Learning Unit 1 | PrepU | Chapter 3: Making Drug Dosing Safer

The nursing student is learning how to do the ratio/proportion method of calculating medication dosages. The student indicates an understanding of this method when stating: "I should put milligrams over grams." "It is not necessary for the numerator and denominator to be of like terms." "The gram is a unit of volume." "All conversions must be done to reflect all units the same."

"All conversions must be done to reflect all units the same."

The nurse teaches a parent the importance of administering appropriate dosages of acetaminophen when the client's infant has a fever. What information should the nurse provide to this client? Select all that apply. "Children's dosages will change with time as they grow." "An infant's dose of acetaminophen is about ½ of an adult dose." "It is important to give the right dose to prevent toxic effects of the medication." "Infant's and children's doses should be based on their weight or age." "In most cases, infants cannot be given medications because of their immature organs."

"Children's dosages will change with time as they grow." "It is important to give the right dose to prevent toxic effects of the medication." "Infant's and children's doses should be based on their weight or age."

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? "There could be a time when my child may need a higher dose than normal." "My baby's dose of acetaminophen is based on a healthy adult male." "My baby can't handle a high dose of acetaminophen because her liver may be damaged." "My child's dose of acetaminophen should be based on her weight or age."

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

A client tells the nurse that the health care provider suggested taking an ounce of magnesium hydroxide periodically if experiencing constipation. The client tells the nurse, "I don't have anything small enough to measure this amount." What response by the nurse would be most appropriate? "You can use two measuring tablespoons to get the same dose." "The cap of the bottle is the same as 1 oz." "Three measuring teaspoons should be just about the same." "Call your health care provider and ask for a special measuring device."

"You can use two measuring tablespoons to get the same dose."

taking an ounce of magnesium hydroxide periodically if experiencing constipation. The client tells the nurse, "I don't have anything small enough to measure this amount." What response by the nurse would be most appropriate? "You can use two measuring tablespoons to get the same dose." "The cap of the bottle is the same as 1 oz." "Three measuring teaspoons should be just about the same." "Call your health care provider and ask for a special measuring device."

"You can use two measuring tablespoons to get the same dose."

Order: Enoxaparin 30 mg subcutaneously Available: Lovenox 60 mg/ 0.6 mL How many mL will the nurse administer?

0.3

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

A client is going to have bowel surgery in the morning. The health care provider (HCP) orders 500 mL of PEG 3350/electrolytes bowel prep to be administered at 17:00. How many liters should the nurse administer? Round your number to the nearest tenth.

0.5 L

The health care provider (HCP) prescribes 250 mg of a drug. The information on the drug vial says the concentration is 500 mg/mL. How much of the drug should the nurse prepare? 0.25 mL 0.33 mL 0.5 mL 0.75 mL

0.5 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? 1.6 1 0.6 0.5

0.6

The pediatric nurse is caring for a child who weighs 44 pounds. The health care provider (HCP) has prescribed methylprednisolone sodium succinate, 0.03 mg/kg/d IV in normal saline. How many milligrams of medication will the nurse prepare? 6.5 6 0.65 0.6

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

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 pound equals 2.2 kg 1 kg equals 2.2 pounds 1 pound equals 4 kg 1 kg equals 4 pounds

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 1 gram = 100 milligrams 1 gram = 10 milligrams

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? 0.3 mL 0.6 mL 1.3 mL 1.6 mL

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 primary care provider orders cimetidine 100 mg P.O. daily. The medication is available as cimetidine 200 mg tablets. How much will the nurse give? 2 tablets 1/2 tablet 1 tablet 3 tablets

1/2 tablet

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? 16/25 1/4 4 2/5

1/4

The PCP orders amoxicillin 250 mg by mouth two times a day. The drug label reads "Amoxicillin 125 mg/5 ml." How much will the nurse administer? 5 mL 2.5 mL 10 mL 7.5 mL

10 mL

A client has orders to receive 2 L 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 will the nurse administer during the first 10 hours of the infusion? Round to the nearest whole number.

100 mL/h

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? 50 mL/hr 100 mL/hr 120 mL/hr 240 mL/hr

100 mL/hr

The nurse receives a new medication order for a client to administer 300 mg of medication per day in equally divided doses every 8 hours. How many milligrams of the drug should the nurse administer for each dose?

100 mg

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

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

Deltasone (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? 2 7 9 14

14

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? 1300 (1 PM) 1400 (2 PM) 1500 (3 PM) 1600 (4 PM)

1500 (3 PM)

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 1 3 4

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 1 3 4

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? one-half tablet 1 tablet 1 and ½ tablet 2 tablets

2 tablets

In the household measurement system, how many teaspoons are in 1 tablespoon? 3 2 1 0.5

3

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

The nurse is converting grams to milligrams. How would the nurse move the decimal point? 2 places to the right 2 places to the left 3 places to the right 3 places to the left

3 places to the right

A client is experiencing pain and states that in the past he or she has been prescribed codeine ½ grain every 4 hours. How many milligrams of codeine was the client taking with each dose? 15 mg 30 mg 60 mg 120 mg

30 mg

The nurse is to infuse 100 mL of 5% dextrose and water solution containing an IV antibiotic over 30 minutes. The infusion set delivers 10 gtt/mL. How many drops per minute will the nurse administer? Round to the nearest whole number. 33 gtt/min 30.3 gtt/min 30 gtt/min 3 gtt/min

33 gtt/min

The nurse is to administer 200 mg of trimethoprim and sulfamethoxazole suspension. The suspension must be shaken well as suspensions settle to the bottom of the bottle. The medication available is trimethoprim and sulfamethoxazole 250 mg in 5 mL. Which is the correct dosage required for administration? 3 mL 4 mL 5 mL 6 mL

4 mL

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 at each dose? 5 5.5 10 10.5

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? 5 mL 125 mg 2.5 mL 725 mg

5 mL

The client drinks 18 ounces of fluid at lunchtime. How many milliliters of intake should the nurse document?

540 mL

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? 8 7 6 5

6

The health care provider (HCP) orders a maintenance dose of oral aminophylline, 3 mg/kg every 6 hours. The client weighs 50 kg. How many milligrams should the nurse administer to the client in a 24-hour period?

600 mg

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

7.5

Which of the following correctly expressed 75% in a fraction? (Select all that apply) 75/100 3/4 100/75 4/3 1 1/3

75/100 3/4

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 4 2 12

8

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 strictly follow the given medication orders. A nurse must possess a good understanding of pharmacology. A nurse must possess a basic understanding of mathematics. A nurse must ask for the primary care provider's assistance.

A nurse must possess a basic understanding of mathematics.

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 denominator by the numerator. Divide the numerator by the denominator. Multiply the denominator by the numerator. Multiply the numerator by the denominator.

Divide the numerator by the denominator.

When reconstituting a multidose vial and medication to be added to an IV solution, the nurse must add which information to the label the nurse will apply to the IV bag containing the medication? (Select all that apply.) Amount of diluent added Dose of drug in mL such as 500 mg/mL Name of prescriber Date of reconstitution Name of the nurse

Dose of drug in mL such as 500 mg/mL Date of reconstitution Name of the nurse

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. It is a method proven to reduce redundancy of medication errors. It is a technique to identify deficiencies in billing procedures of medications. It is a practice of telling the client the mechanism of action of each of the medications given.

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

What is a characteristic of a generic name of the drug as mentioned on the label? It appears in capitalized lettering. It is written first on the label. It is identified by the registration symbol. It is written in smaller print.

It is written in smaller print.

The nursing student learns that the apothecary system was at one time used for weight but was recently eliminated for which reasons? It was too hard to memorize. It was used only for volume and thus was limited. It produced a high rate of errors. It was used for only large doses.

It produced a high rate of errors.

The nurse is calculating medications using percentages. Which of the following is accurate? The term percentage refers to the number per 10 Percent has specific units of measure To convert percentage to a fraction the percent number becomes the numerator The denominator in a percentage is always 100

The denominator in a percentage is always 100

When using dimensional analysis (DA), which is most important? Select all that apply. Unit of measure is the focus. Information is set up in a specific order. Fractions are used for the setup. Decimals are used to represent data. Cross-multiplying is necessary for calculation.

Unit of measure is the focus. Information is set up in a specific order. Fractions are used for the setup.

Which instruction would the nurse include when using dimensional analysis to calculate dosages? Express the dosage strength as a fraction with the numerator having the same unit. Write the next fraction with the numerator having the same unit of measure as the denominator. Write the dosage strength with the numerator always expressed in the same unit identified before. Expand the equation by filling in the missing numbers using the appropriate equivalent.

Write the dosage strength with the numerator always expressed in the same unit identified before.

The nurse understands the importance of correctly reading drug labels when calculating dosages. Which of the following are included on labels and needed to administer a drug correctly? (Select all that apply.) drug name drug form side effects dosage strength drug incompatibilities

drug name drug form dosage strength

In the metric system, what is the unit of weight? liter gram meter pound

gram

The nurse recognizes that what system is being used when seeing a medication ordered in teaspoons? apothecary metric household avoirdupois

household

A nurse is preparing to administer a parenteral medication. Which form of the medication will be used? suspension liquid elixir tincture

liquid

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.) metric system Mercalli system apothecary system household measurement system Avoirdupois system

metric system apothecary system household measurement system

The student nurse is studying common fractions as they apply to the healthcare setting. What is true about common fractions? the numerator refers to the total number of parts the denominator refers to part of the total parts of the number the numerator is part of the whole number and is the top number in common fractions 10 is always the denominator

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

The nurse is preparing to administer cefadroxil 1 g PO. The medication is supplied in 500-mg tablets. How many tablets should the nurse administer?

two tablets

The nurse, when using the method of dispensing drugs in which each tablet or capsule is packaged separately. Which dispensing method is this? dosage-strength method trade-name method unit-dose method generic-name method

unit-dose method