Chapter 3: Making Drug Dosing Safer - PrepU

A young mother asks the nurse why she cannot give her 2-year-old child an adult dose of acetaminophen. The nurse explains why this is unsafe. What statement would indicate that the mother needs further education?

"My baby's dose of acetaminophen is based on a healthy adult male."

A client has been prescribed a one-time dose of 4 mg morphine IV. The medication is available in ampules of 10 mg/mL. What volume of morphine should the nurse draw up?

0.4

An 81-year-old with congestive heart failure has been sent to a cardiologist, who prescribes digoxin (Lanoxin) 0.125 mg PO every morning. The pharmacy dispenses pills that contain 0.25 mg of Lanoxin. How many pills should the nurse teach the client to take every morning?

0.5

The health care provider has ordered 35 mg of Demerol IM for relief of a severe migraine headache. The package insert reads meperidine hydrochloride (Demerol) 50 mg/mL. How many milliliters would the nurse administer?

0.7

After teaching a group of nursing students about using zeros, the instructor determines that the teaching was successful when they identify which as the correct placement of a zero in a decimal?

0.75

Medication doses given to children are usually smaller than those given to adults. Doses for children can also be calculated based on the child's weight. Which would be correct when calculating a dose based on weight?

1 kg equals 2.2 pounds

The nurse must use the metric system in dosage calculations. Which conversions are correct? (Select all that apply.)

1 kilogram = 1000 grams 1 gram = 1000 milligrams 1 milligram = 1000 micrograms

The nurse is preparing to administer 80 mg of methylprednisolone intravenously (IV) to a client with pneumonia. The vial states that it has 120 mg per 2 mL. The nurse would correctly draw up which amount?

1.3 mL

A nurse is to administer 175 mg of a medication intramuscularly. The label on the multidose vial states that the concentration is 100 mg/mL. What volume of the drug should the nurse administer? (Record your answer using two decimal places.)

1.75

The nurse multiplies and divides simple fractions when calculating drug doses for clients. Which fraction is a result of multiplying 2/5 by 5/8?

1/4

A client has not had a bowel movement for four days and has been prescribed milk of magnesia 2 teaspoons orally as needed for relief of constipation. How many mL should the nurse administer?

10 mL

A client has orders to receive 2 liters of IV fluid over a 24-hour period with ½ this amount to be infused in the first 10 hours of treatment. How many milliliters per hour would the client receive during the first 10 hours of the infusion?

100 mL/hr

A newly admitted client has orders to receive 1,000 mL of normal saline IV over 8 hours. If the IV infusion set is a microdrip set that delivers 60 drops per mL, how many drops per minute should the nurse administer to the client?

125

Delatsone (prednisone) has been prescribed to a client with sarcoidosis. The client is to take 20 mg/day for 1 week and then taper the dose. The medication is available in 10-mg tablets. If the client follows the drug regimen, how many tablets would be taken in the first week?

14

The health care provider prescribes ascorbic acid 0.5 g daily. The drug label reads ascorbic acid 250 mg/tablet. The nurse would administer how many tablets?

2

A child weighs 11 kilograms. The health care provider orders a drug 0.2 mg/kg intravenously. The nurse determines the proper dose as:

2.2 mg.

The health care provider orders acetaminophen 15 mg/kg q4 hours PRN (as needed) for an infant's pain. The drug is supplied with 160 mg/5 mL. The infant weighs 12 pounds. How many mL of medication should the nurse administer?

2.5

The nurse is converting grams to milligrams. How would the nurse move the decimal point?

3 places to the right

A client is experiencing pain, as states that in the past she had been prescribed codeine ½ grain every 4 hours. How many milligrams of codeine was the client taking with each dose?

30 mg

Which of the following correctly represents 3/8 in a percentage? (Choose one)

37.5%

Order: 400 mg. Cefazolin I.V. Available: Cefazolin 500 mg powder to be diluted with 5 mL of sterile saline How many mL will the nurse administer?

4

The client is to be given ascorbic acid 1 g daily by mouth. The medication comes in a container labeled, "Ascorbic Acid 250 mg tablets." How much will the nurse give?

4 Tablets

A client with an acute myocardial infarction is admitted to the coronary care unit. The health care provider has ordered Heparin 25,000 units in 250 mL normal saline to infuse at a rate of 600 units/hour. The nurse should set the infusion pump to deliver how many milliliters in an hour?

6

Order: Ibuprofen 150 mg. orally Available: Ibuprofen 100mg/ 5ml How many mL will the nurse administer?

7.5

The nurse recognizes that what system is being used when seeing a medication ordered in minims?

Apothecary

The nurse is teaching a novice nurse how to calculate medications by changing fractions into percentages. How can the percentage designated by any fraction be determined?

Divide the numerator by the denominator.

The nurse is calculating the client's intake and output record and converts ounces to milliliters. What systems is this nurse converting from and to?

From household to metric

The charge nurse is retiring from work after 25 years of service. The staff are bringing potluck for all to enjoy. When planning to make brownies for the party, which measurement system would a nurse use?

Household System

Which best describes the manual redundancy system used to reduce potential error in medication administration by a nurse?

It is a process using the 5 rights and 3 checks.

The nursing student learns that the apothecary system was at one time used for weight but was recently eliminated for which reasons?

It produced a high rate of errors.

A nurse articulates that which measurement system used in medicine?

Metric

Which are systems of measurement associated with drug dosing? Select all that apply.

Metric System Apothecary System Household Measurements

The student nurse is studying common fractions as they apply to the healthcare setting. What is true about common fractions?

The numerator is part of the whole number and is the top number

To convert medication dosages from one quantity to another, the nurse must know how to use ratio and proportion. Which of the following is true about the ratio 2:4 :: 1:2.

The proportion is referred to as a valuable relationship

The client returns from the PACU with the following order: morphine 3 mg IV every 2 hours as needed for relief of pain. The vial reads morphine, 4 mg/mL. How many milliliters of morphine should the client receive?

¾