Dosage Calculations 3rd Canadian Edition by Amy Pickar-Abernethy – Test bBank

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Dosage Calculations 3rd Canadian Edition by Amy Pickar-Abernethy – Test bBank

Chapter 2—Ratios and Percents

MULTIPLE CHOICE

1. A medical unit has 24 patients and 4 nurses to provide care. What is the patient to nurse ratio in lowest terms?
 a. 24:4 b. 6:1 c. 12:2 d. 18:3

ANS:  B                    PTS:   1                    REF:   Pages 40-41   BLM:  Higher Order

1. Which percentage is the equivalent of a 1:1000 epinephrine solution?
 a. 0.1% b. 10% c. 0.001% d. 0.01%

ANS:  A                    PTS:   1                    REF:   Page 42-43     BLM:  Remember

1. Which intravenous solution has the lowest concentration?
 a. 5% dextrose in 0.45% saline b. 5% dextrose in water c. 0.9% normal saline d. 0.45% normal saline

ANS:  D                    PTS:   1                    REF:   Page 43-44     BLM:  Higher Order

1. Which of the following is the strongest solution?
 a. 1:10 b. 1:50 c. 1:1 d. 1:25

ANS:  C                    PTS:   1                    REF:   Page 43-44     BLM:  Higher Order

1. What is 0.37% of 352?
 a. 0.1 b. 5.9 c. 9.5 d. 1.3

ANS:  A                    PTS:   1                    REF:   Pages 45-46   BLM:  Higher Order

 Percent Ratio 1. 45% 2.

Complete row 1 in the table above.

ANS:

9:20

PTS:   1                    REF:   Pages 43-44

 Percent Ratio 1. 45% 2.

Complete row 2 in the table above.

ANS:

30%

PTS:   1                    REF:   Pages 43-44

1. A class of students consists of 9 men and 51 women. Write a proper fraction to represent the part of the total class that is women. Reduce the fraction. Change the fraction to a percent.

Reduced fraction: _____                    Percent: _____

ANS:

17/20; 85%

There are 51 women and 9 men for a total of 60 students in the class..

PTS:   1                    REF:   Pages 42-43

1. A student received a score of 48 points on a test that was worth 60 points. Write a fraction to represent the portion of the test the student answered correctly. Reduce the fraction. Change the fraction to a percent.

Reduced fraction: _____                    Percent: _____

ANS:

4/5; 80%

PTS:   1                    REF:   Pages 42-43

1. To pass a chapter test, a student must answer 80% or more of the questions correctly. If a chapter test has 25 questions, what is the smallest number of questions that the student must answer correctly in order to pass the test?

ANS:

20

At least 80% of 25 questions must be answered correctly.

The student must answer at least 20 questions correctly.

PTS:   1                    REF:   Pages 45-46

1. To pass a unit test, a student must answer 80% or more of the questions correctly. If a unit test has 75 questions, what is the largest number of questions that the student could answer incorrectly, but still pass the unit test?

ANS:

15

At least 80% of 75 questions must be answered correctly.

At least 60 questions must be answered correctly

The largest number of questions that the student could answer incorrectly, but still pass the test, is 15 questions.

PTS:   1                    REF:   45-46

1. Convert the following. Reduce fractions and ratios to the lowest term. Round decimals and percents to 3 decimal places (thousandths):

 Decimal Fraction Percent Ratio 0.125

ANS:

1/8; 12.5%; 1:8

PTS:   1                    REF:   Pages 42-43

1. Convert the following. Reduce fractions and ratios to the lowest term. Round decimals and percents to 3 decimal places (thousandths):

 Decimal Fraction Percent Ratio 0.25%

ANS:

0.0025; 1/400; 1:400

PTS:   1                    REF:   Pages 42-43

Chapter 8—Oral Dosage of Drugs

MULTIPLE CHOICE

Mr. PETE

Mr. Pete is 60 years old and was admitted to the medical unit with pneumonia. He has a history of angina, diabetes, hypertension, and hypothyroidism. His prescribed medications include amoxicillin (Amoxil) 0.5 g PO q8h; ramipril (Altace) 5 mg PO BID; levothyroxine (Eltroxin) 0.15 mg PO daily; glyburide (Diabeta) 10 mg PO ac breakfast and 5 mg PO ac dinner; and nitroglycerin (Nitrostat) 0.4 mg SL prn for chest pain.

1. Ramipril is available in 5 mg capsules. How many capsules will the nurse administer to the patient per dose?
 a. 0.5 b. 1 c. 1.5 d. 2

ANS:  B

5 mg × 1 = 1 cap

5 mg

PTS:   1                    REF:   Page 140-141                                 BLM:  Higher Order

1. How many tablets of glyburide will the nurse administer to Mr. Pete at breakfast if glyburide is available as 5 mg tablets?
 a. 0.5 b. 2 c. 1.5 d. 1

ANS:  B

10 mg × 1 = 2 tab

5 mg

PTS:   1                    REF:   Pages 142-149                                          BLM:   Higher Order

1. Levothyroxine is available as indicated on the drug label below. How many tablets will the nurse give to Mr. Pete?

 a. 2 b. 1 c. 0.5 d. 1.5

ANS:  D

150 mcg × 1 = 1.5 or 11/2 tab

100 mcg

PTS:   1                    REF:   Pages 142-149                                          BLM:   Higher Order

1. Mr. Pete complains of angina chest pain during his 1200 head-to-toe assessment. He tells the nurse that his pain is 6 out of 10 on the pain scale. The nurse decides to give him a dose of nitroglycerin as ordered. The pharmacy label on this medication reads 0.4 mg/tab. How many tablets will the nurse give?
 a. 0.5 b. 2 c. 1 d. 1.5

ANS:  C

0.4 mg × 1 = 1 tab

0.4 mg

PTS:   1                    REF:   Pages 142-149                                          BLM:   Higher Order

1. How many amoxicillin capsules will the nurse administer to Mr. Pete for his afternoon (1400) dose?

 a. 1 b. 2 c. 1.5 d. 0.5

ANS:  B

0.5 g = 500 mg

500 mg × 1 = 2 tab

250 mg

PTS:   1                    REF:   Pages 142-149                                          BLM:   Higher Order

Compute the amount of medication you will give to administer one dose of the following medication orders. Assume all tablets are scored, when necessary. The problems and drug orders are presented for practice only, and actual prescribed dosages will vary according to a patient’s age, condition, reaction, additional medications, and other factors.

1. Order:  furosemide 80 mg po bid

Supply:            bottle containing 50 tablets of Lasix (furosemide), 80 mg per tablet

Give:    __________ tablet(s)

ANS:

PTS:   1                    REF:   Pages 142-149

1. Order:  amoxicillin 0.375 g po q8h

Supply:            100 mL bottle of reconstituted Amoxil oral suspension, 125 mg/5 mL

Give:    __________ mL

ANS:

PTS:   1                    REF:   Pages 153-157

1. Order:  ceflacor 0.3 g po q8h

Supply:            Celcor (cefalcor) reconstituted oral suspension, 375 mg per 5 mL

Give:    __________ mL

ANS:

PTS:   1                    REF:   Pages 153-157

1. Order: erythromycin ethylsuccinate 800 mg po q12h

Supply:            E.E.S. 400 (erythromycin ethylsuccinate) 400 mg per tablet

Give:    __________ tablet(s)

ANS:

PTS:   1                    REF:   Pages 142-149

1. Order:  amoxicillin/clavulanic acid (Apo-Amoxi-Clav) 0.5 g po q8h

Supply:            75 mL bottle or reconstituted amoxicillin/clavulanic acid (Apo-Amoxi-Clav), 250 mg/5 mL

Give:    __________ mL

ANS:

PTS:   1                    REF:   Pages 153-157

1. Order:  levothyroxine 0.2 mg po daily

Supply:            bottle of 100 tablets of levothyroxine 100 mcg per tablet

Give:    __________ tablet(s)

ANS:

PTS:   1                    REF:   Pages 142-149

1. Order:  pediatric dose: clarithromycin 100 mg po q12h

Supply:            100 mL of reconstituted clarithromycin (Biaxin), 250 mg per 5 mL

Give:    __________ mL

ANS:

PTS:   1                    REF:   Pages 153-157

1. Order:  tamoxifen 0.02 g po bid, morning and evening

Supply:            NOVO-TAMOXIFEN (tamoxifen) 20 mg per tablet

Give:    __________ tablet(s)

ANS:

PTS:   1                    REF:   Pages 142-147

1. Order:  valproic acid 375 mg po bid

Supply:            valproic acid 250 mg/5 mL

Give:    __________ mL

ANS:

PTS:   1                    REF:   Pages 142-147

1. Order:  nizatidine 0.15 g po bid

Supply:            bottle containing 60 capsules of nizatidine (Axid), 150 mg per capsule

Give:    __________ capsule(s)

ANS:

PTS:   1                    REF:   Pages 142-147

1. Order:  fluoxetine hydrochloride (Prozac) 40 mg po bid., morning and noon

Supply:            Prozac 20 mg per tablet

Give:    __________ tablet(s)

ANS:

PTS:   1                    REF:   Pages 142-147

1. Order:  hydrochlorothiazide 50 mg po bid

Supply:            hydrochlorothiazide 100 mg tablets

Give:    _____ tab(s)

ANS:

PTS:   1                    REF:   Pages 142-147

1. Decide which supply you would select and enter the number of tablets you would give.

Order:  warfarin sodium (Coumadin) 6 mg once today

Supply:            1 mg, 2 mg, and 3 mg tablets

Give:    Select __________ mg tablets, and give __________ tablet(s)

ANS:

PTS:   1                    REF:   Pages 142-147

1. Decide which supply you would select and enter the number of tablets you would give.

Order:  levothyroxine 75 mcg once daily

Supply:            50 mcg, 100 mcg, and 300 mcg tablets

Give:    Select __________ mg tablets, and give ___________ tablet(s)

ANS:

PTS:   1                    REF:   Pages 142-147

1. Order:  amoxicillin suspension 375 mg po q6h

Supply:            amoxicillin (Amoxil) suspension 250 mg/5mL

Give:    __________ mL

ANS:

PTS:   1                    REF:   Pages 153-157

1. Order:  potassium chloride 10 mEq po bid pc

Supply:            potassium chloride oral solution, 20 mEq/15 mL

Give:    __________ mL

ANS:

PTS:   1                    REF:   Pages 153-157

1. Analyze this situation: Mr. R. is an alert, anxious-appearing, frail gentleman, 76 years old, weighing 65 kilograms. He has been admitted to the hospital two days before with complaints of chest pain. His medication orders included Lanoxin 125 mcg daily every morning. This was the only medication ordered for the morning. On hand on the floor in the nursing station was digoxin (Lanoxin) 0.25 mg/tablet. The patient mentions to the head nurse on the floor that his doctor must have changed his medication order because for two days he had been taking only a half of a tablet in the morning, and yesterday and today, his new nurse had given him two tablets each day. His wife agreed. He wanted to know if this meant that his heart problem was getting worse.

ORDER:

GIVEN:

ERROR(S):

POTENTIAL INJURY:

ANS:

ORDER:  Lanoxin 125 mcg

GIVEN: 1/2 x 250 mcg = 125 mcg for 2 days then 2 x 250 mcg = 500 mcg for yesterday and today

ERROR(S): 250 mcg/125 mcg instead of 125 mcg/250 mcg

POTENTIAL INJURY: 4 times the dose prescribed; –> dysarrthmyia, anxiety for patient, toxic side effects, make cardiac problems worse

PTS:   1

1. Use the label below to answer this question: The physician orders 100 mg of sulfamethoxazole and 20 mg of trimethoprim twice daily.  How many mLs will the patient take per dose?

ANS:

X = 2.5 mL

PTS:   1                    REF:   page 142-147

MULTIPLE CHOICE

HEPARIN

A client presented to the emergency department with a DVT of left leg. The physician orders heparin bolus of 90 units/kg IV, then initiate heparin infusion at 18 units/kg/h from a concentration of heparin 25 000 units in 250 mL 1/2 NS. Bolus should be given from the concentration on heparin label below. The client weighs 187 lbs.

1. What is the bolus dose of heparin in units and millilitres that the client will receive?
 a. 16 830 units in 16.83 mL b. 100 units in 1 mL c. 1530 units in 1.53 mL d. 7650 units in 7.65 mL

ANS:  D

187 ¸ 2.2 = 85 kg

85 kg × 90 units/kg = 7650 units heparin bolus

PTS:   1                    REF:   Pages379-387                                           MSC:   Higher Order

1. How many units/h of heparin will the client receive?
 a. 5000 b. 1000 c. 1530 d. 1030

ANS:  C

85 kg x 18 units/kg/h = 1530 units/h

PTS:   1                    REF:   Page379-387                                  MSC:  Higher Order

1. At what flow rate in mL/h should the nurse program the infusion pump to administer the client’s prescribed heparin infusion dosage?
 a. 13.5 b. 1.5 c. 7 d. 15

ANS:  D

85 kg x 18 units/kg/h = 1530 units/h

PTS:   1                    REF:   Page 379-387                                 MSC:  Higher Order

DOPAMINE

A client weighs 165 lbs. The physician orders dopamine 400 mg/500 mL D5W at 5 mcg/kg/min to start and titrated to 10 mcg/kg/min to stabilize blood pressure.

1. What is the client’s starting dosage of dopamine in mL/min?
 a. 1 b. 2 c. 0.27 d. 0.47

ANS:  D

165 lbs ¸ 2.2 = 75 kg

400 mg × 1000 = 400 000 mcg

PTS:   1                    REF:   Page 398-399                                 MSC:  Higher Order

1. At what rate in mL/h should the nurse program the infusion pump to start administering the dopamine?
 a. 120 b. 16 c. 28 d. 60

ANS:  C

= = 28 mL/h

PTS:   1                    REF:   Page 398-399                                 MSC:  Higher Order

1. 1 L D5W with 10 000 units heparin to infuse at 1000 units/h
 The drop factor is 20 gtt/mL. Flow rate: __________ gtt/min

ANS:

PTS:   1                    REF:   Pages 379-387

1. 1000 mL NS with 10 000 units heparin to infuse at 750 units/h
 The drop factor is 12 gtt/mL. Flow rate: __________ gtt/min

ANS:

PTS:   1                    REF:   Pages 379-387

1. A patient has an IV that is flowing at a rate of 10 gtt/min. The IV bag contains a solution of 500 mL NS with 20 000 units of heparin. The drop factor is 15 gtt/mL.
 How many units is the patient receiving in 24 hours? __________ units/24 h

ANS:

Patient is receiving 40 mL/h.

The patient is receiving 38 400 units/24 h.

PTS:   1                    REF:   Pages 379-387

LIDOCAINE

Compute the answers to the following questions based on this information.

A patient’s IV order for lidocaine states that he should receive an IV bolus of 50 mg over 1 minute, using a supply of 1% lidocaine.

1. What is the supply dosage of the lidocaine in mg/mL?                  __________ mg/mL

ANS:

1% supply

PTS:   1                    REF:   Pages 397-398

1. How many millilitres will you administer for this order, using the available supply?  _________ mL

ANS:

PTS:   1                    REF:   Pages 397-398

1. A patient’s order for famotidine (Pepcid) states that she should receive an IV bolus of 20 mg famotidine (Pepcid) diluted in NS to a total volume of 10 mL, which is to be injected over 2 minutes.  The supply is famotidine (Pepcid) 10 mg/mL.

Compute the volume of famotidine (Pepcid) and the volume of NS.

Pepcid: __________ mL                  NS: __________ mL

ANS:

10 mL total IV solution  2 mL famotidine (Pepcid) solution  8 mL NS.

PTS:   1                    REF:   Pages 397-398

1. Order:  famotidine (Pepcid) 20 mg added to 100 mL D5W IV in 30 min q.12h

An infusion pump will be used.

Supply:            famotidine (Pepcid) 10 mg/mL

Compute the volume of famotidine (Pepcid) to be added to the 100 mL D5W.

Compute the flow rate.

famotidine (Pepcid): __________ mL                Flow rate: __________ mL/h

ANS:

200 mL/60 min  200 mL/h

PTS:   1                    REF:   Pages 397-398

DOBUTAMINE

Compute the answers to the following questions based on this information.

A critical care patient who weighs 80 kg has an order for 10 mcg/kg/min of dobutamine to be administered IV and regulated by an electronic pump. The supply of dobutamine is 500 mg in 250 mL of D5W.

1. Compute the number of micrograms and the number of milligrams per minute that the patient will receive.

micrograms per minute: __________               milligrams per minute: __________

ANS:

Per minute,

The patient will receive 800 mcg/min or 0.8 mg/min.

PTS:   1                    REF:   Pages 398-399

1. Compute the volume of millilitres infused per minute.               __________ mL/min

ANS:

There are 2 mg/mL or 2000 mcg/mL of medication supply

800 mcg of dobutamine are in 0.4 mL of IV solution.

800 mcg/min is delivered by a rate of 0.4 mL/min.

PTS:   1                    REF:   Pages 398-399

1. Compute the flow rate in mL/h.               __________ mL/h

ANS:

PTS:   1                    REF:   Pages 398-399

IVPD

Compute the answers to the following questions based on this information.

A patient’s IV fluids are to be limited. His continuous IV order is for 2000 mL of NS every 24 hours. He is to receive an IVPB of 150 mg of netromycin in 100 mL NS infused in 2 hours, every 8 hours. His IV flow rate is controlled by an infusion pump.

1. What is the flow rate of his IVPB?              __________ mL/h

ANS:

PTS:   1                    REF:   Pages 405-407

1. How many millilitres per day flow for his IVPB?               __________ mL/day

ANS:

Every 8 hours is 3 administrations/day

PTS:   1                    REF:   Pages 405-407

1. How many hours per day does his IVPB flow?

ANS:

PTS:   1                    REF:   Pages 405-407

How many millilitres per day will he receive with his regular IV?    __________ mL/day

How many hours will his continuous IV flow per 24 hours?         __________ hours/day

What will his regular IV flow rate be, in mL/hour?                __________ mL/h

ANS:

PTS:   1                    REF:   Pages 405-407

Standard Weight Heparin

The following questions refer to a patient who is on IV heparin therapy according to the “Standard Weight Based Heparin Protocol” noted below. The patient weighs 144 pounds. On admission the patient’s aPTT is 30 seconds. IV heparin therapy is initiated at 1130 on 06/06/XX. Record your answers in the spaces below unless provided with the “Standard Weight Based Heparin Protocol Worksheet” by your instructor.

 Standard Weight Based Heparin Protocol For all patients on heparin drips: 1.   Weight in KILOGRAMS. Required for order to be processed: ______ kg 2.   Heparin 25 000 units in 250 mL of 1/2 NS. Boluses to be given as 1000 units/mL. 3.   aPTT q6h or 6 hours after rate change; daily after two consecutive therapeutic aPTTs. 4.   CBC initially and repeat every ______ day(s). 5.   Obtain aPTT and PT/INR on day one prior to initiation of therapy. 6.   Guaiac stool initially then every ______ day(s) until heparin discontinued. Notify if positive. 7.   Neuro checks every ______ hours while on heparin. Notify physician of any changes. 8.   D/C aPTT and CBC once heparin drip is discontinued unless otherwise ordered. 9.   Notify physician of any bleeding problems. 10.  Bolus with 80 units/kg.  Start drip at 18 units/kg/h. 11.  If aPTT is < 35 secs:         Rebolus with 80 units/kg and increase rate by 4 units/kg/h 12.  If aPTT is  36–44 secs:     Rebolus with 40 units/kg and increase rate by 2 units/kg/h 13.  If aPTT is  45–75 secs:     Continue current rate 14.  If aPTT is  76–90 secs:     Decrease rate by 2 units/kg/h 15.  If aPTT is > 90 secs:         Hold heparin for 1 hour and decrease rate by 3 units/kg/h

1. What is the patient’s weight as measured in kilograms? (Round to the nearest 10 kg.)

__________ kg

What do the protocol/sample orders indicate for the standard bolus dosage of heparin for this patient?

__________ U/kg

ANS:

PTS:   1                    REF:   Pages 379-387

1. Calculate the dosage of heparin that should be administered for the bolus for this patient.

__________ units

What does the protocol indicate as the required solution concentration (supply dosage) of heparin to use for the bolus?

__________ units/mL

Calculate the dose volume of heparin that should be administered for the bolus for this patient.

__________ mL

ANS:

PTS:   1                    REF:   Pages 379-387

1. What do the protocol/sample orders indicate for the initial infusion rate for this patient?

__________ units/kg/h

Calculate the dosage of heparin this patient should receive each hour.

__________ units/h

What do the protocol/sample orders indicate as the required solution concentration (supply dosage) of heparin to use for the initial infusion?

__________ units/mL

Calculate the heparin solution volume this patient should receive each hour to provide correct infusion for the patient’s weight.

__________ mL/h

ANS:

PTS:   1                    REF:   Pages 379-387

1. According to the protocol/sample orders, how often should the patient’s aPPT be checked? q__________h

At 1730, the patient’s aPPT is 38 seconds. Rebolus with heparin

__________ units                    (__________ mL)

How much should you change the infusion rate?

__________ increase or __________ decrease heparin __________ units/h and __________ mL/h

The new infusion rate will be heparin __________ mL/h.

ANS:

6 h

PTS:   1                    REF:   Pages 379-387

1. At 2345, the patient’s aPPT is 46 seconds. What should you do now?

ANS:

Maintain rate at 14 mL/h

PTS:   1                    REF:   Pages 379-387

1. At 0600 on 06/07/XX, the patient’s aPPT is 50 seconds. What should you do now?

When should the aPPT be checked again?       __________ (hours) on __________ (date)

ANS:

Maintain rate at 14 mL/h

Recheck aPPT at 0600 on 06/08/XX

PTS:   1                    REF:   Pages 379-387

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