Chapter 17 Dosage Calculations and medication administration

3. The following information is included in a health care provider's order: Jane Doe September 23 Amoxicillin 250 mg PO every 6 hours for 10 days Dr. John Smith The essential component missing is the _____________.

time the health care provider's order should include the patient's name, date, time, medication, dose, route, frequency, and health care provider's signature

17. 6 mg is equal to how many grams? a. 6.0 g b. 0.6 g c. 0.06 g d. 0.006 g

d. 0.006 g Small to big, move decimal point three places to the left. 1 gram = 1000 mg

12. What is 0.9% expressed as a decimal? a. 9 b. 0.9 c. 0.09 d. 0.009

d. 0.009 Remove the % and move the decimal point two places to the left. or divide 0.9 by 100

5. What is the sum of 3/4 and 7/8? a. 10/48 b. 10/12 c. 21/4 d. 1 5/8

d. 1 5/8 Find the common denominator and add. Reduce to lowest terms

20. A 35-lb child is to receive an IM medication. The average adult dose is 75 mg. Using the Clark rule, what dosage should the nurse administer? a. 30.5 mg b. 25.5 mg c. 20.5 mg d. 17.5 mg

d. 17.5 mg Clark's Rule = wt (lbs)/ 150 x Average Adult dose

8. What is 2.34 + 0.77? a. 0.01 b. 90.4 c. 2.417 d. 3.11

d. 3.11 Align the decimal point of each decimal fraction in a column and add.

18. 0.5 L is equal to how many mL? a. 0.0005 mL b. 0.05 mL c. 50 mL d. 500 mL

d. 500 mL Big to small, move decimal point three places to the right.

9. What is 6.147 rounded to the nearest tenth? a. 6.2 b. 6.15 c. 6.14 d. 6.1

d. 6.1 A subsequent number that is 5 or larger can increase the previous number by one whole number. A subsequent number that is less than 5 will leave the number unchanged.

29. When a patient comes into the emergency department with a narcotic overdose, the nurse anticipates that the patient will be treated with Naloxone hydrochloride (Narcan). What drug classification is Narcan? a. Enhancer b. Substitute c. Control d. Antagonist

d. Antagonist An antagonist is a drug that will block the action of another drug, such as Naloxone hydrochloride (Narcan) with Demerol. It is given when a person has received too much of an opioid medication, such as morphine sulfate. It is an antidote

40. Which of the following is not considered part of the "three label checks" of medication administration? a. Check label when taking medication from its storage area b. Check label before discarding or replacing the medication container and before giving the medication to the patient. c. Check label before removing medication from its container d. Check label right after giving medication to patient

d. Check label right after giving medication to patient. 1. check label when removing medication from storage 2. check label prior to removing medication from container 3. check label before discarding and replacing the med container and before giving the medication to the patient pg 438 box 17.6

23. Atropine 0.4 mg is to be given. Ampule is labeled gr 1/150/mL. What dose should the nurse administer? a. 1.5 mL b. 0.25 mL c. 0.5 mL d. 1 mL

1 mL 1 grain = 60 mg 0.4 mg / 60 mg x 1 grain = 0.0066 0.0066 grains / 1 grain x 150 mL = 1

25. 0.5 g of medication is ordered. The label reads 125 mg/mL. What is the correct dose to be administered? a. 1 mL b. 2 mL c. 3 mL d. 4 mL

4 mL 1 gram = 1000 mg 0.5 grams x 1000 mg = 500 mg 500 mg / 125 mg = 4 mL

6. What is the product of 5/6 x 1/2? A. 5/12 b. 6/10 c. 10/6 d. 51/12

A. 5/12 Multiply the numerators and denominators.

21. Tylenol gr V is ordered. The available tablet is 0.3 g. What dosage should the nurse administer? a. 1 tablet b. 1.5 tablets c. 1/2 tablet d. 2 tablets

a. 1 tablet 0.3 grains x 15 = 4.5 grains = 5 grains = 1 tab 1 grain = 60 mg 1 gram = 15 grains

3. which of the following is the largest? a. 1/2 b. 1/3 c. 1/4 d. 1/5

a. 1/2 The smaller the denominator, the larger the fraction.

14. Which is the same ratio as 2:100? a. 1:50 b. 5:300 c. 1:20 d. 4:25

a. 1:50 The value of a ratio is not changed if both sides are multiplied or divided by the same number.

19. The average adult dose of Phenergan is 50 mg. Using the Young rule for a 10-year-old, what is the correct dosage for the child? a. 23 mg b. 25 mg c. 30 mg d. 35 mg

a. 23 mg Young's Rule=Age of child divided by age of a child + 12 x Average adult dose.

4. Which of the following fractions is the smallest? a. 3/12 b. 2/3 c. 5/6 d. 3/4

a. 3/12 The larger the denominator, the smaller the fraction.

Which of the following is a true benefit of nasal sprays? a. Absorbed quickly, less medication is used and wasted b. Absorption is gradual, therefore more medication is dispersed c. Absorption is direct, therefore results are felt quickly d. Absorption is painless, therefore a more preferred form

a. Absorbed quickly, less medication is used and wasted

So as not to irritate the GI tract, when should non-enteric coated PRN tablets be administered? a. After meals or during meal time b. Before meals c. Without meals d. Mixed with food

a. After meals or during meal time. Enteric-coated: encased by a coated shell, keeps tablet from being absorbed in the stomach. takes place in the small intestine. May be destroyed by gastric acid. or cause irritation

34. When the patient complains about his IV lines and asks if he can have the medication by mouth, what is the most appropriate response by the nurse? a. "Pills are difficult for many patients to swallow." b. "Medication by mouth is absorbed more slowly than by any other route." c. "It takes more time for the nurse to prepare and administer oral medications." d. "It leads to more errors to give pills, because the pills all look alike."

b. "Medication by mouth is absorbed more slowly than by any other route." Medications that enter the GI tract are absorbed more slowly than by any other route. It is not known whether or not this particular patient has difficulty swallowing. The decision to give IV medications does not depend on the time of administration. It is not true that all pills look alike.

16. The health care provider has ordered furosemide 20 mg stat. The ampule is labeled 40 mg/mL. What dose should the nurse administer? a. 0.8 mL b. 0.5 mL c. 2.0 mL d. 8.0 mL

b. 0.5 mL Desired dosage over the available dosage times the unit. The unit is what the available dosage is contained in.

11. what is 4.5 divided by 3? a. 0.75 b. 1.5 c. 5 d. 0.66

b. 1.5

7. what is the 3/4 divided by 1/5? a. 3/20 b. 15/4 c. 31/45 d. 4/15

b. 15/4 Write the problem down correctly, invert second number, and multiply

13. what is 1/5 expressed as a percent? a. 50% b. 20% c. 10% d. 5%

b. 20% Change a fraction to a percent by dividing the numerator by the denominator and multiplying by 100

10. What is 2.5 x 2? a. 1.25 b. 5 c. 50 d. 22.5

b. 5

24. A 150-lb man is to receive a medication based on milligrams/kilograms. He is to receive 1 mg/kg. What dosage should the nurse administer? a. 50 mg b. 68 mg c. 75 mg d. 80 mg

b. 68 mg 2.2 lb = 1 kg

1. what is the correct conversion for the improper fraction 77/9? a. 7 7/9 b. 8 5/9 c. 7.79 d. 79.7

b. 8 5/9 Divide the numerator by the denominator.

33. What important principle should be taken to prevent medication errors? a. Placing an unlabeled syringe on the medication cart b. Following the six rights of medication administration c. Leaving a medication with the patient only when family is there d. Always charting medications before the end of the shift

b. Following the six rights of medication administration Following the six rights ensures excellent drug administration practice. Unlabeled syringes should never be left on a medication cart. Medications should never be left in a patient's room. Medications should be charted immediately after they are administered.

26. What is the main organ that inactivates and metabolizes drugs? a. Spleen b. Liver c. Lungs d. Pancreas

b. Liver absorption occurs when the active ingredient of the drug enters the body fluids. main organ that inactivates and metabolizes drugs. kidneys are the principle organs that eliminate the metabolites of drugs from the body. metabolite: substance produced by metabolic action, which results in the breakdown of the drug. assess and consider hepatic and renal functions has potential to prolong the length of time a drug stays in the body and may continue to be active

1. What should the nurse do with an injection of 2 mL of Demerol that the patient has refused? (Select all that apply.) a. Independently waste the drug in a secure place. b. Record in the narcotic log that the drug was wasted. c. Chart in the patient's record the reason the medication was refused. d. Get any staff member to sign the narcotic log as witness to the drug being wasted. e. Confirm the count is correct on the narcotic log.

b. Record in the narcotic log that the drug was wasted. c. Chart in the patient's record the reason the medication was refused. e. Confirm the count is correct on the narcotic log. When a controlled substance is wasted, the actual wasting must be witnessed by a licensed person, the narcotic log must be signed by both the nurse wasting the drug and the witness, and the narcotic count is confirmed by both people.

31. In some health care facilities, the LPN/LVN is allowed to take telephone orders from a health care provider. What is one precaution the nurse must take when receiving a verbal order? a. Write quickly. b. Repeat the order to the health care provider. c. Have another nurse listen on an extension. d. Sign and initial the health care provider's name on the order.

b. Repeat the order to the health care provider. The nurse should always repeat the order to the health care provider. The nurse should write slowly to avoid making a mistake. It is not necessary to have another nurse listen to the verbal order. The nurse should not sign the health care provider's name to the order.

36. What screening test is accomplished by performing an intradermal injection? a. Diabetes b. Tuberculosis c. Hepatitis d. Meningitis

b. Tuberculosis Intradermal injection absorption is slow, which makes it the best route for tuberculosis screening. -absorption is slow -TB -skin tests -desensitization injections of local anesthetics and vaccines. holds max 1 mL 25 G 3/8 - 5/8 in -upper chest, inner aspect of the Lower arm or scapular area.

22. Lanoxin 0.125 mg is to be given. The nurse converts the dose to how many grams? a. 1.250 g b. 1250 g c. 0.000125 g d. 0.00125 g

c. 0.000125 g 1 gram = 1000 mg 0.125 mg/ 1000 mg x 1 gram = 0.000125

15. The medication order reads "Ibuprofen 600 mg PO tid." The bottle is labeled "Ibuprofen 200 mg/tab." How many tablets should the nurse administer? a. 1 b. 2 c. 3 d. 6

c. 3 Desired dose over available dose times the unit. The unit is what the available dose is contained in.

2. What is the fraction 80/100 when reduced to its lowest term ? a. 8/10 b. 1/4 c. 4/5 d. 3

c. 4/5 Find a number that will evenly divide into the numerator and the denominator.

35. What landmarks are used for the administration of an intramuscular injection into the gluteal site? a. The tip of the coccyx and the greater trochanter b. Between the center of the gluteus and the iliac spine c. Between the posterior iliac crest and the greater trochanter d. On an imaginary line between the center of the gluteus and the greater trochanter

c. Between the posterior iliac crest and the greater trochanter the gluteal site is marked by the greater trochanter and the posterior iliac crest.

38. Amount of drug prescribed for a patient by a physician in a given amount of time or at a given frequency. a. Route b. Number of Tablets c. Dosage d. Prescription

c. Dosage schedule of administration -amount -frequency pg 432

30. The nurse administered a sedative to an older adult who was having difficulty sleeping. Later, the patient was walking the halls and becoming agitated. What is this drug response known as? a. Expected b. Untoward c. Idiosyncratic d. Hypersensitive

c. Idiosyncratic An unexpected response to a medication. reaction to a drug results from the individual's unique hypersensitivity to it. opposite reaction: example. pt takes med to reduce anxiety, instead pt becomes more agitated and restless instead.

42. Most people take caffeine as a stimulant. When someone takes it as a sedative, the effect of caffeine is then said to be what? a. Idiopathic b. Idiogenetic c. Idiosyncratic d. Idiologic

c. Idiosyncratic reaction to a drug result to an individual's hypersensitivity. Unexpected response. Ex. pt takes anti anxiety to reduce symptoms, however becomes more agitated.

32. The nurse who was going off shift had prepared the medications for the nurse who was going to relieve her to save the oncoming nurse time. What would be the correct action of the oncoming nurse? a. Give the medications when ordered. b. Recheck the medications. c. Never give medications another person has prepared. d. Identify each medication as it is given.

c. Never give medications another person has prepared. The nurse should never give a medication that has been prepared by another person

27. When giving a subcutaneous injection to a very thin patient, how does the nurse alter the injection technique? a. Using a 23-gauge needle b. Spreading the skin before injection c. Pinching up the skin and inserting the needle at a 45-degree angle d. Injecting the medicine quickly to reduce pain

c. Pinching up the skin and inserting the needle at a 45-degree angle The subcutaneous technique changes when injecting a thin patient. The selection of needles is the same ( 1/2 in needle of 27 or 28 gauge), the site selection is the same technique changes to pinch up the skin and inject at a 45-degree angle. *1/2-5/8 in: 25 - 27 G: 45 - 90 (obese) degree angle no more than 1 mL into these sites: drug absorption slower

28. The nurse cautions a patient taking an anticoagulant that he should avoid taking aspirin because one drug may increase the action of the other drug. What is the correct term for this effect? a. Compatibility b. Antagonism c. Synergism/Potentiation d. Cooperation

c. Synergism/Pontentiation When one drug increases the action of another drug, it is called synergism. pg 433 compatibility: ability to administer medications together easily without any difficulty for the patient. Antagonism: drug that blocks the action of another drug. Agonist: drug that produces a predictable response at the intended site of action

37. A 5 month old is to be immunized for DTP. What type of injection will be given and which site? a. Sub Q - Deltoid b. Sub Q - Abdominal c. IM - Gluteus Maximus d. IM - Vastus Lateralis

d. IM - Vastus Lateralis preferred on children younger than 12 months for immunizations(younger than 3) free of nerves and blood vessels. most fully developed muscle in newborns. greater trochanter and knee lateral (outer side) thigh

1. To help relax the anal sphincter during the insertion of a suppository, the nurse should ask the patient to ____________.

exhale exhaling will help relax the anal sphincter

2. When giving a tubal medication, the nurse should flush the tubing with 30 to 50 _______ of water.

mL the water will enhance the absorption of the drug and also clear the tubing

4. The order is for 100 mL to run over 8 hours as a "piggyback." The drop factor of the secondary unit is 15. The nurse should set the drop control to deliver 3 gtts/_____.

min 100 mL divided by 8 = 12.5 mL/h 125 x 15/60=187.5/60=3.1