Prep-u Making drug dosing safer
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
The provider orders a maintenance dose of oral aminophylline, 3 mg/kg every 6 hours. The client weighs 50 kg. How many mg should the nurse administer to the client in a 24-hour period?
600
Order: Ibuprofen 150 mg. orally Available: Ibuprofen 100mg/ 5ml How many mL will the nurse administer?
7.5
A home care nurse is to administer one aspirin a day to the client. The client has the over-the-counter medication in two forms. The first is available in the form of 325-mg scored tablets. The second is a Lo-dose aspirin of 81mg aspirin. What would the nurse's action be?
Consult the health care provider.
The nursing instructor is teaching about liquid medications. The student learns that liquids are given for which reasons? (Select all that apply.)
The client is a child. The drug is to be put in a feeding tube. The client is too ill to swallow a solid. The drug is to be injected into a tissue or IV line.
The nurse is calculating medications using percentages. Which of the following is accurate?
The denominator in a percentage is always 100
Clients may refuse a medication if they do not recognize which name?
generic name
A nurse is preparing to administer a parenteral medication. Which form of the medication will be used?
liquid
The nursing student is learning about the metric system and how it is the most commonly used system of measurement in medicine. The student demonstrates an understanding of the metric system when stating which?
"In the metric system, the liter is a unit of volume."
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.
When the nurse uses ratio and proportion to complete drug calculations, which formula would have the most potential for error?
1 mg.: 1,0000 mcg = X mg: 0.620 mcg
A client with mild postoperative pain has been prescribed 650 mg acetaminophen q6h PO PRN. The medication is available in 325 mg tablets. How many tablets can the client safely take in any 24-hour period?
8
The nurse knows that household measurements are used for volume only and are not commonly used in health care settings. Sometimes for convenience the health care provider will order a drug in a household measurement. Which is an example of a drug ordered this way?
Amoxicillin 125 mg per teaspoon
The nurse recognizes that what system is being used when seeing a medication ordered in minims?
Apothecary
At 0700 (7 AM) the health care provider has ordered the nurse to begin an IV infusion and has ordered the client to receive 125 mL/hr of IV fluid. At what time will the nurse be prepared to hang the next liter of IV fluid?
1500(3PM)
The primary care provider orders cimetadine 100 mg P.O. daily. The medication is available as cimetadine 200 mg tablets. How much will the nurse give?
1/2 tablet
The nurse begins administering 500 mL of 5% dextrose and water solution at 0100 to run over 4 hours. At 0200, the nurse administers 80 mg gentamicin in 50 cc normal saline to infuse over 30 minutes. How many mL of fluid will the nurse administer to the client between 0200 and 0300?
175
A client needs to take 1 g PO of cefadroxil. The nurse explains to the client that the drug comes in 500-mg tablets. How many tablets would the nurse tell the client to take?
2
The health care provider prescription reads prednisone 20 mg orally in the morning and at bedtime. The label on the drug reads 20-mg tablets. The nurse would expect the client to receive how many tablets in 24 hours?
2
A client is being treated for congestive heart failure (CHF) and is to receive 0.5 milligrams of digoxin, which is available in 250-microgram tablets. The nurse would correctly administer how many tablets?
2 tablets
A client with diabetic ketoacidosis is to receive a continuous infusion of regular insulin. The health care provider presctibes 1 L of 5% dextrose and water solution to run at 150 mL/h once the client's blood glucose has reached 250 mg/dL. The drip factor of the tubing is 15 gtt/mL. How many drops per minute will the nurse deliver?
37 gtt/min
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
Order: 250 mcg. Digoxin solution orally Available: Digoxin 0.05mg/mL How many mL will the nurse administer?
5
The nursing student is studying drug dosing with liquids. The student knows that a specific amount of drug will be in a given volume. A particular drug label reads "Augmentin 125 mg/5 mL." Which is the correct volume?
5ml
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
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 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.
A client will have bowel surgery in the morning. The health care provider orders 500 mL of GoLytly PO starting at 5 PM this evening. What would this amount be in liters?
½
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
The nurse is converting grams to milligrams. How would the nurse move the decimal point?
3 places to the right
A nurse articulates that which measurement system used in medicine?
metric
The health care provider has ordered 250 micrograms of a cardiac medication. The nurse knows through conversions of the metric system that this is equal to how many milligrams?
0.25 mg
Order: Enoxaparin 30 mg subcutaneously Available: Lovenox 60 mg/ 0.6 mL How many mL will the nurse administer?
0.3
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 nurse must use the metric system in dosage calculations. Which conversions are correct? (Select all that apply.)
1 gram = 1000 milligrams 1 milligram = 1000 micrograms 1 kilogram = 1000 grams
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, when using the metric system, identifies which be correct regarding volume measurement? (Select all that apply.)
1 liter = 1000 milliliters
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 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 heatlh care provider orders 500 mL of IV solution be administered over 8 hours. If the IV infusion set delivers 15 drops per mL, how many drops per minute should the nurse administer to the client?
16
A child weighs 11 kilograms. The health care provider orders a drug as follows: 0.2 mg/kg intravenously. What dose should the nurse administer?
2.2
Remicade 3 mg/kg IV infusion monthly has been prescribed for a client diagnosed with rheumatoid arthritis. The client weighs 150 pounds. How many mg of Remicade will be infused? Round your answer to the nearest whole number.
205
Methocarbamol (Robaxin) 1.5 g orally four times a day has been prescribed for a client to treat neck pain. Robaxin is available in 500-mg tablets. How many tablets will the nurse administer for each dose?
3
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?
30mg
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
The nurse is preparing medication for a 30-month-old with right otitis media. The child weighs 33 pounds. The health care provider has ordered cephalexin, 50 mg/kg/day in divided doses every 8 hours. The medication concentration is 250mg/5mL. How many milliliters should the nurse give the toddler?
5
An adolescent is admitted to the ICU in diabetic ketoacidosis. The health care provider orders a continuous insulin infusion of 100U NPH insulin in 500 mL normal saline. What is the concentration of the infusion?
0.2 U/ml
The health care provider has ordered 30 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 inject?
0.6
The pediatric nurse is caring for a child who weighs 44 pounds. The health care provider has prescribed methylprednisolone sodium succinate, 0.03 mg/kg/d IV in normal saline. How many milligrams of medication will the nurse prepare?
0.6
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
Which best describes 100 mg/10 mL?
100 mg of the drug in 10 milliliters of liquid
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 child with a urinary tract infection who is prescribed cephalexin 25 mg/kg/day in 3 divided doses. Knowing that the child weighs 15 kilograms, the nurse should administer how many mg with each dose?
125
According to protocol, a nursing student is required to complete metric conversions to ensure accurate administration of medication dosage. What does this indicate?
a nurse must possess a basic understanding of mathematics
A pediatric nurse is reading new medication orders for a school-aged client. How should the nurse best determine the correct dosage?
consult a nomogram using body surface area
The nursing student is studying drug dosage and has learned that there are three systems of measurement associated with drug dosing. What are these systems? (Select all that apply.)
household measurement system apothecary system metric 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 nurse knows that there are three systems of measurement used when working with drug dosing. The most frequently used system in medication administration is which?
metric system
Besides calculating a medication dosage, what other factors in the nursing environment contribute to errors in medication administration? Select all that apply.
noise lighting interruptions
The health care provider has ordered a client to receive 0.75 g of amoxicillin. The medication is available as 250 mg/tablet. The nurse uses ratio and proportion to perform the drug calculation and sets up the formula to look like this: 1000 mg:1 g =X mg:0.75 g. What does the X represent in this formula?
the dosage to be delivered to the client
The nursing student has learned that drug labels contain two names: trade name and generic name. The student demonstrates an understanding of the differences between the two when stating which of the following?
the trade name is the same as the brand name
The nurse, when using the method of dispensing drugs in which each tablet or capsule is packaged separately. Which dispensing method is this?
unit-dose method
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