HESI Practice 1

The healthcare provider prescribes phytonadione (AquaMEPHYTON) 250 mcg IM to be administered to an infant within 1 hour of admission to the nursery. A 0.5 ml ampule labeled 2 mg in 1 ml is available. The nurse should administer how many ml? (Enter numeric value only. If rounding is required, round to the nearest hundredth.)

0.13 Change mcg to mg, 1000 mcg = 1 mgUse ratio and proportion to calculate the dose: 2 mg : 1 ml :: 0.25 mg : X ml2X = 0.25 mgX = 0.125 =0.13 ml

The healthcare provider prescribes thiamine HCL 0.03 grams IM TID for a client with beriberi. Thiamine is available for injection 100 mg/ml. The nurse should prepare to administer how many ml? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

0.3 Using the known conversion: 1 gram = 1000 mg as 0.03 gram = 30 mg Next, using the Desired / Have x 1 ml formula:30 mg / 100 mg x 1 ml = 0.3 ml

A client with hypernatremia is to receive an IV infusion of 1000 ml 5% dextrose in water to be infused over 6 hours. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

167 Calculate using the ratio: 1000 ml : 6 hours :: X ml : 1 hour 1000/X :: 6/1 6X = 1000 X = 167 ml/hour

A client with a Trichomonas vaginalis infection receives a prescription for metronidazole (Flagyl) 1 gram. The medication is available in 500 mg tablets. How many tablets should the nurse administer? (Enter numeric value only.)

2 1 gram = 1000 mg 1 tablet :: 500 mg = X tablets :: 1000 mg X = 1000/500 = 2 tablets

Mineral oil U.S.P 30 ml PO daily for 3 days is prescribed for a client who is experiencing severe constipation. The dose cup is marked in tablespoons. How many tablespoons should the nurse administer? (Enter numeric value only.)

2 15 ml equals 1 Tablespoon. Use the ratio equation: 15 ml : 1 Tbs :: 30 ml : X 15 / 30 :: 1 / X 15X = 30 X = 2 Tablespoons

A male client receives a prescription for ondansetron hydrochloride (Zofran) 4 mg IV to prevent postoperative nausea after an inguinal hernia repair. The medication is available in 2 mg/ml. How many ml should the nurse administer? (Enter numeric value only, whole number).

2 Rationale Use ratio and proportion, 4 mg : X ml = 2 mg : 1 ml 2X = 4 X = 2

A child who weighs 55 pounds receives a prescription for atovaquone with proguanil (Malarone Pediatric) 125 mg/50 mg PO daily. A drug reference states that children 11 to 20 kg should receive 1 pediatric tablet daily; 21 to 30 kg should receive 2 pediatric tablets daily; 31 to 40 kg should receive 3 pediatric tablets daily; and greater than 40 kg should receive 1 adult tablet daily with food. The drug is available as atovaquone 62.5 mg/proguanil 25 mg pediatric tablets. How many tablets should the nurse administer?

2 Rationale Calculate each drug component dose, using the formula, D/H125 mg / 62.5 mg (atovaquone) = 2combined with 50 mg / 25 mg (proguanil) = 2The child should receive 2 tablets of the combination drug, Malarone Pediatric.

A client with Mycobacterium avium complex (MAC) is receiving an infusion of 5 % dextrose in water (D5W)with amikacin (Amikin) 0.572 grams/100 ml every 12 hours. The nurse prepares the dose of amikacin using a vial labeled, " 250 mg/ml." How many ml should the nurse add to the infusion? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

2.3 Rationale First convert gram to milligram:1 gm = 1000 mg so 0.572 gram x 1000 = 572 mgNext use the formula D/H x Q:572/250 x 1 = 2.288 (rounded to) 2.3 ml

The healthcare provider prescribes furosemide (Lasix) 25 mg IV. The drug is available in a solution of 40 mg/4ml. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

2.5 Using the formula D/H x Q: 25 mg/40 mg x 4 ml = 2.5 ml

A client who has preeclampsia receives a prescription for an IV infusion of 0.9% normal saline with magnesium sulfate 4 gram/250 ml to be infused at a rate of 125 ml/hour. The nurse should administer how many mg/hour of magnesium sulfate? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

2000 To calculate the amount of medication being delivered each hour: First convert grams to mg: 1 gram = 1000 mg :: 4 grams = 4000 mgNext calculate number of mg delivered/hour4000 mg : 250 ml :: X mg : 125 ml4000/X :: 250/12550000= 250XX = 2000 mg/hour

An IV seondary infusion of 0.9% normal saline 100 ml with inamrinone (Inocor) 0.1 grams/100 ml is prescribed for client with heart failure. The medication is to be delivered at a rate of 400 mcg/minute. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

24 Rationale First calculate the number of mcg/hour: 400 mcg x 60 minutes = 24000 mcg/hour Next calculate the number of ml/hour needed to administer 24,000 mcg/hour: 100,000 mcg: 100ml :: 24,000 mcg : X 100,000/24,000 :: 100/X 100,000X = 2,400,000 X = 24 ml/hour

A client who is experiencing cardiogenic shock receives a prescription for an IV solution of 0.9% normal saline 100 ml with milrinone (Primacor) 10 mg in at an infusion rate of 46 mcg/minute. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

28 Rationale First calculate the number of mcg/hour: 46 mcg x 60 minutes = 2760 mcg/hourNext calculate the number of ml/hour needed to administer 2760 mcg/hour:10,000 mcg : 100 ml :: 2760 mcg : X10,000 / 2760 :: 100 / X = 10,000X = 276000X = 27.6 (rounded to 28 ml/hour)

A client receives a prescription for tobramycin sulfate (Nebcin)0.128 grams IV every 8 hours. Tobramycin is available in liquid concentration of 40 mg/ml. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

3.2 First using the known conversion: 1 gram = 1000 mg = 0.128 gram = 128 mgNext use the Desired/Have x 1 ml = 128 mg/40 mg x 1ml = 3.2 ml

A client is receiving an IV solution of 2 grams of medication diluted in 100 ml of normal saline over a one hour time period. How many mg of medication is the client receiving per minute? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

33 2 grams = 2000 mg1 hour = 60 minutes2000 mg/60 minutes = 33.333 mg/minute, rounded to 33 mg/minute

The healthcare provider prescribes an infusion of Dextrose 5% in Water (D5W) with sodium nitoprusside (Nitropress) 100 mg/250 ml at a rate of 4 mcg/kg/minute for a client in hypertensive crisis. The client's current weight is 130 pounds. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

35 First convert the weight into kilograms: 130 pounds/2.2 kg = 59 kgNext calculate the number of mcg/kg/minute: 4 x 59 = 236 mcg/minuteCalculate the number of mcg/hour: 236 x 60 minutes = 14,160 mcg/hourNow calculate the number of ml/hour needed to administer 14,160 mcg/hour: 100,000 mcg : 250 ml :: 14,160 mcg : X100,000/14,160 :: 250/X100,000X = 3,540,000X = 35.4 (rounded to) 35 ml/hour

The nurse needs to calculate a client's oral temperature of 99.2??? Fahrenheit to Celsius. What temperature in Celsius should the nurse document? (Enter numeric value only. Round to the nearest tenth.)

37.3 Use the formula to convert Fahrenheit to Celsius, Fahrenheit temperature (99.2) minus 32 divided by 1.8 = 37.3 degrees Celsius.

A child with a urinary tract infection is receiving cephalexin (Keflex) 100 mg suspension PO QID. Keflex oral suspension is labeled "125 mg in 5 ml." How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

4 Rationale Using the formula Desired/Have available x Quantity:100/125 x 5 = 500/125 = 4 ml

A client who weighs 65 kg is receiving an infusion of Dextrose 5% in Water (D5W) 250 ml with dopamine 400 mg at 12 ml/hour. How many mcg/kg/minute is the client receiving? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

4.9 Using the formula, mg/ml x 1000 ml x ml/hour / 60 / kg = mcg/kg/minute400/250 x 1000 x 12 / 60 / 65 = 4.9 mcg/kg/minuteThe solution on hand is 1.6 mg/ml x 12 hours = 19.2 mg19.2 mg x 1000 mcg = 19,200 mcg / 65 kg = 295.38 / 60 minutes = 4.92 = 4.9

A child weighing 28.4 kg is in hypertensive crisis. The healthcare provider prescibes methyldopa (Aldomet) 40 mg/kg/day IV in 4 divided doses. The pharmacy provides a 50 mg/ml injection vial. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

5.7 First calculate the total mg dose/day: 40 mg x 28.4 kg = 1136 mg/day Next divide the total mg into the 4 dosages for the day: 1136 mg/4 doses = 284 mg/dose Using the Desired/Have formula: 284 mg/50mg x 1 ml = 5.68 ml/ dose, rounded to 5.7 ml.

A client with impetigo receives a prescription for azithromycin (Zithromax) 500 mg PO on day 1, then 250 mg/day on days 2 through 5 for a total administration of 1.5 gram. The pharmacy has 250 mg tablets available. How many tablets total should the nurse give to the client for the duration of treatment? (Enter numeric value only.)

6 Using Desired/Have available formula: 500 mg/250 mg x 1 times a day = 2 tablets on Day 1.Days 2 to 5: 1 tablet each day = 4 tablets. 2+4 = 6.

The healthcare provider prescribes a continuous feeding of half strength Osmolite240 ml to be infused every 4 hours for a client with a gastrostomy tube (GT). The nurse should program the enteral pump to deliver how many ml/hour? (Enter numeric value only).

60 The continuous feeding is regulated using the prescribed volume/time, ml/hour. 240 ml/4 hour = 60 ml/hour

A client is to receive an IV of Sodium Chloride 0.9% Injection (Normal Saline) 250 ml with KCl 10 mEq IV over 4 hours. What rate should the nurse program the client's IV infusion pump? 13 ml/hour. 63 ml/hour. 80 ml/hour. 125 ml/hour.

63 ml/hour Rationale To calculate the infusion rate, the dose of KCl is not used in the calculation. Using the total volume of Normal Saline solution, 250 ml/4 hours = 63 ml/hour.

A client is receiving acetaminophen (Tylenol) 0.65 gram PO every 6 hours PRN for pain. Acetaminophen is available in 325 mg tablets. How many milligrams should the nurse administer? (Enter numeric value only.)

650 Using the known equivalent, 1 gram = 1000 mg, the nurse should first convert the dose to the same unit of measurement, which is 0.65 grams = 650 mg.

A client with Parkinson's disease is receiving benztropine (Cogentin) 3.5 mg PO twice daily. The medication is available in 0.5 mg tablets. How many tablets should the nurse administer for each dose? (Enter numeric value only.)

7 Using D/H: 3.5 mg / 0.5 mg = 7 tablets

The healthcare provider prescribes a continuous infusion of dextrose 5% in water with isoproterenol (Isuprel) 2 mg in 500 ml at a rate of 5 mcg/minute for a client with cardiac arrhythmia. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest hundredth.)

75 First using the known conversion 1 mg = 1000 micrograms.Next, calculate the number of micrograms in solution: 1mg = 1000 mcg :: 2 mg = 2000 mcgThen calculate how many ml of solution contain 5 mcg dose/minute: 2000 mcg : 500ml :: 5 mcg : X ml2000/5 :: 500/XX = 1.25 ml/minuteCalculating ml/hour: 1.25 ml x 60 minutes = 75 ml/hour

A client with septic shock receives a prescription for dDextrose 5% in Water (D5W) 250 ml with dopamine (Intropin) 0.6 grams/250 ml at a rate of 5 mcg/kg/minute. The client's weight is 148 pounds The nurse should set the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

8 Rationale First convert the weight into kilograms: 148 pounds/2.2 kg = 67 kgNext calculate the number of mcg/kg/minute: 5 x 67 x 1 minute = 335 mcg/minuteCalculate the number of mcg/hour: 335 x 60 minutes = 20,100 mcg/hourNow calculate the number of ml/hour needed to administer 20,100 mcg/hour: 600,000 mcg : 250 ml :: 20,100 mcg : X ml600,000 / 20100 :: 250 / X = 600,000X = 5,02500X = 8.375 (rounded to) 8 ml/hour

A client returning from surgery has a prescription for an IV of 0.9% sodium chloride to be infused at 250 ml over 3 hours. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

83 250 ml : 3 hours :: X : 1 hour 250/X :: 3/1 250: 3X X = 83 ml/hour

A client receives a prescription for an intravenous infusion of Dextrose 5% in 0.45% Sodium chloride (D51/2 NS) 500 ml to be infused over 6 hours. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

83 Rationale Calculate using Volume/Time: 500 ml/6 hours = 83.3 ml/hour = 83 ml/hour

A client who has been NPO for 3 days is receiving an infusion of Dextrose 5% in 0.45% Sodium chloride (D51/2 NS) with potassium chloride (KCl) 20 mEq at 83 ml/hour. The client's 8-hour urine output is 400 ml, blood urea nitrogen (BUN) is 15 mg/dl (5.355 mmol/L), lungs are clear bilaterally, serum glucose is 110 mg/dl ( 6.1 mmol/L), and serum potassium is 3.7 mEq/L (3.7 mmol/L). Which action should the nurse implement? Notify healthcare provider and request to change the IV infusion to hypertonic D10W. Decrease in the infusion rate of the current IV and report to the healthcare provider. Document in the medical record that these normal findings are expected outcomes. Obtain potassium chloride 20 mEq in anticipation of a prescription to add to present IV.

Document in the medical record that these normal findings are expected outcomes. Rationale The results are all within normal range (BUN 10 to 20 mg/dl or 3.6-7.1 mmol/L (SI units), serum glucose 70 to 110 mg/dl or less than 6.1 mmol/L (SI), and serum potassium 3.5 to 5.0 mEq/L or 3.5-5.0 mmol/L (SI units). The other actions are not indicated.

A client is receiving Dextrose 5% in Water (D5W) 1,000 ml at 75 ml/hour. The nurse hangs the bag of IV fluids at 0300. At what time, based on the 24-hour clock, should the infusion be completed? a) 1620. b) 1630. c) 0420. d) 0430.

a) 1620 Calculate the number of hours an IV bag of 1,000 ml should infuse, 1,000 ml / 75 ml/hour = 13.3 hr = 13 hours 20 minutes.Calculate the time, 0300 AM + 1320 = 1620 by the 24-hour clock (or 4:20 PM).

Amoxicillin 500 mg PO every 8 hours is prescribed for a client with an infection. The drug is available in a suspension of 125 mg/5ml. How many ml should the nurse administer with each dose? a) 20 ml. b) 4 ml. c) 100 ml. d) 10 ml.

a) 20 mL 500 : X :: 125 : 5 125X = 2,500 X = 20 ml

A client with coronary artery disease receives a prescription for clopidogrel (Plavix) 300 mg PO. The medication is available in 75 mg tablets. How many tablets should the nurse administer? (Enter numeric value only.)

4 Using the formula, Desired/Have: 300 mg/75 mg = 4 tablets

A client scheduled for surgery is to receive an IV infusion of 0.9% sodium chloride with prochlorperazine edisylate (Compazine) 10 mg/50 ml over 30 minutes. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only, as a whole number.)

100 Rationale Calculate: 50 ml : 30 minutes :: X ml : 60 minutes50/X :: 30/603000 = 15XX = 100 ml

The nurse is preparing to administer Hepatitis B Vaccine, Recombinant (Energix-B) 5 mcg IM to a school-aged child. The vaccine is labeled, 10 mcg/ml. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth).

0.5 Rationale Use ratio and proportion, 5 mcg : X ml :: 10 mcg : 1ml10X = 5 X = 0.5 ml

A client receives a prescription for levothyroxine sodium (Synthroid) 0.05 mg by mouth once daily. The medication is available in scored tablets labeled 0.1 mg. How many tablets should the nurse administer? (If rounding is required, round to the nearest tenth.)

0.5 Using the formula, Desired / Available x 1 tablet = 0.05/0.1 x 1 = 0.5

Heparin protocol is prescribed for a client weighing 90 kg. Per protocol, the heparin loading dose is 60 units/kg IV rounded to the nearest 100 units, with a maximum loading dose of 4,000 units. The heparin vial is labeled 5,000 units/ml. How many ml should the nurse administer? (Enter the numeric value only. If rounding is required, round to the nearest tenth.) falseItem 51164 By Sheila DuncanHeparin Protocol: Heparin loading dose: 60 units/kg IV, rounded to the nearest 100 units, followed by a maintenance infusion of 12 units/kg/hr, rounded to the nearest 100 units/hr. The maximum bolus is 4,000 units and the maximum initial infusion is 1000 units/hr.

0.8 Determine the client loading dose: 60 units x 90 kg = 5,400 unit.Per protocol, use the maximum loading dose of 4,000 units, and calculate the client's dose using the formula D/H x Q = 4,000 units / 5,000 units x 1 ml = 4/5 = 0.8 mlor Use ratio and proportion: 5,000 : 1 ml :: 4,000 : XX = 0.8 ml

A 9-month-old infant receives a prescription for digoxin 40 mcg PO daily. Digoxin Oral Solution, USP 50 mcg (0.05 mg) per ml is available. How many ml should the nurse administer? (Enter the numerical value only. If rounding is required, round to the nearest tenth.)

0.8 Using ratio and proportion, 40 mcg : X ml :: 50 mcg : 1 ml = 0.8 ml

The nurse is preparing to administer bumetanide (Bumex) 0.25 mg IV. The medication is available in a vial labeled "1 mg/4 ml." How many ml of medication should the nurse administer? (Enter numeric value only.)

1 Rationale Using the Desired/Have x Volume formula: 0.25 mg Desired / 1 mg Have x 4 ml Volume =0.25 mg/1 mg x 4 ml = 1 ml

A client is receiving an IV solution of sodium chloride 0.9% (Normal Saline) 250 ml with amiodarone (Cordarone) 1 gram at 17 ml/hour. How many mg/minute of amiodarone is infusing? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

1.1 Rationale Convert grams to mg, 1 gram equals 1,000 mg. Using ratio and proportion - 1,000 mg : 250 ml :: X mg : 1ml250X= 1,000 so X = 4 mg/ml is the solution concentration of amiodarone.The infusion rate (ml/hour) x concentration (mg/ml) divided by 60 minutes/hour17 ml/hour x 4 mg/ml = 68/60 = 1.13 = 1.1 mg/minute.

A client who has AIDS is receiving octreotide (Sandostatin) 1,200 mcg by subcutaneous injection every day for symptoms of diarrhea. Octreotide is available for injection in 1 mg/ml vials. How many ml should the nurse administer? (Enter the numeric value only. If rounding is required, round to the nearest tenth.)

1.2 Rationale First, to convert micrograms to milligrams, divide the number of micrograms by 1000:1,200/1000 = 1.2 mg.Using the Desired/Have available formula:1.2 mg/1 mg x 1 ml = 1.2 ml

A client with multiple sclerosis and muscle spasms receives a prescription for baclofen (Kemstro) 30 mg PO daily. The medication is supplied from the pharmacy in 20 mg scored tablets. How many tablets should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

1.5 Use ratio and proportion, 30 mg : X tablets = 20 mg : 1 tablet 20X = 30 X = 1.5

The nurse plans to administer labetalol hydrochloride (Trandate) 0.3 grams PO to a client with hypertension. Trandate is available in 200 mg scored tablets. How many tablets should the nurse administer? (Enter numeric value only.)

1.5 First convert grams to milligrams using the known conversion: 1 gram = 1000 mg. 0.1 gram = 100 mg as 0.3 gram = 300 mg Next using the formula, Desired/Available x 1 tablet = 300 mg/200 mg x 1 = 1.5 tablets

The healthcare provider prescribes furosemide (Lasix) 15 mg IV STAT for a client. On hand is an ampoule labeled, furosemide (Lasix) 20 mg/2ml. How many milliliters should the nurse administer? 1 ml. 1.5 ml. 1.75 ml. 2 ml.

1.5 ml Rationale The correct calculation: Dosage on hand/amount on hand = Dosage desired/X amount. 20mg : 2ml = 15mg : X20X = 30X = 30/20 = 1 1/2 or 1.5 ml

A client who has heart failure with paroxysmal atrial tachycardia is receiving digoxin (Lanoxin) 0.45 mg IV as the inital digitalizing dose. The pharmacy provides 0.25 mg/ml. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

1.8 Using the formula D/H x Q = 0.45 mg/0.25 mg x 1 mL = 1.8 ml

A client who weighs 70 kg is receiving a solution of 0.9% Sodium Chloride (Normal Saline) 500 ml with dopamine 800 mg at 5 ml/hour. How many mcg/kg/minute is the client receiving? (Enter the numeric value only. If rounding is required, round to the nearest tenth.)

1.9 Rationale To change ml/hour to mcg/kg/minute, use the formula: desired rate (5 ml/hour) / volume available (500ml) x dose available (800mg) = 8 mg/hour.Next, convert milligrams/hour to mcg/kg/minute: mg (8) x 1000 / kg (70) / 60 minutes = 1.904 = 1.9 mcg/kg/minute.

The nurse notes that a client is receiving an oxytocin (Pitocin) infusion via a pump that is programmed to deliver 30 ml/hour. The available solution is Ringer's Lactated 1,000 ml with Pitocin 20 units. How many milliunits/minute is the client receiving? (Enter numeric value only, whole number.)

10 Rationale Convert units to milliunits, 20 units x 1,000 = 20,000 milliunits.Using D/H x Q = 30 ml/hour:X/20,000 milliunits x 1,000 ml = 30 ml/hour (60 minutes).X/20 = 30ml/60 minutes, reduce to: X/2 = 1/2, and 2X = 20, so X = 10 milliunits/minute

The nurse programs an IV infusion pump of Ringer's Lactated 1,000 ml with oxytocin (Pitocin) 40 units to be delivered at 15 ml/hour. How many milliunits/minute is the client receiving? (Enter numeric value only, whole number.)

10 Convert units to milliunits, 40 x 1,000 = 40,000 milliunits. Using D/H x Q = 15 ml/hour: X/40,000 milliunits x 1,000 ml = 15 ml/hour (60 minutes) X/40 =15/60 60X = 600 X = 10

An adult client with myasthenia gravis is receiving pyridostigmine (Mestinon) 126 mg PO every 4 hours. The drug is available as 60 mg in 5 ml syrup. How many ml should the nurse administer? (If rounding is required, round to the nearest tenth.)

10.5 Using the formula, Desired dose / dose on Hand x Quantity of volume on hand (D/H x Q) 126 mg / 60 mg x 5 ml = 10.5 ml

An IV infusion of 0.9% normal saline 500 ml with ammonium chloride 0.2 mEq/ml is prescribed for a client who was admitted for an amphetamine overdose. How many mEq of ammonium chloride should the nurse use to prepare the solution? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

100 0.2 mEq x 500 ml = 100 mEq

A client who weights 176 pounds is receiving an IV infusion with esmolol hydrochloride (Brevibloc) at 48 ml/hour. The IV solution is labeled with the concentration of Brevibloc 10 mg/ml. How many mcg/kg/minute is the client receiving? (Enter numeric value only. Round to nearest whole number.)

100 Rationale Convert pounds to kg by dividing 176 pounds by 2.2 pounds = 80 kg.Convert the IV concentration from mg to mcg. 1 mg : 1000 mcg :: 10 mg : 10,000 mcg.Infusion rate (48 ml/hour) x concentration (10,000 mcg/ml) divided by 60 minutes/hour x 80 kg =48 x 10,000 divided by 60 x 80 = 480,000 / 4800 = 100 mcg/kg/minute.

A client returns to the nursing unit from surgery with a prescription for Lactated Ringer's solution 1,000 ml to be infused over 10 hours. The IV administration set delivers 60 gtts/ml. The nurse should regulate the infusion to deliver how many gtts/minute? (If rounding is required, enter a whole number.)

100 Rationale First convert hours to minutes:10 hrs x 60 = 600 minutesUsing the formula Volume/Time x drop factor:1000 ml /600 minutes = 1.66666 x 60 = 100 gtts/minute

A client with a gastrostomy tube (GT) receives a prescription for a 250 ml bolus feeding of Glucerna60% enteral formula. The nurse should dilute the full-strength formula with how many ml of water? (Enter numeric value only).

100 Rationale Use the formula, Desired strength/strength on Hand x Volume = 60/100 x 250 = 15000/100 = 150 ml of Glucernaenteral formulaOr use ratio and proportion, Desired strength (60%) :: Volume (full strength) : Desire volume60 : 100 :: X : 250 ml100X = 15,000 and X = 150 ml of Glucerna enteral formula250 ml total volume - 150 ml of full-strength formula = 100 ml of water to create 60% concentration

The healthcare provider prescribes a secondary infusion of Dextrose 5% in Water (D5W) 50 mg IV with magnesium sulfate 4 gram/50 mI to be infused over 30 minutes for a client with preeclampsia. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

100 Rationale Using ratio and proportion to calculate the rate of infusion for ml/hour: 50 ml: 30 minutes :: X ml : 60 minutes50 ml / X ml :: 30 min / 60 minutes3000 = 30XX = 100 ml/hour

Heparin 20,000 units in 500 ml D5W at 50 ml/hour has been infusing for 5.5 hours. How many units of heparin has the client received? 11,000 units. 13,000 units. 15,000 units. 17,000 units.

11,000 units. Rationale The correct calculation: 20,000 units/500 ml = 40 units (the amount of units in one ml of fluid). 40 units/ml x 50 ml/hr = 2,000 units/hour (1,000 units in 1/2 hour). 5.5 x 2,000 = 11,000 units.OR, multiply 5 x 2,000 and add the 1/2 hour amount of 1,000 to reach the same conclusion = 11,000 units.

A client who had mitral valve replacement surgery receives a prescription for Dextrose 5% in Water (D5W) 250 ml with dobutamine 0.5 grams for IV infusion at a rate of 5 mcg/kg/minute. The client weighs 75 kg. The nurse should program the infusion pump to deliver how many ml/hr? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

11.3 Rationale First calculate the number of mcg/kg/minute: 5 x 75 = 375 mcg/minuteCalculate the number of mcg/hour: 375 x 60 minutes = 22,500 mcg/hourNext calculate the number of ml/hour needed to administer 22,500 mcg/hour: 500,000 mcg : 250 ml :: 22,500 mcg/ X ml500,000X = 5,625,000X = 11.25 (rounded to 11.3 ml/hour

A client with cardiogenic shock who weighs 220 pounds is receiving a solution of Dextrose 5% in Water (D5W) 250 ml with dopamine 400 mg at the rate of 3 mcg/kg/minute. The nurse should set the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

11.3 Rationale First, convert pounds to kg, 220 lb : X = 2.2 lb : 1 kg = 100 kgNext, calculate the dosage per minute, 3 mcg/kg/min x 100 kg = 300 mcg/minuteConvert mcg/min to mcg/hour, 300 mcg/min x 60 min=18,000 mcg/hour and Convert mcg/hour to mg/hour, 18,000 mcg/hr = 18.0 mg/hourCalculate the rate, 400 mg : 250 ml = 18 mg : X ml400X = 4500 X = 1.25 = 11.3 ml. So, 18 mg/11.3 ml should be infused at 11.3 ml/hour.

A child who is scheduled for a kidney transplant receives a prescription for basiliximab (Simulect) 20 mg IV 2 hours prior to surgery. The medication is available in a 20 mg vial that is reconstituted by adding 5 ml sterile water for injection, and administered as a secondary infusion of normal saline 50 ml to be infused over 30 minutes. The nurse should program the infusion pump to deliver how many ml/hour? (Enter the numeric value only as a whole number.)

110 Rationale After reconstituting the medication vial, the nurse adds the 5 ml of medication to the 50 ml of sterile water to result in a 55 ml volume to infuse in 30 minutes.Using the formula, Volume/Time = 55 ml / 0.5 hours = 110 ml/hour

Oxytocin (Pitocin) 4 milliunits/minute IV is prescribed for a client with an ineffective contraction pattern. To administer the prescribed dosage, the nurse adds 20 units of oxytocin to Ringer's Lactate 1,000 ml. The infusion pump should be set to deliver how many ml/hour. (Enter numeric value only.)

12 4 milliunits/min x 1 unit/1000 milliunits x 1000 ml/20 units x 60 min/hr = 240,000/20,000 = 12 ml/hour

A client receives a prescription for inamrinone (Inocor) 0.75 mg/kg IV bolus to be delivered over 3 minutes. The client weighs 80 kg. Inamrinone is available for injection, 100 mg/20 ml. How many ml of inamrinone should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

12 Rationale First calculate the mg/kg dosage needed:0.75 mg x 80 kg = 60 mg neededThen calculate: Desired / Have x ml60 mg / 100 mg x 20 ml = 12 ml

A client experiencing ventricular tachycardia receives a prescription a continuous infusion of dextrose 5% in water (D5W)1000 ml with lidocaine (Xylocaine) 2 grams at a rate of 4 mg per minute. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

120 First convert solution gram/ml to milligrams/ml: 2 gm/1000 ml = 2000 mg/1000 ml = 2 mg/mlNext calculate the number of mg/hour for the dose: 4 mg X 60 minutes = 240 mg/hourNext calculate the number of ml/hour needed to administer 240 mg/hour: 2000 mg: 1000 ml :: 240 mg : X ml2000/240 = 1000/XX = 120 ml/hour

A loading dose of acetylcysteine (Mucomyst) 8 grams, which is available as a 20% solution (200 mg acetylcysteine per ml) is prescribed by nasogastric tube for a client with acetaminophen toxicity. How many ml of diluent should be added to the medication to obtain a 1:4 concentration? (Enter the numerical value only. If rounding is required, round to the whole number.)

120 Rationale 8 grams = 8,000 mg prescribed dose.Using the formula, D/H x Q, 8,000 mg / 200 mg x 1 ml = 40 ml of the 20% solution.Dilute the 40 ml to a 1:4 concentration for administration using ratio and proportion, 1 : 4 solution :: 40 ml : XX= 160 ml total volume to administer.Subtract total volume of 160 ml - 40 ml of 20% concentration = 120 ml diluent is added to obtain a 1:4 concentration.

Nitroprusside sodium (Nipride) 50 mg is mixed in D5W 250 ml. The nurse plans to administer the solution at a rate of 5 mcg/kg/minute to a client weighing 182 pounds. Using a drip factor of 60 gtt/ml, how many drops per minute should the nurse regulate the infusion? 31 gtt/min. 62 gtt/min. 93 gtt/min. 124 gtt/min.

124 gtt/min. Rationale Convert pounds to kg: 182/2.2 = 82.73 kg. Determine the dosage for this client: 5 mcg x 82.73 = 413.65 mcg/minute. Determine how many mcg are contained in 1 ml: 250/50,000 mcg = 200 mcg per ml. The client is to receive 413.65 mcg/minute. There are 200 mcg/ml, so the client is to receive 2.07 ml/minute. The nurse calculates the drip rate using the drip factor of 60 gtt/ml, then 60 x 2.07 = 124.28 gtt/minute OR, using dimensional analysis: gtt/min = 60 gtt/ml X 250 ml/50 mg X 1 mg/1,000 mcg X 5 mcg/kg/min X 1 kg/2.2 lbs X 182 pounds.

The nurse is administering an intravenous solution 250 ml to be infused over 2 hours. How many ml/hour should the nurse program the infusion pump? (Enter numeric value only, whole number.)

125 Rationale 250 ml : 2 hours = X ml : 1 hour2X = 250X = 125 ml/hour

The healthcare provider prescribes a continuous intravenous infusion of Dextrose 5% in 0.45% sodium chloride ((D51/2 NS) with KCl 20 mEq / 1000 ml to be infused over 8 hours. How many ml/hour should the nurse program the infusion pump? (Enter numeric value only. If rounding is required, round to the nearest whole number.) ________

125 Rationale Using the formula, volume/time: 1000 ml/8 hours = 125 ml/hour

A client with dehydration receives a prescription for an IV of Lactated Ringer's 1,000 ml to be administered over 8 hours. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only, using whole number.)

125 Use the ratio of: 1000 ml : 8 hours :: X : 1 hour1000/X :: 8/1X = 125 ml/hour

The healthcare provider prescribes a continuous infusion of 5% dextrose in 0.45% sodium chloride at 85 ml/hour. The IV administration set delivers 10 gtt/ml. The nurse should regulate the drop rate to deliver how many gtts/minute? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

14 Rationale Volume/Time (minutes) x drop factor (gtt/ml) =85 ml/ 60 minutes x 10 gtt/ml = 14.16 = 14 gtt/minute

The healthcare provider prescribes acetazolamide (Diamox) 600 mg/m2/day divided into 3 doses. The nurse calculates the child's body surface area (BSA) as 0.7 m2 . How many mg should the child receive per dose? (Enter the numeric value, whole number, only.)

140 Rationale Using the child's BSA, 0.7 m2, calculate the mg/dose, 600 mg x 0.7 m2 =420 mg/day/3 doses = 140 mg/dose

The nurse is preparing a tube feeding of Ensure 280 ml (50% solution). Full strength Ensure is available in a 240 ml can. The nurse should use how many ml of Ensure to prepare the feeding? (Enter numeric value for only. If rounding is required, round to nearest whole number.)

140 mL Using the formula D/H (Desired % / % on Hand) x Total volume desired: 50/100 x 280ml = 0.5 x 280 ml = 140 ml Ensure + 140 ml water = 280 ml (50% solution)

A client receives a prescription for a dose of medication 300 mg IV every 6 hours. The preparation arrives from the pharmacy diluted in a secondary infusion of 0.9% Sodium Chloride (NaCl) 50 ml. The nurse plans to administer the dose over 20 minutes. How many ml/hour should the nurse program the infusion pump to deliver the secondary infusion? (Enter the numeric value only, rounded to a whole number.)

150 Rationale The infusion rate is calculated as a ratio proportion problem.50 ml : 20 minutes :: X ml : 60 minutes20X = 30003000/20 = 150 ml/hour

The healthcare provider prescribes an intermittent infusion of nafcillin (Unipen) 800 mg IV for a pediatric client. The drug is dispensed in a concentration of 250 mg/ml, and the recommended infusion concentration is 40 mg/ml. When adding the prescribed dose to the volume control device, how many ml of IV solution should the nurse add to dilute? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

16.8 First, calculate the amount of milliliters of medication needed to provide 800 mg of nafcillin. Prescribed dose (800 mg) divided by dose on hand (250 mg/ml) equals 3.2 mlNext, determine the recommended concentration using equivalent fractions. 800 mg/X = 40 mg/1 ml40X = 800 = 20 ml (the total volume at the recommended concentration)20 ml (total volume) minus the 3.2 ml (800 mg dose) equals an additional 16.8 ml of fluid to be added to the volume control device to obtain the recommended concentration.

A client with a gastrostomy tube (GT) receives a prescription for Osmolite 1/2 strength enteral formula at 80 ml/hour. To prepare a 4 hour solution, the nurse should dilute the full-strength formula with how many ml of water? (Enter numeric value only.)

160 Determine the total volume needed at 80 ml/hour x 4 hours = 320 ml. Use the formula, Desired strength/strength on Hand x Volume = 50/100 x 320 = 160 ml of Osmolite enteral formula, which must be diluted to half strength. Or use ratio and proportion, Desired strength (1/2 = 1 part : 2 parts) :: Volume of full strength : Total Desire volume = 1 : 2 :: X : 320 ml 2X = 320, and X = 160 ml of Osmolite enteral formula, full strength 320 ml total volume - 160 ml of full-strength formula = 160 ml of water to create 1/2 strength or 50% concentration

The healthcare provider prescribes the adjustment of the IV hourly rate based on the nasogastric tube (NGT) output every 4 hour for a client who had abdominal surgery yesterday. From 1200 to 1600, the NGT output was 240 ml, and the IV ofDextrose 5% in 0.45% Sodium chloride (D51/2 NS) was infused at a rate of 100 ml/hour. At 1600 the nurse should regulate the IV to deliver how many ml/hour to replace this fluid loss? (Enter numeric value only, using a whole number.)

160 To calculate the hourly rate of IV fluid replacement based on the last 4 hours of NGT output, the nurse should calculate an average hourly output by dividing 240 ml by 4 hours = 60 ml NGT output every 1 hour.The nurse should then add the 60 ml loss per hour to the present infusion rate of 100 ml/hr, totaling an infusion rate of 160 ml/hour for the next 4 hours.

The healthcare provider prescribes an IV infusion of 0.9% sodium chloride 500 ml with potassium chloride (KCl) 40 mEq to infuse over 3 hours for a client with hypokalemia. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

167 Rationale To determine ml/hour: 500 ml : 3 hours :: X ml : 1 hour500/X :: 3/1500 = 3XX = 166.66 (rounded to)= 167 ml/hour

A client is receiving 5% Dextrose Injection 500 ml IV with Heparin Sodium 25,000 Units at 1,000 unit/hour per protocol for acute coronary syndrome (ACS). The client's partial thromboplastin time (PTT) is 76 seconds. Based on the ACS protocol, the infusion should be decreased by 100 units/hour for a PTT between 71 to 80 seconds. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only, whole number.)

18 Rationale Adjust the infusion to 900 units/hour (1,000 units/hour minus 100 units/hour per protocol). Using the formula, D/H x Q, 900 units/1 hour divided by 25,000 units x 500 ml = 90/5= 18 ml/hour

The healthcare provider prescribes acetaminophen elixir (Tylenol elixir) 600 mg PO every 6 hours for an adult client experiencing pain associated with maxillofacial surgery. The bottle is labeled 500 mg/15 ml. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

18 Rationale Using the formula D/H x Q:600 mg/500mg x 15 ml = 18 ml

An IV infusion of terbutaline sulfate 5 mg in 500 ml of D5W, infusing at a rate of 30 mcg/min, is prescribed for a client in premature labor. How many ml/hr should the nurse set the infusion pump? 30. 60. 120. 180.

180 Rationale 180 ml/hr = 500 ml/5 mg X 1mg/1000 mcg X 30 mcg/min X 60 min/hr.

A client who has a gastrostomy feeding tube is receiving 3/4 strength Ensure 240 ml every 6 hours. Full strength Ensure is available in a 240 ml can. The nurse should use how many ml of Ensure to prepare the feeding? (Enter numeric value only. If needed, round to the nearest whole number.)

180 Rationale 240 ml Ensure : 1 :: X ml Ensure : 0.75240/X : 1 / 0.75X = 240 x 0.75 = 180 ml Ensure + 60 ml water = 240 ml

A client admitted to the unit from the emergency room receives a prescription for an IV infusion of 0.9% sodium chloride 1,000 ml at 750 ml/4 hours. The IV administration set delivers 60 gtts/ml. The nurse should regulate the infusion to deliver how many gtts/minute? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

188 First convert hours to minutes: 4 hours x 60 = 240 minutesUsing formula Volume/Time x gtt factor: 750 ml/240 min = 3.125 x 60gtts = 187.5 (rounding to) 188 gtts/minute

An adult male who weighs 180-pound is admitted to the Emergency Center after receiving thermal burns to 60 percent of his body. Using the Parkland formula of 4 ml/kg/24 hours, the client should receive how many ml of fluid during the first 24 hours? (Enter the numeric value only. If rounding is required, round to the nearest whole number.)

19632 Rationale Using the Parkland formula, the client's fluid requirements for the first 24 hours after injury:4 ml lactated Ringer's solution x Body weight (in kilograms) x Percent burnConvert 180 pounds to kg = 180 / 2.2 = 81.8 kg4 ml x 81.8 kg x 60 = 19632 ml over the first 24 hours

A client who is complaining of nausea and vomiting postoperatively receives a prescription for metoclopramide (Reglan) 10 mg IV. The medication is available in vials containing 5 mg/ml. How many ml should the nurse administer? (Enter numeric value only.)

2 10 mg : X ml = 5 mg : 1 ml5X = 10X = 2 ml

A healthcare provider prescribes an IV infusion of 0.9% normal saline 1,000 ml with oxytocin (Pitocin) 30 units at a rate of 1 mu/minute for a client at 42-weeks gestation. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

2 First calculate the number of units/hour: 0.001 units/minute x 60 minutes = 0.06 units/hour Next calculate the number of ml/hour needed to administer 0.06 units/hour: 30 units: 1000ml :: 0.06 units : X = 30/0.06 :: 1000/X 30X = 60 X = 2 ml/hour

The nurse is preparing to administer vancomycin (Vancocin) 750 mg in 250 ml of Dextrose 5% in Water (D5W) over 75 minutes. The secondary infusion pump should be programmed to administer how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

200 250 ml of the antibiotic is to infuse over 75 minutes or 1.25 hours250 ml divided by 1.25 hour equals = 200 ml/hour

A client who had a small bowel resection two weeks ago is receiving 3/4 strength Ensure feedings 275 ml every 4 hours via nasogastric tube. Full strength Ensure is available in a 240 ml can. The nurse should use how many ml of Ensure to prepare the feeding? (Enter numeric value only. Round to nearest whole number if needed.)

206 Using the formula Desired % / on Hand % x Volume Desired = 75/100 x 275 = 0.75 x 275 = 206 Ensure 206 ml Ensure + 69 ml water = 275 ml (75% solution)

The nurse prepares 5% Dextrose Injection, USP, 1,000 ml IV to be infused over 8 hours. The infusion set delivers 10 drops per milliliter. The nurse should regulate the IV to administer how many drops per minute? (Round to nearest whole number.) 80. 8. 21. 25.

21 Rationale The accepted formula for figuring drops per minute is: amount to be infused in one hour x drop factor/time for infusion (min ) = drops per minute. Using this formula: 1,000/8 hours = 125 ml/ hour 125 x 10 (drip factor) = 1,250 drops in one hour. 1,250/ 60 (number of minutes in one hour) = 20.8 = 21 gtt/minute.

The healthcare provider prescribes propofol (Diprivan) at 8 mcg/kg/minute for a client during conscious sedation. The drug is dispensed as a econdary infusion labled, 0.9% normal saline 50 ml with propofol 100 mg/50 ml The client's weight is 198 pounds. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

21.6 The client's weight in kg is 90 kg (198 pounds / 2.2 pounds).Next, determine the total mcg in the NS infusion (1 mg : 1000 mcg :: 100 mg : 100,000 mcg)and the IV concentration per ml (100,000 mcg : 50 ml :: X mcg : 1 ml). 100,000 / 50 = 2000 mcg/ml.Then, calculate the prescribed dose (mcg/kg/min) x 60 min/hour x kilograms divided by concentration (mcg/ml).8 x 90 x 60 divided by 2000 = 21.6 ml/hour

A client weighing 86 kg is receiving dopamine at 8 mcg/kg/minute. The drug is dispensed as dopamine 800 mg/500 ml. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

25.8 First, change the concentration of dispensed dopamine to mcg/ml. 1 mg : 1000 mcg :: 800 mg : X mcg = 800,000 mcg/500 ml = 1600 mcg/ ml.Using the formula, prescribed dose (8 mcg/kg/minute) x 60 minute/hour x weight (86 kg) divided by the concentration of the available drug (1600 mcg/ml) = 8 x 60 x 86 divided by 1600 = 25.8 ml/hour

The healthcare provider prescribes oxytocin (Pitocin) 0.5 milliunits/minute for a client in labor. One liter Ringer's Lactate with 10 units of oxytocin (Pitocin) is infusing. The nurse should program the infusion pump at how many ml/hour? (Enter numeric value only.)

3 Rationale Convert units to milliunits = 10 units x 1,000 = 10,000 milliunits per literUsing the formula, D/H x Q = 0.5 milliunits / 10,000 milliunits x 1000 ml = 0.05 ml/minute Multiply by 60 minutes = 3 ml/hour

A client with hypertension receives a prescription for carteolol (Cartel) 7.5mg PO daily. The drug is available in 2.5 mg tablets. How many tablets should the nurse administer? (Enter numeric value only, whole number.)

3 Rationale Using D/H: 7.5mg / 2.5mg = 3 tablets

The healthcare provider prescribes trimethoprim-sulfamethoxazole (Bactrim-DS Oral Suspension) 120 mg BID for a child with bronchitis. The Bactrim bottle is labeled "200 mg/5ml." How many ml should the nurse administer at each dose? (Enter the numeric value, whole number, only. )

3 Rationale Using the formula D/H x Q, 120/200 x 5 = 3 ml

A client with hypertension who weighs 72.4 kg is receiving an IV infusion of Dextrose 5% in Water (D5W) 250 ml with nitroprusside (Nipride) 50 mg at 75 ml/hour. How many mcg/kg/minute is the client receiving? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

3.5 Rationale Calculate the mg/hour infusing, 50 mg : 250 ml = X : 75 ml250X = 3750 and X = 15 mg/hourNext, convert mg/hr to mcg/hour, 15 mg/hour = 1 mg / 1000 mcg = 15,000 mcg/hour, then divide by 60 min = 250 mcg/minuteLastly, 250 mcg/72.4 kg/min = 3.45 = 3.5 mcg/kg/minute

A client scheduled for a stress echocardiogram is to receive an IV infusion of Dextrose 5% in Water (D5W) with dobutamine (Dobutrex) 0.5 grams/250 ml at a rate of 1,200 mcg/minute. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

36 First calculate the number of mcg/hour: 1,200 x 60 minutes = 72,000 mcg/hourNext calculate the number of ml/hour needed to administer 72,000 mcg/hour500,000 mcg : 250 ml :: 72,000 mcg : X500,000 / 72,000 :: 250 / X500,000X = 18,000,000X = 36 ml/hour

A client with acute decompensated heart failure (HF) is to receive an IV infusion of 0.9% normal saline with inamrinone (Inocor) 0.1 grams/100 ml at a rate of 8 mcg/kg/minute. The client' s current weight is 183 lbs. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

40 First convert the weight into kilograms: 183 pounds/2.2 kg = 83 kgNext calculate the number of mcg/kg/minute: 8 x 83 = 664 mcg/minCalculate the number of mcg/hour: 664 x 60 minutes = 39,840 mcg/hourNow calculate the number of ml/hour needed to administer 39,840 mcg/hour:100,000 mcg : 250 ml :: 39,840 mcg : X = 100,000/39,840 :: 250/X and 100,000X = 3,984,000X = 39.84 (rounded to) 40 ml/hour

A 110-pound, adult female is admitted to the Emergency Center after receiving burns to 40 percent of her body. Using the Parkland formula, the client's fluid requirements for the first 24 hours after injury is calculated using Lactated Ringer's 4 ml solution x Body weight (in kilograms) x Percent burn. The client should receive one-half of the 24-hour calculated fluid volume in the first 8 hours of treatment. The nurse should set the infusion pump to deliver how many ml/hour during the first 8 hours? (Enter the numerical value only. If rounding is required, round to the nearest whole number.)

500 Using the Parkland formula, the client's fluid requirements for the first 24 hours after injury is calculated using 4 ml lactated Ringer's solution x Body weight (in kilograms) x Percent burnConvert 110 pounds to kg = 110 / 2.2 = 50 kg4 ml x 50 kg x 40 = 8,000 mlOne-half in first 8 hours = 4,000 ml4,000 ml / 8 hours = 500 = 500 ml/hour

A child who weighs 32 pounds receives a prescription for amoxicillin with clavulanate (Augmentin) 194 mg PO every 8 hours. The recommended dose is 40 mg/kg/day, and the bottle contains 125 mg/5ml. How many mg should the child receive in a 24-hour period? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

582 The child's weight in kg (2.2 : 1 kg :: 32 pounds : X kg = 14.54 kg) is used to calculate the recommended dose (40 mg x 14.54 kg/day = 581.81 = 582 mg).The prescribed dose in 24 hours is 194 mg x 3 doses = rounded to 582 mg.

An IV infusion of Dextrose 5% in normal saline (D5NS) 1,000 ml with oxytocin (Pitocin) 20 units is prescibed for a client to control postpartum bleeding. The solution is to be administered at a rate of 2 mu/minute. How many ml/hour should the nurse program the infusion pump? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

6 Rationale First calculate the number of units/hour.0.002 units/minute x 60 minutes = 0.12 units/hourNext calculate the number of ml/hour needed to administer 0.12 units/hour.20 units : 1,000 ml :: 0.12 units : X20 / 0.12 :: 1,000/X 20X : 120X = 6

A healthcare provider prescribes a continuous infusion of 0.9% sodium chloride 250 ml with pancuronium (Pavulon) 25 mg at a rate of 0.1 mg/kg/hour for a client with coronary artery bypass grafting. The client weighs 78 kg. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

78 Rationale First calculate the number of mg the client will receive in 1 hour: 0.1 mg x 78 kg = 7.8 mg/hourNext calculate the number of ml containing 7.8 mg of medication: 25 mg : 250 ml :: 7.8 mg : X25 mg/ 7.8 mg :: 250 ml/X25X = 1950X = 78 ml/hour

The healthcare provider prescribes an IV infusion of Ringer's Lactate 1,000 ml with 30 Units of Pitocin to run in over 4 hours for a client who has just delivered a 10 pound infant by cesarean section. The tubing has been changed to a 20 gtt/ml administration set. The nurse plans to set the flow rate at how many gtt/minute? 42 gtt/min. 83 gtt/min. 125 gtt/min. 250 gtt/min.

83 Rationale Ratio proportion using Dimentional analysis.Drops/ Minutes (gtt/min) = 20gtt/ml X 1000 ml/4hrs X 1 hr/60 min = 83 gtts/minute

The nurse is preparing the change-of-shift report for a client who has a 265 ml secondary infusion that was started 2 hours ago at a rate of 85 ml/hour via an infusion pump. The nurse should report that how many ml remain to be infused by the on-coming nurse? (Enter numeric value only.)

95 Rationale 85 ml x 2 hours = 170 ml has infused. 265 ml (total amount to be infused) - 170 ml (amount infused) = 95 ml remain to be infused.

A client is receiving dantrolene sodium (Dantrium) PO for malignant hyperthermia. The maximum safe dose is 8 mg/kg/day in 4 divided doses. The client currently weighs 48.5kg. What is the maximum safe dose the nurse should administer? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

97 Rationale Determine the maximum number of mg this client should receive in a day:48.5 kg x 8 mg/kg/day = 388 mg/dayNext determine how many mg the nurse should deliver each dose:388 mg/4 doses = 97 mg

The nurse is caring for a client who is receiving 24-hour total parenteral nutrition (TPN) via a central line at 54 ml/hr. When initially assessing the client, the nurse notes that the TPN solution has run out and the next TPN solution is not available. What immediate action should the nurse take? Infuse normal saline at a keep vein open rate. Discontinue the IV and flush the port with heparin. Infuse 10% dextrose and water at 54 ml/hour. Obtain a stat blood glucose level and notify the healthcare provider.

Infuse 10% dextrose and water at 54 ml/hour. Rationale TPN should be discontinued gradually to allow the client to adjust to decreased levels of glucose. Administering 10% dextrose in water at the prescribed rate should reduce the client's risk of hypoglycemia until the next TPN solution is available. The other actions are not indicated.

A client is receiving a cephalosporin antibiotic IV and complains of pain and irritation at the infusion site. The nurse observes erythema, swelling, and a red streak along the vessel above the IV access site. Which action should the nurse take? Administer the medication more rapidly using the same IV site. Initiate an alternate site for the IV infusion of the medication. Notify the healthcare provider before administering the next dose. Give the client a PRN dose of aspirin while the medication infuses.

Initiate an alternate site for the IV infusion of the medication. Rationale A cephalosporin antibiotic that is administered IV may cause vessel irritation. Rotating the infusion site minimizes the risk of thrombophlebitis, so an alternate infusion site should be initiated before administering the next dose. The other actions are not indicated.

What action should the nurse implement when accessing an implanted infusion port for a client who receives long term IV medications? Cleanse the site with iodine solution. Insert a Huber-point needle into the port. Flush tubing with 5 ml of normal saline. Place a sterile dressing over the port.

Insert a Huber-point needle into the port. Rationale An implanted infusion port needs to be accessed using a Huber-point needle (non-coring) to be prevent damage to the self-sealing septum of the port. The other actions are not necessary when accessing an implanted infusion port.

A client's IV infusion of 0.9% Sodium Chloride (normal saline) infiltrated earlier today, and approximately 500 ml of normal saline infused into the subcutaneous tissue. The client is now complaining of excruciating arm pain and demanding "stronger pain medications." What action is most important for the nurse to take? Ask about any past history of drug abuse or addiction. Measure the pulse volume and capillary refill distal to the infiltration. Compress the infiltrated tissue to measure the degree of edema. Evaluate the extent of ecchymosis over the forearm area.

Measure the pulse volume and capillary refill distal to the infiltration. Rationale Compartment syndrome occurs when external pressure (usually from a cast), or internal pressure (usually from subcutaneous infused fluid), exceeds capillary perfusion pressure resulting in decreased blood flow to the extremity. The most important action is to assess pulse volume and capillary refill distal to the infiltration site toetermin d loss of the peripheral pulse in the extremity, which is evidence of compartment syndrome. The other actions are of less priority than determining the effects of the infiltrate fluids on circulation and nerve function.

The healthcare provider prescribes diltiazem (Cardizem) 0.87 mg PO four times daily for an infant who weighs 22 pounds. The recommended maximum dose is 3.5 mg/kg/day. What action should the nurse take? a) Give the prescribed dosages. b) Notify the healthcare provider. c) Ask the pharmacist to clarify the calculations. d) Assess the child's heart rate before administration.

b) Notify the healthcare provider. Calculate the recommended maximum dose, 22 pounds = 10 kg, so 3.5 mg x 10 kg = 35 mg.Calculate the prescribed daily dose. 0.87 mg x 4 doses = 3.48 = 3.5 mg/day.The prescribed daily dose 3.5 mg/day is below the recommended dose of 35 mg, which may be a misplaced decimal in the prescription.The healthcare provider should be notified for clarification of the dosage.