:13: 978-1-4390-5847-3)
Medication Administration Examination
The MAE is administered to all Basic-BSN and Accelerated Second Degree nursing students at
each level of the nursing curriculum. The date, time, and location for the exam is announced on
the School of Nursing (SON) website. Please refer to the SON Undergraduate Student Handbook
for information related to the MAE policy and requirements. On the MAE, you need to show all
calculations, label the answer correctly (mL, mg, gtt/hr, mg/dose, etc.), and circle your answer.
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Required Readings
Section 1: Basic Math Review
Complete the Mathematics Diagnostic Evaluation (pp. 28-30) and check your answers to
determine your need for further independent practice of basic mathematical skills. If you identify
specific problems, review basic math skills in Chapters 1 and 2. The OU Study Skills Center
located in North Foundation Hall provides tutoring services for basic math skills by appointment.
Section 2: Systems of Measurement
Chapters 3, 4, 5, 6, 7, 8, and 9
Read and review these chapters. Complete review sets found in each chapter and the selfevaluation for this section on pages 199-204. Students are not required to memorize all
conversions found in the textbook. ONLY THE CONVERSION CHARTS, TABLES A
AND B, IN THIS MODULE NEED TO BE MEMORIZED .
Section 3: Drug Dosage Calculation
Chapter 10, 11, 12, and 14
Read and review these chapters. Complete review sets in each chapter and the selfevaluation for this section on pages 423-436.
Section 4: Intravenous Solutions, Equipment and Calculations
Chapter 15
Read and review this chapter. Complete review sets in the chapter and the self-evaluation
for this section on pages 439-488. For the Level I MAE, the focus is calculating
intravenous (IV) solution flow rates for electronic or gravity infusion systems.
Table A
TABLE OF EQUIVALENTS/CONVERSIONS
APOTHECARY
1 fluidounce (fl oz)
16 fluidounces
32 fluidounces
1 grain (gr)
15 grains
2.2 pounds (lb)
METRIC
1 Milliliter (mL)
4 mL – 5* mL
15*mL/16 mL
30 mL
500 mL
1000 mL or 1 L
60* – 65 Milligrams (mg)
1 gram (g)
1000 gm or 1 Kilogram (Kg)
2.54 cm
HOUSEHOLD
15 drops (gtt)
1 teaspoon (t, tsp)
1 tablespoon (T, tbsp)
2 tablespoons
1 pint (pt)
1 quart (gt)
2.2 lb
1 inch
*These numbers are the normal ones used for conversions
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Table B
COMMON METRIC CONVERSIONS
1 Liter (L)
1 Kilogram (Kg)
1 Gram (g)
1 Milligram (mg)
1000 milliliters (mL)
1000 grams (g)
1000 milligrams (mg)
1000 micrograms (mcg)
Table C
STANDARD AND INTERNATIONAL/MILITARY TIME
Standard
AM
1:00
2:00
3:00
4:00
5:00
6:00
7:00
8:00
9:00
10:00
11:00
12:00 (noon)
Intl/Miltary
AM
01:00
02:00
03:00
04:00
05:00
06:00
07:00
08:00
09:00
10:00
11:00
12:00
Standard
PM
1:00
1:00
3:00
4:00
5:00
6:00
7:00
8:00
9:00
10:00
11:00
12:00
Intl/Military
PM
13:00
14:00
15:00
16:00
17:00
18:00
19:00
20:00
21:00
22:00
23:00
24:00
Table D
COMMON ABBREVIATIONS
aa
a.c.
ad lib
bid
c
caps
c/o
DAT
D5W
elix
ID
I.M.
I.V.
IVPB
KVO
LA
NKA
NPO
OTC
pc
NS
of each
before meals
as desired
twice a day
with
capsules
complains of
diet as tolerated
dextrose 5% in water
elixir
intradermal
intramuscularly
intravenously
intravenous piggyback
keep vein open
long acting
no known allergies
nothing by mouth
over the counter
after meals
Normal Saline
po
prn
qam
qh
q2h
q3h
q4h
qid
qs
s
SR
SL
Sol./soln.
stat
SubQ
susp.
syp.
tab
tid
ung/oint.
by mouth
when required
every morning
every hour
every two hours
every three hours
every four hours
four times a day
quantity sufficient
without
sustained release
sublingual
solution
immediately
subcutaneous
suspension
syrup
tablet
three times a day
Ointment
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Institute for Safe Medical Practice & Joint Commission on Accreditation of Healthcare
Organizations Guidelines for Abbreviations
Do Not Use
Recommended
Write “units”
Write “international unit”
Write ‘daily’
Write “every other day”
Write “bedtime” or “half strength”
Write “Sub Q”
Write “discontinue” or “discharge”
Write “mL”
Write “left ear”, “right ear”, or “both ears”
Write “at”
Write “by mouth”
Write drug name in full
Write sliding scale
Write “right eye, left eye, both eyes”
U
IU
QD
QOD
HS
SC or SQ
DS or D/C
cc
AD, AS, AU
@
Per OS
Abbreviation for drug names
SS
OD, OS, OU
METHODS OF CALCULATION
A. Drug Dosage Calculations
D = Desired Dose
H = Dose on Hand
Q = Quantity (form and amount drug comes in, tabs, caps, mL.
Rounding: For purposes of this module, calculate all problems to 2 decimal points (e.g.,
1.7596 mL would be rounded to 1.76 mL). In actual clinical practice, these numbers may
be rounded to 1 decimal point (e.g. 1.7596 would round to 1.8) in order to draw up
medications, pour medication into a cup, or providing a tablet to a patient.
Formula-Basic Formula (most current method)
Convert Units to One System
X (amount) = D (desired) x Q (quantity)
H (have)
Evaluate answer.
B. IV Infusion Rates
1. Infusion Pump : Calculate mL/hr of infusion
Amount of fluid ÷ Hours to administer = mL/hr
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2. Regulation of flow rate (gtt/min) by gravity flow
a. 1 step formula for primary and secondary (IVPB infusion)
Amount of solution x gtt/mL of the IV tubing set
----------------------------------------------------------- = gtt/min
Minutes to Administer
b. 2 Step method for primary infusions
Step 1: Amount of fluid ÷ hours to administer = gtt/min
Step 2: mL/hr x IV tubing (set) drop factor = gtt/min
60 min
Evaluate answer.
3. If a medication is added to an IV bag, then add the medication volume to the
amount in the bag for a total amount of fluid. This total will be used for
calculation purposes. For example, if 20 mL of KCL is added to 1000 mL NS,
then the total amount of solution is 1020 mL. (The textbook presents two thoughts
on this rule, but it is always safe practice to add the medication volume and is
especially important when caring for infants and children.)
4. Work the problem to 2 decimal places and then round to the whole number for
setting the drip rate in clinical practice (e.g. 83.95 =84 gtt/min).
C. Reconstitution/Solutions from Powders
A powdered drug is reconstituted (dissolved) with fluid (e.g. sterile water) following the
manufacturer’s directions to become a solution. The powder will increase the volume of
the fluid. Thus, the reconstituted solution will always be more than the original volume of
diluent. The drug dosage is based on the total volume.
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