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Safe Administration Medication Exam Prep Study Guide PDF
Safe Administration Medication Exam Prep Study Guide PDF
SAME
Safe Administration of
Medications Exam
A Review of Dosage Calculations,
Preparation, and Administration
Version 2.1
2-4
5
6
7
8-11
12-13
14-15
16-17
18-21
23-24
25
26
27
28
29
30
31
32-68
-1-
Example
3/25 is equal to ____ of 25 pieces?
The numerator describes how many parts there are in
the denominator. So, 3/25 means 3 of 25 pieces.
250/250 is equal to ____?
Any number over that same number is equal to 1. So,
250/250 = 1.
1/4 is equal to:
a) 4 b) 0.5 c) 1 d) 0.25
A fraction can be expressed as a decimal by dividing
the denominator into the numerator. So, when you
divide 4 into 1 you get d) 0.25
You Try
1) 2/50 is equal to ____.
2) 4/1 is equal to ____.
3) 60/60 is equal to ____.
4) 1/2 is equal to ____.
5) 25/400 is equal to ____.
6) 15/60 is equal to ____.
-2-
Decimals
Example
When you are working with decimals you should think of the
decimal point as the divider between whole amounts and
fractional amounts.
X
X
X
X
.
X
X
X
X
Ten thousandths
Thousandths
Hundreths
Tenths
Decimal Point
Ones
Tens
Hundreds
Thousands
125.00 x 10 = 1250.0
325.50 / 10 = 32.550
450.677 x 1000 = 450677
1546.286 / 1000 = 1.546286
Hint: Let the zeros be your guide.
When multiplying by a factor of 10 (10, 100, 1,000, 10,000,
etc) the number of spaces the decimal point moves is equal
to the number of zeros you see after the one.
Just remember that divide means
to the left and multiply means to the right!
You Try
7) 350.60 x 10 = ____.
8) 4.256 / 100 = ____.
9) 500 / 1000 = ____.
10) 125.5 x 100 = ____.
-3-
Rounding
Sometimes a number has many numbers to the right of the
decimal point. So, we use rounding to make the number easier
to use.
Remember: in this review packet we always use decimals out
to the hundredths point. Any result that has thousandths or
more needs to be rounded.
For example: 10.054 needs rounding
255.25 does not need rounding
Look for the thousandths.
Find the number in the thousandths place. This is
the number that is 3 places to the right of the
decimal place.
Round UP: round up if the number is greater than
or equal to 5
Round DOWN: round down if the number is less
than 5. When you decide to round down the
number in the hundredths place just stays the
same.
Examples
2.256 = 2.26
You round up in this example. The 6 is in the
hundredths place and is greater than or equal to
5soround the 5 up to a 6 and the answer is 2.26.
Example
100.257 needs to be rounded up to 100.26
1.24 is a number out to the hundredths so it should not be
rounded
2.542 needs to be rounded down to 2.54
60.255 needs to be rounded up to 60.26
You Try
11) 500.259 = ____.
12) 285.001 = ____.
13) 1.2555 = ____.
14) 45.509 = ____.
10.542 = 10.54
You round down in this example. The 2 is in the
hundredths place and is less than 5sothe 4
that is in hundredths place stays the same and the
answer is 10.54.
SAME version 2.1.
Haspela 2004
-4-
Conversions
Medications are often ordered in larger or smaller units than
those held in stock. So, as a nurse you will need to convert
metric units.
1 gram (g) = 1000 milligrams (mg)
1 milligram (mg) = 1000 micrograms (mcg)
1 microgram (mcg) = 0.001 milligrams (mg)
1 milligram (mg) = 0.001 gram (g)
The nurse will frequently need to convert metric
measurements into household measurements to help patients
understand how to take medications or so that the nurse can
understand what the patient is describing.
2.2 pounds (lb) = 1 kilogram(kg)
1 tablespoon (tbsp) = 15 milliliters(ml)
3 teaspoons(tsp) = 15 milliliters(ml)
1 cup(C) = 240 milliliters(ml)
8 ounces(oz) = 240 milliliters(ml)
1 teaspoon(tsp) = 5 milliliters(ml)
1 cup(C) = 8 ounces(oz)
16 ounces(oz) = 1 pound(lb)
1 ouncs(oz) = 30milliliters(ml)
DONT FORGET!!
When referring to volumes you
will see cc and/or ml REMEMBER that 1ml = 1cc.
You will see these units used interchangeably.
Example
ORDER:
STOCK:
GIVE:
ORDER:
STOCK:
GIVE:
ORDER:
STOCK:
GIVE:
You Try
15) How many pounds is 60kg?
16) How many kg is 225lbs?
17) How many ml are there in cup?
18) How many ml are there in 4oz.?
19) How many mg are there in 24g?
20) How many mcg are there in 0.5mg?
-5-
Ratio-Proportions
A ratio is a comparison of two numbers. For example, the
ratio of 1 to 4 is most often represented by the fraction .
Another example of a ratio is 5 to 6 and this is most often
represented by the fraction 5/6.
A ratio might be used by a nurse to explain a relationship
between two things. For example, for every 1 tablet there are
5 milligrams. This might be written as a ratio like this:
1 tab
5mg
When two ratios are compared to each other it is called a
proportion. A proportion looks like two fractions with an
equal sign between them. A proportion might look like this:
1
= 4
4
16
Remember because there is an equal sign between the
two fractions the fractions are equal to each other. In the
above example this means that is equivalent to 4/16.
If one piece of information is missing you can use a
proportion to solve a problem by cross-multiplying.
For example:
QUESTION: In one pill there are 4mg.
So, how many pills make 16 mg?
= X_
1) Set up a proportion
1
like this
4
16
2) Cross multiply like this: (4) x (X) = (1) x (16)
3) Solve for X like this:
4) The answer is then:
SAME version 2.1.
Haspela 2004
Example
In 3mL there are 6mg of Morphine Sulfate. How many mg
are there in 1mL?
1) Set up a proportion
3ml
= 1ml_
like this:
6mg
Xmg
2) Cross multiply like this: (3) x (X) = (1) x (6)
3) Solve for X like this:
4) The answer is then:
X = (1) x (6)
3
X=2
You Try
21) How many mg are in 3ml if 1ml has 5mg?
22) If there are 25mg in one tablet then how many mg are
there in 3 tablets?
23) In one tablet there is 100mg. How many pills make up
50mg?
24) How many mg are there in 10ml if 1ml has 2.5mg?
X = (1) x (16)
4
X=4
-6-
Read.
Stop & Think.
Solve.
Check & Question.
READ
Example
In fourteen-hundred-ninety-two
Columbus sailed the ocean blue.
How did he get so smart anyway?
He did it by following basics of problem solving. He
thought about his questions, solved them carefully, and
was not afraid to question the feasibility of his answers.
-7-
Example
ORDER:
Decadron 1.5mg PO twice a day
STOCK:
tablets labeled 0.75mg
How many tablets do you administer?
1) Set up a proportion
like this
2) Cross multiply like this:
3) Solve for X like this:
You can solve tablet and capsule problems by using ratios and
proportions.
REMEMBER: When you are setting up a proportion
the units of numerators must match and the units of
the denominators must match. If they dont you CAN
NOT proceed. (i.e. you might need to convert grams
to milligrams or pounds to kilograms so that the units
will match)
For example:
ORDER:
STOCK:
X = (1) x (50)
25
X = 2 tablets
X = (1) x (1.5)
0.75
X = 2 tablets
You Try
25.
1) Set up a proportion
1 tab
= X tab_
like this
25mg
50mg
2) Cross multiply like this: (25) x (X) = (1) x (50)
_1 tab
= X tab_
0.75mg
1.5mg
(0.75) x (X) = (1) x (1.5)
26.
27.
28.
ORDER:
prednisone 10mg PO three times a day
STOCK:
tablets labeled 2.5mg
How many tablets do you administer?
ORDER:
Tylenol 650mg PO every eight hours
STOCK:
tablets labeled 325mg
How many tablets do you administer?
ORDER:
digoxin 0.125mg PO at 4pm daily
STOCK:
tablets labeled 0.25mg (scored)
How many tablets do you administer?
ORDER:
diphenhydramine 50mg PO every 8
hours
STOCK:
capsules labeled 25mg
How many capsules do you administer?
-8-
Example
ORDER:
Decadron 1.5mg PO twice a day
STOCK:
tablets labeled 0.75mg
How many tablets do you administer?
_D_ x Q = Correct dose to administer
H
50mg Toprol XL PO QD
Toprol XL tablets labeled 25mg
50mg x 1 whole tablet = 2 tablets
25mg
You Try
29.
30.
31.
32.
ORDER:
prednisone 10mg PO three times a day
STOCK:
tablets labeled 2.5mg
How many tablets do you administer?
ORDER:
Tylenol 650mg PO every 8 hours
STOCK:
tablets labeled 325mg
How many tablets do you administer?
ORDER:
digoxin 0.125mg PO at 4pm daily
STOCK:
tablets labeled 0.25mg (scored)
How many tablets do you administer?
ORDER:
diphenhydramine 50mg PO every 8
hours
STOCK:
capsules labeled 25mg
How many capsules do you administer?
-9-
ORDER:
synthroid 300mcg PO once daily
STOCK:
tablets labeled 0.1mg (scored)
How many tablets will you administer?
First, convert to same units of measure
1000mcg = X mcg
1mg
0.1mg
You Try
33.
34.
Fifth,
Sixth,
Now that the units are the same you can solve the problem. If
you use the formula is will look like this:
Third,
Example
35.
36.
ORDER:
amoxicillin 1.5g PO every 8 hours
STOCK:
capsules labeled 250mg
How many capsules do you administer?
ORDER:
ethchlorvynol 2000mg PO at bedtime
STOCK:
capsules labeled 1g
How many capsules do you administer?
ORDER:
digoxin 0.5mg PO once a day
STOCK:
tablets labeled 125mcg
How many tablets do you administer?
ORDER:
carvedilol 6.25mg PO twice a day
STOCK:
capsules labeled 6250mcg
How many capsules do you administer?
- 10 -
Example
ORDER:
synthroid 300mcg PO once daily
STOCK:
tablets labeled 0.1mg (scored)
How many tablets will you administer?
First, convert to same units of measure
1000mcg = X mcg
1mg
0.1mg
Now that the units are the same you can solve the problem. If
you use the ratio-proportion method is will look like this:
1) Set up a proportion
like this
2) Cross multiply like this:
Notice that the units ordered are in mcg and the units in stock
are mg. Before you can use the formula you must first convert
into the same units of measure. You can do this by using a
proportion.
First,
Second,
Third,
Fourth,
Fifth,
Sixth,
_1 tab
= X tab_
100mcg
300mcg
(100) x (X) = (1) x (300)
X = (1) x (300)
100
X = 3 tablets
You Try
37.
38.
39.
40.
ORDER:
amoxicillin 1.5g PO every 8 hours
STOCK:
capsules labeled 250mg
How many capsules do you administer?
ORDER:
ethchlorvynol 2000mg PO at bedtime
STOCK:
capsules labeled 1g
How many capsules do you administer?
ORDER:
digoxin 0.5mg PO once daily
STOCK:
tablets labeled 125mcg
How many tablets do you administer?
ORDER:
carvedilol 6.25mg PO twice daily
STOCK:
capsules labeled 6250mcg
How many capsules do you administer?
- 11 -
Example
ORDER:
amoxicillin oral suspension 500mg PO Q8H
STOCK:
amoxicillin oral suspension 1g per 10ml
How many ml do you administer?
First, convert to same units of measure:
1000mg = X mg
1g
1g
ORDER:
cloxacillin sodium 0.25g PO every 6 hours
STOCK:
cloxacillin sodium 125mg per 5ml
How many ml do you administer?
First, convert to same units of measure
1000mg = X mg
1g
0.25g
X = (5) x (250)
125
X = 10 ml
then.1000mg x 1g = X = 1000mg
1g
42.
43.
44.
X = (10) x (500)
1000
X = 5 ml
You Try
hydrocortisone cypionate oral
suspension 0.03g PO every 6 hours
STOCK:
liquid labeled 10mg per 5ml
How many ml do you administer?
ORDER:
cephalex in oral suspension
0.35g PO every 6 hours
STOCK:
liquid labeled 125mg per 5ml
How many ml do you administer?
ORDER:
erythromycin susp. 0.75g PO 4 times
a day
STOCK:
liquid labeled 250mg per 5ml
How many ml do you administer?
ORDER:
penicillin V potassium 0.6g PO
every 6 hours
STOCK:
liquid labeled 250mg per 5ml
How many ml do you administer?
ORDER:
- 12 -
Example
ORDER:
46.
47.
then.1000mg x 1g = X = 1000mg
1g
48.
You Try
hydrocortisone cypionate oral
susp. 0.03g PO once every 6 hours
STOCK:
liquid labeled 10mg per 5ml
How many ml do you administer?
ORDER:
cephalex in oral suspension
0.35g PO every 6 hours
STOCK:
liquid labeled 125mg per 5ml
How many ml do you administer?
ORDER:
erythromycin susp. 0.75g PO 4 times
a day
STOCK:
liquid labeled 250mg per 5ml
How many ml do you administer?
ORDER:
penicillin V potassium 0.6g PO every
6 hours
STOCK:
liquid labeled 250mg per 5ml
How many ml do you administer?
ORDER:
- 13 -
Example
1) True or False: Administer 2ml IM to a 2 month old infant.
Answers: 1) F 2) F 3) T 4) T 5) F 6) F
SQ
IM
ID
SAME version 2.1.
Haspela 2004
Syringe
Size
Needle
Guage
Needle
Length
Maximum
Injectable
Volume
1ml, U50
insulin, or
U100 insulin
syringes
25 27
guage
3/8 5/8
inches
0.5 1ml
1 1
inches
Adult:3ml
Child or
small
adult:2ml
Small
children:1ml
2-5ml for
adult and 12ml for child
19 23
guage
1ml tuberculin
syringe
26 27
guage
3/8 5/8
inches
0.1 0.3 ml
You Try
49.
True or False:
Administer 1ml SQ with a 5ml syringe that is 3/8
inches and 26 guage
50.
True or False:
Administer 25units insulin with a U100 syringe that is
3/8 inches in length and 27 guage
51.
True or False:
Administer a TB test by injecting 0.2ml of test
solution with a 1ml tuberculin syringe that is 5/8
inches in length and 26 guage
52.
True or False:
Administer 3ml SQ to an adult using a 1 inch
needle that is 20 guage
- 14 -
Injections
Liquid medications are sterile solutions or suspensions.
Sterile technique must be maintained when preparing
injections. Each syringe has different gradations on it.
Example
2.5ml is marked on the following syringe.
You Try
Insulin syringes come in two types. Each line in a U-50
syringe is equal to 1 unit and the whole syringe holds 0.5ml.
Each line in a U-100 syringe is equal to 1 unit and the whole
syringe holds 1ml.
- 15 -
X = (1) x (5)
10
X = ml or 0.5ml
1) Set up a proportion
like this
2) Cross multiply like this:
1 ml
= X ml_
10mg
5mg
(10) x (X) = (1) x (5)
ORDER:
metoprolol 25mg IV push stat
STOCK:
ampule labeled 50mg per 5 ml
How many ml will you draw up into a syringe?
What size syringe is ideal?
1) Set up a proportion
like this
2) Cross multiply like this:
ANSWER:
Example
5 ml
= X ml_
50mg
25mg
(50) x (X) = (5) x (25)
X = (5) x (25)
50
X = 2.5 ml
ANSWER:
You Try
56.
57.
58.
59.
Example
ORDER:
metoprolol 25mg IV push stat
STOCK:
ampule labeled 50mg per 5 ml
How many ml will you draw up into a syringe?
What size syringe is ideal?
25mg x 5 ml = 2.5 ml
50mg
ANSWER:
You Try
60.
61.
62.
63.
Example
ORDER:
450ml of NS over 6 hours
TUBING:
15gtt/ml
What is the drip rate you will set?
First convert the hours to minutes like this:
6 hours x 60 minutes = 360 minutes
Then plug the numbers into the formula:
450 ml x 15gtt = 18.75 or 19 gtts per minute
360min
1ml
In this example the time (T) was 6 hours. Remember that you
need to convert this to minutes when plugging the numbers
into the formula. 6 hours x 60 minutes = 360 minutes.
The answer 18.75 gtts was rounded up to 19 gtts. You must
round the answer to the nearest whole number because it is
impossible to count fractions or portions of drops.
You Try
64.
ORDER:
2 L of NS over 24 hours
TUBING:
10gtt/ml
What is the drip rate you will set?
65.
ORDER:
250ml of NS over 30 minutes
TUBING:
15gtt/ml
What is the drip rate you will set?
66.
ORDER:
1 gram of Magnesium
Sulfate in 100ml of NS over 2 hrs
TUBING:
60gtt/ml
What is the drip rate you will set?
- 18 -
Third.
Example
ORDER:
3000 ml of D10W over 24 hours
TUBING:
15 gtts / ml
What is the drip rate that you will set?
First.
Second.
Third.
You Try
67. ORDER: 4000ml of Lactated Ringers over 24 hours
TUBING: 15 gtts / ml
What is the drip rate that you will set?
68. ORDER: 2000ml of Normal Saline over 10 hours
TUBING: 15 gtts / ml
What is the drip rate that you will set?
69. ORDER: 2000ml of Normal Saline over 6 hours
TUBING: 10 gtts / ml
What is the drip rate that you will set?
70. ORDER: 4000ml of Lactated Ringers over 48 hours
TUBING: 10 gtts / ml
What is the drip rate that you will set?
- 19 -
Example
ORDER:
150 ml of NS over 20 minutes
How many ml/hour will you set the pump at?
1) Use the formula like this:
150ml = Pump rate
20min
The answer is then 7.5 ml/minute.
ANSWER:
x ml
hour
ANSWER:
You Try
What would you set the pump rate (ml/hour) in the following
examples?
71.
ORDER:
1 gram of vancomycin over 60 minutes
STOCK:
2 grams of vancomycin in 500ml of NS
72.
ORDER:
STOCK:
73.
ORDER
STOCK:
74.
ORDER:
STOCK:
SAME version 2.1.
Haspela 2004
- 20 -
Example
ORDER:
STOCK:
You Try
What would you set the pump rate (ml/hour) in the following
examples?
75.
ORDER:
STOCK:
76.
ORDER:
STOCK:
77.
ORDER:
STOCK:
78.
ORDER:
x = 10 ml
STOCK:
SAME
A Review of Dosage Calculations,
Preparation, and Administration
Version 2.1
PEDIATRIC FOCUS
- 22 -
PEDIATRICS: Conversions
Pediatric drug calculations commonly use household
measurement.
Therefore, it is important that the nurse understand how to
convert between household units and metric units.
Example
1. A mother says she gave her child 1 tablespoons of
robitussion. How many ml is this?
1 tbsp = 1.5 tbsp
15ml
Xml
(1.5) x (15)
1
22.5ml
You Try
79. There are _____ml in 1 cups
80. There are _____ml in 3 teaspoons
81. 15ml is the same as _____ teaspoons or ______
tablespoons
- 23 -
PEDIATRICS: Conversions
The most accurate and common way to calculate pediatric
dosages is by using mg/kg/day. Often a childs weight is
recorded in pounds and ounces. Therefore, you must first
convert the ounces to pounds and then convert pounds to
kilograms.
Remember the following conversion factors:
There are 16 ounces in a pound.
There are 2.2 pounds in 1 kilogram.
For example. Consider a child who is 14 pounds 4 ounces.
How many kilograms is this child?
Example
How many kilograms is equal to 45 pounds 2 ounces?
1. Convert the ounces like this: 2/16 = 0.125
2. Add 0.125 to 45 to get 45.125 pounds
3. Convert to kilograms like this: 45.125/2.2
4. Answer: 20.511 kilograms. Round to 20.51kg
Convert 24 pounds 15 ounces to kilograms.
1. Convert the ounces like this: 15/16 = 0.937
2. Add 0.937 to 24 pounds to get 24.937 pounds
2. Convert to kilograms like this: 24.937/2.2
3. Answer: 11.335 kilograms. Round to 11.34kg
You Try
84.
85.
86.
87.
- 24 -
Example
A child weighs 11 pounds 3 oz. A medication is ordered at
20mg/kg/day. The safe range for this medication is up to
200mg/kg/day.
11 pounds 3 ounces = 11.188 pounds
11.188 pounds / 2.2 = 5.085 kilograms
(20mg) x (5.085 kg) = 101.7 mg / day
101.7 mg/day is within the safe range of this medication.
You Try
88.
89.
90.
91.
- 25 -
Example
For example: You are working with a 54 pound 9 ounce child
and a medication is ordered at 100mg/kg/day and is to be
given in 2 divided doses.
1. First convert from pounds to kilograms:
9 ounces / 16 = 0.562 pounds
54 + 0.562 = 54.562 pounds
54.562 pounds/2.2 = 24.8kg
2. Next you should calculate the pounds per kilogram
per day:
(100 mg) x (24.8 kg) = 2480 mg/day
You Try
92.
93.
94.
95.
Example
An order asks you to administer 50mg of a medication to a 6 pound 2
ounce premature infant via a PEG tube. A drug reference book indicated
that the safe medication range for this medication is 10 15 mg/kg/day. Is
50mg a safe dose to give?
1. Convert to kilograms like this:
6 pounds 2 ounces
2 / 16 = 0.125
0.125 + 6 = 6.125 pounds
6.125 pounds / 2.2 = 2.784 kg
2. Calculate the maximum and minimum doses like this:
Minimum of range: (2.784 kg) x (10 mg) = 27.84 kg
Maximum of range: (2.784 kg) x (15 mg) = 41.76 kg
3. The order asked you to give 50mg to this 2.8kg child.
Since 50mg is greater than 42 (the maximum safe
recommended dose) you should NOT give the medication.
This is not a safe dose.
You should contact the ordering physician to discuss
modification to the order.
You Try
You are working with a child who is 26.6kg. Calculate the
maximum and minimum recommended doses for the
following medications:
96. digoxin PO; 20 40 mc g/kg/day
97. paraldehyde IM; 0.15ml/kg/day; not to exceed
5ml/kg/day
98. Ritalin PO; 5mg before breakfast and lunch; increasing
by 5-10mg/week; not to exceed 60mg/day
99. neomycin PO; 50-100mg/kg/day
100. ondasteron IV; up to 0.15mg/kg/day
- 27 -
Example
READ
Read.
Stop & Think.
Solve.
Check & Question.
- 28 -
Example
ORDER: Bactrim 1 gram IV over 1 hour BID
STOCK: 1000mg Bactrim in 100cc NS; 60gtt/ml tubing
What is the drip rate you will set?
100ml x 60gtt = 100 gtts per minute
60min
1ml
ANSWER: Set the roller clamp to 100 gtts/minute
ORDER: Vancomycin 375mg IV over 30 minutes four times
a day
STOCK: 1875mg Vancomycin in 500ml of D5W.
What will you set the pump at?
_100ml_ = x ml
0.5hours
hours
ANSWER:
x = 200 ml/hour.
You Try
103.
104.
105.
106.
PEDIATRICS: Reconstitution
Example
ORDER:
STOCK:
You Try
107.
108.
109.
- 30 -
Intended
Meaning
Morphine sulfate
MgSO4
Magnesium
sulfate
1mg
Trailing zeros:
Zero written after
decimal points
(ex. 1.0mg)
0.5mg
Missing leading
zeros:
Zero missing
before decimal
points
(ex. .5mg)
U
IU
Unit
International Unit
ug
QD
microgram
Once daily
QOD
Letter d
(ex. x3d)
TIW or tiw
Days (times 3
days)
Three times a
week
Acceptable
Alternative
Use morphine
sulfate
Use magnesium
sulfate
Do not use terminal
zeros for doses
expressed in whole
units (Write
1mg)
Always us zero
before a decimal
point when the
dose is less than a
whole unit (Write
0.5mg
Use unit
Use unit or
international unit
Use mcg
Use daily or
once daily
Use every other
day
Use days or
doses
Do no use this
abbreviation.
Specify which days
of the week,
Example
Example
DO
DONT
You Try
See if you can underline all the unacceptable abbreviations.
There are 9 of them in the following short nursing note.
110.
- 31 -
SAME
Answers to practice problems.
Additional practice problems.
Version 2.1
- 32 -
1. 2 divided by 50 = 0.04
2. 4 divided by 1 = 4
3. 60 divided by 60 = 1
4. 1 divided by 2 = 0.5
5. 25/400 is equal to
__0.0625__.
6. 15 divided by 60 = 0.25
7. 350.60 x 10 = 3506
8. Dividing by 100 moves the decimal place twice to the left. 0.04256
9. Dividing by 1000 moves the decimal place three places to the left. 0.5
10.
11.
500.259 = 500.26
12.
285.001 = 285
13.
1.2555 = 1.26
10. Multiplying by 100 moves the decimal place two places to the right.
12550
11. The number in the thousandths place (9) is greater than or equal to 5,
therefore we round the hundredths place up from 5 to a 6. 500.26
12. The number in the thousandths place (1) is less than 5, therefore we
round down and leave the hundredths place number alone. 285
13. The number in the thousandths place (5) is greater than or equal to 5,
therefore we round the hundredths place up from 5 to a 6. 1.26
- 33 -
14. The number in the thousandths place (9) is greater than or equal to 5,
therefore we round the hundredths place up from 0 to 1. 45.51
15.
First.
Second.
Third.
Fourth.
16.
First.
Second.
Third.
Fourth.
17.
First.
Second.
Third.
Fourth.
18.
First.
Second.
Third.
Fourth.
19.
First.
Second.
Third.
Fourth.
20.
First.
Second.
Third.
Fourth.
- 35 -
21.
First.
Second.
Third .
22.
First.
Second.
Third .
23.
First.
Second.
Third .
- 36 -
24.
First.
Second.
Third .
25.
ORDER:
prednisone 10mg
PO three times a
day
STOCK:
tablets labeled
2.5mg
How many tablets do you
administer? 4 tablets
26.
ORDER:
Tylenol 650mg
PO every eight
hours
STOCK:
tablets labeled
325mg
How many tablets do you
administer? 2 tablets
SAME version 2.1.
Haspela 2004
25.
First.
Second.
Third.
26. . First.
Second.
Third.
- 37 -
27.
ORDER:
27.
digoxin 0.125mg
PO at 4pm daily
STOCK:
tablets labeled
0.25mg (scored)
How many tablets do you
administer? tablet
28.
ORDER:
diphenhydramine
50mg PO every 8
hours
STOCK:
capsules labeled
25mg
How many capsules do you
administer? 2 capsules
29.
ORDER:
prednisone 10mg
PO 3 times a day
tablets labeled
STOCK:
2.5mg
How many tablets do you
administer? 4 tablets
First.
Second.
Third .
28.
First.
Second.
Third .
29.
First.
Second
- 38 -
30.
ORDER:
30.
Tylenol 650mg
PO every 8 hours
STOCK:
tablets labeled
325mg
How many tablets do you
administer? 2 tablets
31.
ORDER:
digoxin 0.125mg
PO at 4pm daily
STOCK:
tablets labeled
0.25mg (scored)
How many tablets do you
administer? tablet
32.
ORDER:
diphenhydramine
50mg PO every 8
hours
STOCK:
capsules labeled
25mg
How many tablets do you
administer? 2 capsules
SAME version 2.1.
Haspela 2004
First.
Second
31.
First.
Second
32.
First.
Second
- 39 -
33.
ORDER:
33.
amoxicillin 1.5g
PO every 8 hours
STOCK:
capsules labeled
250mg
How many capsules do you
administer? 6 capsules
First.
Second.
Third.
Fourth
34.
ORDER:
ethchlorvynol
2000mg PO at
bedtime
STOCK:
capsules labeled
1g
How many tablets do you
administer? 2 capsules
34.
First.
Second.
Third.
Fourth
35.
ORDER:
35.
digoxin 0.5mg
PO once daily
STOCK:
tablets labeled
125mcg
How many tablets do you
administer? 4 tablets
First.
Second.
Third.
Fourth
36.
ORDER:
carvedilol
6.25mg PO twice
a day
STOCK:
capsules labeled
6250 mcg
How many tablets do you
administer? 1 capsule
36.
First.
Second.
Third.
Fourth
37.
ORDER:
37.
amoxicillin 1.5g
PO every 8 hours
STOCK:
capsules labeled
250 mg
How many tablets do you
administer? 6 capsules
First.
Second.
Third.
Fourth.
Fifth.
38.
ORDER:
ethchlorvynol
2000mg PO at
bedtime
STOCK:
capsules labeled
1g
How many capsules do you
administer? 2 capsules
38.
First.
Second.
Third.
Fourth.
Fifth.
- 42 -
39.
ORDER:
39.
digoxin 0.5mg
PO once a day
STOCK:
tablets labeled
125mcg
How many tablets do you
administer? 4 tablets
First.
Second.
Third.
Fourth.
Fifth.
40.
ORDER:
carvedilol
6.25mg PO twice
daily
STOCK:
capsules labeled
6250mcg
How many capsules do you
administer? 1 capsule
40.
First.
Second.
Third.
Fourth.
Fifth.
- 43 -
41.
ORDER:
41.
hydrocortisone
cypionate oral
susp. 0.03 g PO
every 6 hours
STOCK:
liquid labeled
10mg per 5ml
How many ml do you
administer? 15ml
First.
Second:
Third.
Fourth.
42.
ORDER:
cephalex in oral
suspension
0.35g PO every 6
hours
STOCK:
liquid labeled
125mg per 5ml
How many ml do you
administer? 14 ml
Fifth.
42.
First.
Second:
Third.
Fourth.
Fifth.
43.
ORDER:
43.
erythromycin
susp. 0.75g PO
four times a day
STOCK:
liquid labeled
250mg per 5ml
How many ml do you
administer? 15 ml
First.
Second:
Third.
Fourth.
Fifth.
44.
44.
ORDER:
penicillin V
potassium 0.6 g
PO every 6 hours
STOCK:
liquid labeled
250mg per 5ml
How many ml do you
administer? 12ml
First.
Second:
Third.
Fourth.
Fifth.
45.
ORDER:
45.
hydrocortisone
cypionate oral
susp. 0.03g PO
every 6 hours
STOCK:
liquid labeled
10mg per 5ml
How many ml do you
administer? 15 ml
First.
Second.
Third.
Fourth
46.
ORDER:
cephalex in oral
suspension
0.35g PO every 6
hours
STOCK:
liquid labeled
125mg per 5ml
How many ml do you
administer? 14 ml
46.
First.
Second.
Third.
Fourth
- 46 -
47.
ORDER:
47.
erythromycin
susp. 0.75g PO
four times a day
STOCK:
liquid labeled
250mg per 5ml
How many ml do you
administer? 15 ml
First.
Second.
Third.
Fourth
48.
ORDER:
penicillin V
potassium 0.6g
PO every 6 hours
STOCK:
liquid labeled 250
mg per 5 ml
How many ml do you
administer? 12 ml
48.
First.
Second.
Third.
Fourth
- 47 -
49.
50.
True.
51.
True.
52.
- 48 -
54.
55.
56.
ORDER:
56.
meperidine 75mg
IM every 4 hours
STOCK:
meperidine 50mg
per ml
How many ml will you draw
up into a syringe? 1.5 ml
First.
Second.
Third.
- 49 -
57.
ORDER:
Phenergan 15mg
IM every 4 6
hours PRN;
nausea
STOCK:
Phenergan 50mg
per ml
How many ml will you draw
up into a syringe? 0.3 ml
58.
ORDER: nebcin 60mg IV
every 8 hours
STOCK:
nebcin 80mg per
2ml
How many mL will you draw
up into a syringe? 1.5ml
59.
ORDER:
57.
First.
Second.
Third.
58.
First.
Second.
Third.
59.
First.
Second.
Third.
- 50 -
60.
ORDER:
60.
meperidine 75mg
IM every 4 hours
STOCK:
meperidine 50mg
per ml
How many ml will you draw
up into a syringe? 1.5 ml
61.
ORDER:
Second.
61.
phenergan 15 mg
IM every 4 6
hours PRN;
nausea
STOCK:
phenergan 50 mg
per ml
How many ml will you draw
up into a syringe? 0.3 ml
62.
ORDER:
nebcin 60mg IV
every 8 hours
STOCK:
nebcin 80mg per
2 ml
How many ml will you draw
up into a syringe? 1.5 ml
First.
First.
Second.
62.
First.
Second.
- 51 -
63.
ORDER:
63.
64.
ORDER:
2 L of NS over 24
hours
TUBING: 10gtt/ml
What is the drip rate you will
set? 14 gtts/min
First.
Second.
64.
First.
Second.
Third.
65.
ORDER:
250ml of NS over
30 minutes
TUBING: 15gtts/ml
What is the drip rate you will
set? 125 gtts/ml
Fourth.
65.
First.
Second.
- 52 -
66.
ORDER:
1 gram of Magnesium
Sulfate in 100ml of NS
over 2 hrs
TUBING:
60 gtts/ml
What is the drip rate you will set? 50
gtts/min
67.
ORDER:
4000ml of Lactated
Ringers over 24 hrs
TUBING:
15 gtts / ml
What is the drip rate you will set?
42 gtts / min
66.
First.
Second.
67.
First.
Second.
Third.
68.
ORDER:
68.
50 gtts / minute
Second.
2000ml of Normal
Saline over 10 hours
TUBING:
15 gtts / ml
What is the drip rate you will set?
First.
Third.
- 53 -
69.
ORDER:
69.
56 gtts / min
Second.
2000ml of Normal
Saline over 6 hours
TUBING:
10 gtts / ml
What is the drip rate you will set?
First.
Third.
70.
ORDER:
4000ml of Lactated
Ringers over 48 hours
TUBING:
10 gtts / ml
What is the drip rate you will set?
14 gtts / min
70.
First.
- 54 -
71.
ORDER:
71.
1 gram of
vancomycin over
60 minutes
STOCK:
2 grams of
vancomycin in
500 ml of NS
What would you set the pump
rate to? 250 ml/hour
72.
ORDER:
2 grams of
magnesium
sulfate IV over 20
minutes
STOCK:
2000mg of
magnesium
sulfate in 100 ml
What would you set the pump
rate to? 300 ml/hr
First.
Second.
72.
First.
Second.
Third.
hour
- 55 -
73.
ORDER
73.
50mg furosemide
per hour IV
STOCK:
500mg
furosemide in
250 ml bag of NS
What would you set the pump
rate to? 25 ml/hour
First.
Second.
Third.
Fourth.
Fifth.
74.
ORDER:
cefmetazole
4grams IV over
30 minutes
STOCK:
cefmetazole 4
grams in 100ml
of
NS
What would you set the pump
rate to? 200 ml/hour
74.
First.
Second.
- 56 -
75.
ORDER:
75.
1200units of
Heparin per hour
STOCK:
250ml bag
containing 25,000
units of heparin
What would you set the pump
rate (cc/hour)? 12ml/hour
First.
Second.
Third.
Fourth.
Fifth.
76.
ORDER:
1550units of
Heparin per hour
STOCK:
250ml bag
containing 25,000
units of heparin
What would you set the pump
rate (cc/hour)? 15.5 ml/hour
76.
First.
Second.
Third.
Fourth.
Fifth.
77.
ORDER:
77.
3 units an hour of
Insulin
STOCK:
100 units of
insulin in 100ml
bag of NS
What would you set the pump
rate (ml/hour)? 3 ml/hour
First.
Second.
Third.
Fourth.
Fifth.
78.
ORDER:
2 g Magnesium
Sulfate over 2
hours
STOCK:
2 g Magnesium
Sulfate in 100mL
of D5W
What would you set the pump
rate (ml/hour)? 50 ml/hour
78.
First.
Second.
- 58 -
79.
1 cup = 240 ml
of 240 is 120
80.
1 teaspoon = 5 ml
3 times 5ml = 15ml
81.
82.
83.
1 ounce = 30 ml
If you divide 375 by 30 = 12.5 ounces
84.
First.
Second.
Third.
85.
First.
Second.
Third.
86.
First.
Second.
Third.
87.
First.
Second.
Second.
88.
88.
First.
89.
90.
89.
90.
Second.
Third.
First.
Second.
Third.
First.
Second.
Third.
- 60 -
91.
92.
91.
First.
Third.
92.
First.
Second.
Second.
93.
93.
First.
Second.
Third.
94.
94.
First.
Second.
Third.
Fourth
- 61 -
95.
95.
First.
Second.
Third.
Fourth
96.
97.
98.
Min: The answer is in the problem two 5mg doses. One before
breakfast and one before lunch.
Max: The answer is in the problem not to exceed 60mg/day
(regardless of childs weight).
- 62 -
99.
101. First.
Second.
Third.
- 63 -
102. First.
Second.
103.
ORDER:
103. First.
Bactrim 0.25 g
IV over 30 min.
STOCK: 500mg Bactrim in
50ml NS; 60gtt tubing
What is the drip rate you will
set? 50 gtts/min
Third
104.
ORDER:
Vancomycin
150mg IV over
60 minutes
STOCK:
300mgVancomycin in 100ml
of D5W
What will you set the pump
at? 50ml/hour
104. First.
Second.
Third.
Fourth.
Fifth.
105.
ORDER:
NS 50 ml IV over
30 minutes
STOCK:
NS 100ml; 60gtt
tubing
What is the drip rate you will
set? 100gtts/minute
105. First.
Second.
- 65 -
106. First.
Second.
Third.
Fourth.
Fifth.
107.
First.
108.
109.
First.
110.
O2 @ 2L/minute NC, 2.0mg MS IV, 3 SL .3mg nitroglycerine given
every 5 minutes, and an EKG was done. No relief within this first 15
minutes. Patient continued to complain of 9/10 substernal pain. IV
nitroglycerine was started and titrated up to 200.00ug/min. Blood
glucose was checked and result was 350.0, therefore 10U regular
insulin was given SC in the left abdomen. Lasix 40mg PO QOD
changed to 40.0 mg IV now.
- 68 -