final exam clinical calc

Order: Heparin sodium 10,000 units subcutaneously stat.The label on the vial reads "40,000 units/mL." How many milliliters will you administer per dose?

0.25 mL 40,000 units per 1 mL.

There are 70 milligrams of iodine in how many milliliters of a 1:4 iodine solution?

0.28 mL

Order: Heparin sodium 5000 units subcutaneously q.8h.The label on the vial reads "10,000 units/mL." How many milliliters will you administer per dose?

0.5 mL 10,000 units per 1 mL.

Convert 25 mL to an equivalent amount in ounces.

0.83 oz

Order: Ketoroloac tromethamine (Toradol) 20 mg IV q.12h.The label on the vial reads 15 mg/mL. How many mL will you administer per dose?

1.3 mL 15 mg = 1 mL

The order reads 7,500 units of heparin subcutaneous b.i.d. How many ml of heparin will you administer per dose?

1.5 mL 5,000 units/ml = 7,500 units/1.5 ml.

Mrs. Rooney is to receive 300 mg q 8h. Using the formula method, determine how many tablets will she receive in one day? Show your work.

1.5 tabs

Order: Heparin sodium 25,000 units in 250 mL DW IVPB, infuse at 1500 units /h.Calculate the flow rate in milliliters per hour.

15 mL/h 1500 units/h × 250 mL/25,000 units = 15 mL/h.

An IV is infusing at 25 gtt/min. If the drop factor is 10 gtt/mL, what would this rate of flow equal in mL/h?

150 mL/h 25 gtt/min × mL/10 gtt × 60 min/h = 150 mL/h.

Calculate the daily rate of maintenance fluids and the IV hourly flow rate for a child who weighs 95 pounds.

1960 mL per day; 80 mL/h 43 kg, 1000 + 500 + 460 = 1960 mL.

Mrs. Cook is to receive 10 mg of oxymorphone HCL t.i.d. How many tablets will she receive per dose?

2 1 tablet = 5 mg

The physician writes an order for Atacand 16 mg. Each tablet contains 8 mg. How many tablets would you administer?

2 tablets

Order: Phenobarbital sodium 4 mg/kg PO, daily at bedtime.The label on the bottle reads, "30 mg/tab." Calculate how many tablets you should administer for a child who weighs 33 pounds.

2 tablets 33 lb = 15 kg.

Order: Claforan (cefotaxime sodium) 750 mg IM q.8h.The directions on the package insert state: "For IM or IV administration reconstitution of the 1g vial with 3 mL yields 300 mg/mL." How many milliliters will you administer per dose?

2.5 mL 300 mg = 1 mL

How many milliliters of chlorine bleach are in 1 liter of a 1:5 bleach solution?

200 mL 1000 mL × 1 mL/5 mL = 200 mL.

Calculate the daily fluid intake for an adult that weighs 135 lbs. Use the following formula. First 10 kg x 100 ml Second 10 kg x 50 ml Remaining kg x 15 ml Type only the number of ml, do not include ml in answer This is total, not fluid only. When rounding, round to the nearest 10th.

2121

Solve for x. 16 /40 = x/50 x = _____

22

Perform the indicated operation with decimals. 66.66 × 3.33 = _____

221.9778

Calculate the daily fluid intake for an adult that weighs 195 lbs. Use the following formula. First 10 kg x 100 ml Second 10 kg x 50 ml Remaining kg x 15 ml Type only the number of ml, do not include ml in answer This is total, not fluid only. When rounding, round to the nearest 10th.

2529

How many 2-gram tablets are needed to prepare 100 mL of a 6% solution?

3 tablets

The physician writes an order for levothyroxine sodium (Synthroid) 75 micrograms. Each table contains 0.025 mg. How many tablets would you administer?

3 tablets

Order: Prednisone 0.15 mg/kg PO daily.The label on the bottle reads 2.5 mg/tab, and the child weighs 110 pounds. Calculate the number of tablets that you should administer.

3 tablets 110 ÷ 2.2 = 50 kg, 7.5 mg.

A patient is to receive a drug at the rate of 10 mg/kg p.o. daily. The patient weighs 93 kg. The strength of the drug is 250 mg/mL. How many milliliters should the patient receive?

3.7 mL The correct dosage for a 93 kg. client = 93 × 10 = 930 mg. 250 mg/1 mL = 930mg/x; cross multiply yielding 250x = 930; x = 930 ÷ 250 = 3.72 mL

A client has a 2,500 mL bag of irrigation solution hanging. 750 mL of the solution have infused. What percent of the irrigation solution has infused?

30%

An IV is infusing at 125 mL/h. If the drop factor is 15 gtt/mL, what would this rate of flow equal in gtt/min?

31 gtt/min 125mL/hour × 15 gtt/mL × 1 h/60 min = 31.25 gtt/min.

How many grams of dextrose are needed to prepare 250 mL of a 12.5% solution?

31.25 g 250 mL × 12.5 g/100 mL = 31.25 g.

Solve for x in the following. 11:121 = 3:x x = _____

33

Convert 4500 mL to an equivalent amount in liters.

4.5 L

Order: 1000 ml 0.45% NS with heparin 25,000 units to infuse at 1000 units/hr Calculate the flow rate ________________________ ml/hr

40 ml/hr

What is the strength (expressed as a percent) of a 200 milliliter solution that contains 10 grams of dextrose?

5% 10/200 = 5%.

Order: Heparin 25,000 units in 1000 mL 0.09% NS, infuse at 100 mL/h.Calculate the units per day if the dose is within the normal daily range (20,000—40,000 units in 24 h).

60,000 units, which is not within the normal daily range

The physician orders methadone 7.5 mg p.o. q.4h. The methadone label reads 5 mg/5mL. How many milliliters would you administer?

7.5 mL 5 mg per 5 mL.

Using the information from Question 12, select your actions as the RN when your LNA informs you of your patient's finger stick blood sugar result that is 464. Select all that apply. A. Repeat finger stick in 2 hours. B. Administer 8 units of Humulin R U-100 IM C. Administer 8 units of Humulin R U-100 subcut D. Recheck the finger stick immediately. E. Confirm the finger stick with a peripheral lab draw per hospital policy. F. Call the provider immediately.

A, C, E

The health care provider writes medication orders at 8 AM on March 10, 2014, for a client and signs the orders. Which order(s) should the nurse question? a. Lasix 20 mg p.o. daily b. Digoxin 0.125 mg p.o. everyday c. Ampicillin 250 mg q6h d. Multivitamin daily e. Colace 200 mg p.o. t.i.d f. Tylenol 650 mg p.r.n. for pain

C, D, F

What would be the appropriate interpretation for the following order? Demerol 50 mg IM stat? Administer:_______________

Demerol 50 mg IM immediately

A nurse is administering a medication at the bedside. Which of the following actions should be the first priority?

Establish the identity of the client

The safe-dosage range for acetaminophen (Tylenol) is 650-3250 mg per day. The client is taking 650 mg as needed for pain every four hours. What is the maximum number of dosages per day the client can take safely?

Five doses Maximum daily dose = 3250. Each dose is 650. 3250 ÷ 650 = 5.

Order: Pen-Vee K (penicillin V potassium) 7.5 mg/kg PO, daily q.4h.The medication is supplied in 125 mg/tab, 250 mg/tab, and 500 mg/tab. Using the minimum number of tablets, how many tablets, and of which strength, will you administer to a child who weighs 110 pounds?

One 250mg tablet and one 125mg tablet 375 mg per dose

The "six rights" of medication administration are:

medication, dosage, route, time, client, documentation.

Order: Amoxil 125 mg PO, q.8h.The recommended dose for children who weigh less than 40 kg is 25 mg/kg/day divided q.12h., or 20 mg/kg/day divided q.8h. Is this a safe dose for a child who weighs 16 pounds? ________

no

Perform the indicated operation and record the result in lowercase Roman numerals. 7 × 2 = _____

xiv

A patient is to receive 250 mL D5W at 24 mL/h. Calculate the flow rate in gtt/min. The drop factor is 15 gtt/mL.

6 gtt/min 24 mL/h × 15 gtt/mL × 1 h/60 min = 6 gtt/min. Note: a rate this slow in most facilities would require use of an IV pump.

The order for a patient with an exacerbation of rheumatoid arthritis is dexamethasone sodium phosphate 4 mg q5days. Using the drug label below, determine how many ml you will administer per dose.

1 mL D/H x Q = X 4/20 x 5 = 1

A patient is 5 feet 8 inches tall and weighs 178 lbs. What is the patient's height in centimeters and weight in kilograms?

170 cm, 81 kg

Mrs. Bailey is ordered 15 mg of zoledronic acid solution. Using the label below, determine how many milliliters of the drug contains 15 mg.

18.75 ml 15 mg × 1 ml/0.8 mg

Perform the indicated operation with fractions. Reduce to lowest terms as indicated. 16 5/6 - 14 3/8 = ____

2 11/24

Using the formula method, determine how many Detrol LA capsules the patient will receive each day for a 4-mg dose.

2 caps

The order reads: hydrocortisone sodium succinate 275 mg IV q6h. Using the Act-o-vial seen in the image, how many ml will you administer?

2.2 500 mg/4ml, 275 mg/2.2 ml

An IV of 1000 mL NS is to infuse over eight hours. The drop factor is 10 gtt/mL. Calculate the flow rate in gtt/min.

21 gtt/min 1000 mL/8 h × 10 gtt/mL × 1 h/60 min = 20.8 gtt/min.

An IV is infusing at 75 mL/h. If the drop factor is 20 gtt/mL, what would this rate of flow equal in gtt/min?

25 gtt/min 75mL/hour × 20 gtt/mL × 1 h/60 min = 25 gtt/min.

Using the image below, determine the infusion rate in milliliters per hour if the order reads: Heparin sodium @ 1000 units/hr.

25 ml/hr. Supplied 40 units/ml, order 1000 units/hr. = 25 ml/hr.

The physician orders potassium gluconate (Kaylixir) 45 mEq. The solution contains 20 mEq per 15 mL. How many mL would you administer?

33.75 mL

The doctor orders Ampicillin 500 mg q6h to be administered in a volume control chamber in a total solution of 40 mL. The ampicillin vial has a strength of 100 mg/mL. After adding the ampicillin to the VCC, how many mL of fluid will you then also add to the VCC?

35 mL You add 5 mL from the vial, and need another 35 mL to have a total of 40 mL.

Order: Heparin 40,000 units in 1000 mL 0.9% NS, infuse at 40 mL/h.Calculate the units per day and determine if the dose is within the normal daily range (20,000-40,000 units in 24 h).

38,400 units/d, which is within the normal daily range

Your patient has a sliding scale for insulin dosage. The order is for Humulin Regular insulin U-100 q6h as follows: Finger stick blood sugar: 0-180 mg/dL no coverage 181-240 mg/dL 2 units subcut 241-300 mg/dL 4 units subcut 301-400 mg/dL 6 units subcut Greater than 400 mg/dL 8 units subcut and repeat finger stick in 2 hrs. At 0730, the patients finger stick is 256 mg/dL. How much insulin will you administer to your patient?

4 units subcut

Order: Amoxicillin oral suspension 20 mg/kg/day PO in three divided doses.The label on the bottle reads 125 mg/5 mL, and the child weighs 35 pounds. Calculate the number of milliliters that you should administer.

4.2 mL 35 lb/1 × kg/2.2 lb × 20 mg/kg × 5 mL/125 mg = 12.8 mL.

Order: Heparin 20,000 units in 1000 mL 0.9% NaCl stat., infuse at 25 mL/h.Calculate the units per hour and determine if the dose is within the normal daily range (20,000-40,000 units in 24 h).

500 units/h, and the dose is lower than the normal daily range 25 mL/h × 20,000 units/1000 mL = 500 units/h.

For the following scenario, identify which of the "six rights" of medication administration has been violated. A nurse has an order for heparin 5,000 units subcut for a client in room 407 whose name is Henry Jones (initials HJ). The nurse enters room 408 and administers the medication to Horace Jackson (initials HJ): _______________.

client

Mrs. Haley is ordered 2 teaspoons of memantine HCL. How many mg of memantine will be administered?

10 mg

The physician orders erythromycin ethylsuccinate 280 mg. The suspension contains 400 mg per 5mL. How many mL would you administer?

3.5 mL 400 mg per 5 mL

Convert 8 pounds, 8 ounces to an equivalent amount in kilograms.

3.86 kilograms

Order: 1000 ml 0.45% NS with heparin 25,000 units to infuse at 1000 units/hr Calculate the volume per minute ________________________ ml/min

0.67 ml/min

Order: Heparin sodium 8000 units subcutaneously q.12h.The label on the vial reads "10,000 units/mL." How many milliliters will you administer per dose?

0.8 mL

Mr. Bixon is ordered 250 mg of Depakane (valproic acid). Using the label below. Determine how many capsules the patient will receive.

1 capsule

Using the formula method. Determine how many milliliters the patient will require for a 200-mg dose. Show your work.

10 mL

Convert 2 teaspoons to an equivalent amount in milliliters.

10 ml

How many milliliters of a 20% magnesium sulfate solution will contain 20 g of magnesium sulfate?

100 ml 20 g × 100 ml/20 g = 100 ml.

How many milliliters of a 12.5% glucose solution contain 125 grams of dextrose?

1000 mL 125 g × 100 mL/12.5 g = 1000 mL.

Order: For every 100 mL of urine output, replace with 30 mL of water via PEG tube q.4h.The client's urine output is 350 mL. What is the replacement volume?

105 mL 350 mL (out) × 30 mL (in)/100 mL (out) = 105 mL.

Convert 5.3 kilograms to an equivalent amount in pounds.

11.66 pounds 2.2 lbs= 1 kg

Order: 1000 ml 0.45% NS with heparin 25,000 units to infuse at 1000 units/hr What is the concentration of solution? ____________________ units/ml

25 units/ml

Change the following percentage to a fraction. Reduce to lowest terms. 37.5% = _____

3/8

A client has a gastrostomy tube (GT) in place. The health care provider ordered the medication p.o. What action would be appropriate for the nurse to take?

Clarify the order with the health care provider who wrote the order.

For the following medication order indicate what component of the order is missing. Demerol 75 mg IM prn.

frequency

Mr. Wags is prescribed 750,000 units of penicillin G. Because he has renal failure, the amount of fluid that he will receive is limited, and as such, the highest concentration of the medication is required. Using the drug label below, determine which diluent volume you will add to the vial.

11.5 mL

Using the formula method determine how many milliliters of this antibiotic a patient who weighs 85 lbs. would receive per dose if the order reads 2 mg/lb. daily po for 10 days.

17 ml

The physician writes an order for a loading dose of theophylline (Lanophyllin) 5 mg/kg. The client weighs 65 kg. The medication is supplied 150 mg/15 mL. How many mL would you administer?

32.5 mL The correct dosage for a 65 kg client = 5 × 65 = 325 mg.

9 teaspoons is equal to:

45 ml 1 tsp= 5 ml

The prescriber ordered Mr. Mederes amlodipine besylate 5 mg p.o. daily. How many grams of Norvasc will Mr. Mederes receive in one week?

0.35 g 5 mg × 7 days = 35 mg = 0.35 g.

The physician orders palifermin (Kepivance) 60 mcg/kg to be administered daily. The client weighs 35 kg. The medication is supplied 5 mg/mL. How many mL would you administer?

0.42 mL The correct dose for a 35 kg. client = 35 × 60 = 2100 mcg; 2100 mcg = 2.1 mg.

The physician orders digoxin (Lanoxin) 125 micrograms. The elixir contains 0.25 mg per mL. How many mL would you administer?

0.5 mL Convert 0.25 mg to 250 micrograms. 250 mcg per 1mL.

Mrs. Field has contracted a fungal infection after being on a mission trip in a third world country. Using the drug label shown below, determine how many ml of caspofungin you will administer per dose if the order reads: Cancidas 70 mg IV x 1 on day one and 50 mg daily x 6 days.

Initial dose: 14 ml, subsequent doses: 10 ml

Perform the indicated operation and record the result in lowercase Roman numerals. 6 × 3 = _____

xviii

Order: 600 mL D5W IV to infuse in six hours. At what rate in mL/h will you set the pump?

100 mL/h 600 ÷ 6 = 100 mL/h.

Convert 300 mL to an equivalent amount in liters.

0.3 L

Change the following decimal to a fraction. Reduce to lowest terms if indicated. 0.0001 = _____

1/10,000

Using the formula method and the drug label below. Determine how many ml you will administer per doses if the order reads: 750 mg clindamycin IV q12h. Show your work.

750/900= 0.83 x 6 = 5 mL

"Administer Colace 100 mg by mouth three times a day." Which of the following correctly indicates the order?

Colace 100 mg p.o t.i.d

Order: 1000 mL NS to infuse in eight hours. At what rate in mL/h will you set the pump?

125 mL/h 1000 mL/8 h = 125 mL/h

Convert 2 1/2 pints to an equivalent amount in milliliters.

1250 milliliters 1 pint= 500 milliliters

Calculate the daily rate of maintenance fluids and the hourly flow rate for a child who weighs 13 kilograms.

1150 mL per day; 47.9 mL/h (10 × 100) + (3 × 50) = 1150 mL.

A physician's order sheet contains the following entry:Lanoxin (digoxin) 125 mcg p.o. daily.How much of the drug will be administered per dose? ________ micrograms

125

Convert 10 inches into an equivalent amount in centimeters.

25 centimeters 1 inch= 2.5 cm

Using the formula method and the label below, determine how many ml of furosemide the patient will receive per dose when the order reads: Lasix 80 mg IV q8h.

8/20 = 4 x 2 = 8 mL

How many milliliters of a 10% sodium chloride solution contain 8 grams of sodium chloride?

80 mL 8 g × 100 mL/0.5 g = 80 mL.

Order: Amiodarone HCl 100 mg/m2 PO, daily.Calculate how many milligrams a child whose BSA is 0.8m2 should receive.

80 mg 0.8 m2 × 100 mg/ m2 = 80 mg.

Order: 2000 mL D5W IV infused in six hours. The drop factor is 15 gtt/mL. Calculate the flow rate in gtt/min.

83 gtt/min 2000 mL/6 h × 15 gtt/mL × 1 h/ 60 min = 83.3 gtt/min.

An IV is infusing at 30 gtt/min. If the drop factor is 20 gtt/mL, what would this rate of flow equal in mL/h?

90 mL/h 30 gtt/min × mL/20 gtt × 60 min/h = 90 mL/h.

Change the following mixed number to an improper fraction. 12 1/8 = _____

97/8

An IV is infusing at 47 mcgtt/min. What would this rate of flow equal in mL/h?

47 ml/h mcgtt/min = mL/h

Order: GlucaGen (glucagon) 1.25 mg stat.The directions on the package state: "For IV administration reconstitution of the 1 mg powder with 1.8 mL yields 1 mg/2 mL." How many mL will you administer per dose?

2.5 ml 1 mg = 2 mL

Ms. Armstrong is a patient who had an open cholecystectomy two days ago. She is now eating a full meal tray and has had her insulin reordered. She is ordered aspart insulin 6 units ac meals and 18 units of Humulin N ac breakfast and Humulin N 23 units qhs. How many total units of insulin will Ms. Armstrong be given before breakfast?

24 units

The physician orders phenytoin (Dilantin) 85 mg. The suspension contains 125 mg in 5 mL. How many mL would you administer?

3.4 mL 125 mg = 5 mL