RED RIVER COLLEGE
NURSING SKILLS LABORATORY
CALCULATIONS
PRACTICE TEST
1.
Please read questions carefully.
2.
Show your work for each answer. Be sure to:
• change all fractions to decimals
• round off to 2 decimal points for mL, mg and kg (where appropriate)
• for IV drip rates (gtt/ min) and flow rates (mL/ hr) round off to the nearest
whole number when applicable
• state the unit of measurement in each answer
3.
There are a total of 20 marks.
4.
The pass grade is 90% (18/20).
1.
GENTAMYCIN
For I.V. use
40mg/mL
Usual Dosage: Adults: 250mg in divided
daily doses
CAUTION: Federal law prohibits dispensing
without prescription.
Each vial contains equivalent of 400mg Gentamycin.
Dilution not required.
Discard open solution after 24 hours at room temperature
or 96 hours under refrigeration.
See enclosure for prescribing information.
EXPIRES 09/09/09
The physician’s order reads: Gentamycin 60 mg IV q8h
How many mLs are required for one dose?
2.
PHENOBARBITOL
For I.V. use only
1g/ 2mL
Usual Dosage: Adults: 100 mg IV
CAUTION: Federal law prohibits
dispensing without prescription.
Vial contains Phenobarbitol equivalent to 5g.
Keep from freezing.
Protect from light.
Discard open solution.
Read accompanying circular.
EXPIRES 09/09/09
The physician’s order reads: Phenobarbitol 100 mg IV daily X3
How many mLs are required for one dose?
3.
THIAMINE
HYDROCHLORIDE
For I.V. injection
100mg/mL
Vial contains equivalent of 1g Thiamine hydrochloride.
Dilution not required.
Discard open solution after 24 hours at room temperature
or 96 hours under refrigeration.
See enclosure for prescribing information.
EXPIRES 09/09/09
Usual Dosage: Adults: 250 IV daily
CAUTION: Federal law prohibits
dispensing without prescription.
The physician’s order reads: Thiamine hydrochloride 75mg IV tid for 2 weeks
How many mLs are required for one dose?
4.
ADENOSINE
For I.V. use only
3mg/2mL
Usual Dosage: Adults: 6mg IV; may repeat
for a maximum of 2 times
CAUTION: Federal law prohibits
dispensing without prescription.
Each vial contains 30mL.
Keep from freezing.
Discard open solution after 8 hours at room temperature or
72 hours under refrigeration.
Read accompanying circular.
EXPIRES 09/09/09
The physician’s order reads: Adenosine 6 mg IV stat
How many mLs are required for one dose?
5.
TAZIDIME
For I.V. use
500mg
CAUTION: Federal law prohibits
dispensing without prescription.
Add 5mL of sterile water for a final concentration
of 500mg/5mL
Stable for 24 hours at room temperature or 3 days in the
refrigerator.
Read accompanying circular.
EXPIRES 09/09/09
The physician’s order reads: Tazidime 200 mg IV q6h
a)
How many mLs are required for one dose?
b)
If there is medication left after you prepare your dose, how should you label the vial?
6.
TOBRAMYCIN
For I.V. use only
300mg
CAUTION: Federal law prohibits
dispensing without prescription.
EXPIRES 09/09/09
For a FINAL Concentration of:
Add sterile NS:
10mg/ mL
30 mL
50mg/ mL
6 mL
100mg/ mL
3 mL
Stable for 48 hours at room temperature or 7 days in the refrigerator.
Read accompanying circular.
The physician’s order reads: Tobramycin 75mg IV q8h
7.
8.
a)
Considering the information given above, how many mL of NS would you use to
reconstitute the medication? (give only one answer)
b)
Based on how you answered 6a above, how many mLs are required for one dose?
The physician’s order reads: Oxacillin 300 mg IV q6h
The patient weighs 43.5 kg.
The nursing drug guide recommends a maximum of 5 – 7.5 mg/kg/dose.
a)
What is the maximum safe dose for this patient?
b)
Is the ordered dose for your patient “safe”? (show your work to support how you
arrived at your answer)
The physician’s order reads: Ticar 35 mg IV q4h
The patient weighs 14 lb.
The nursing drug guide recommends a maximum of 20 - 30 mg/kg/day.
a)
What is the maximum safe individual dose for this patient?
b)
Is the ordered dose for your patient “safe”? (show your work to support how you
arrived at your answer)
9.
10.
11.
The physician’s order reads:
2 L of D5NS to infuse over 14 hours
a)
How many mL/ h will the IV need to run at in order to deliver the solution
as ordered?
b)
The drop factor of the IV tubing is 10 gtt/mL.
What should you set the drip rate (gtt/min) at in order to deliver the solution as ordered?
The physician’s order reads:
100mL of NS to infuse over 30 min
a)
How many mL/ h will the IV need to run at in order to deliver the solution
as ordered?
b)
The drop factor of the IV tubing is 60 gtt/mL.
What should you set the drip rate (gtt/min) at in order to deliver the solution as ordered?
The physician’s order reads:
1000mL of NS to infuse over 6 hours
a)
How many mL/ h will the IV need to run at in order to deliver the solution
as ordered?
b)
The drop factor of the IV tubing is 20 gtt/mL.
What should you set the drip rate (gtt/min) at in order to deliver the solution as ordered?
12.
13.
1 L of D5W is to run over 10 hours.
After 4 hours, there are 400 mL remaining in the bag.
a)
Is the IV ahead or behind?
(show your work to support how you arrived at your answer)
b)
Recalculate a new flow rate (mL/ h) in order to finish the IV on time.
c)
Does the new flow rate fit with acceptable practice? Explain your answer.
500 mL of NS is to run over 4 hours.
After 2 hours, there are 350 mL remaining in the bag.
a)
Is the IV ahead or behind?
(show your work to support how you arrived at your answer)
b)
Recalculate a new flow rate (mL/ h) in order to finish the IV on time.
c)
Does the new flow rate fit with acceptable practice? Explain your answer.
14.
PRONESTYL
For I.V. use
1mg/mL
Usual Dosage: Adults: 5mg per day for
10-14 days
CAUTION: Federal law prohibits
dispensing without prescription.
Contains the equivalent of 10mg Pronestyl.
Dilution not required.
Discard open solution immediately.
See enclosure for prescribing information.
EXPIRES 09/09/09
The physician’s order reads: Pronestyl 8 mg IV stat
You decide to give this by the direct IV method. The drug monograph states that IV infusion is
not to exceed 6 mg/ min.
15.
16.
a)
How many mLs are required for one dose?
b)
Over what period of time will you administer this dose? (if applicable, show your work
to support that the time period you select is safe)
c)
Based on how you answered 14b above, how many mLs is that q15seconds?
The physician’s order reads: Aminophylline 80 mg/ h IV
The drug is supplied in a bag containing 500 mg of Aminophylline in 50 mL of solution.
a)
What is the concentration (mg/ per 1 mL) of Aminophylline in the bag?
b)
At what rate (mL/ h) would you deliver the medication?
The physician’s order reads: Regular Insulin 1 unit/ h IV
The drug is supplied in a bag containing 10 units of Regular Insulin in 100 mL of solution.
a)
What is the concentration (units/ per 1 mL) of Regular Insulin in the bag?
b)
At what rate (mL/ h) would you deliver the medication?
DOSAGE CALCULATIONS PRACTICE TEST ANSWER KEY
X
1 mL =
1.
60 mg
40 mg
2.
100 mg
1000 mg
3.
75 mg
100 mg
4.
6 mg
3 mg
5a.
200 mg
500 mg
5b.
TAZIDIME 500 mg/ 5mL
05/05/05 1400h km
6a.
3 mL is the best choice because the final concentration matches the dose that you need to give.
However, it would also be acceptable to use 6 mL or 30 mL.
6b.
If you picked 3 mL for previous answer then:
X
X
X
2 mL =
1 mL =
2 mL =
X
75 mg X
100 mg
5 mL =
1.5 mL
0.2 mL
0.75 mL
4 mL
2 mL
1 mL =
0.75 mL
If you picked 6 mL for previous answer then:
75 mg
50 mg
X
1 mL =
1.5 mL
If you picked 30 mL for previous answer then:
75 mg
10 mg
X
1 mL =
7a.
7.5 mg
X
43.5 kg =
7b.
The maximum safe dose is 326.25 mg/ dose.
The patient is to receive 300 mg so →
7.5 mL
326.25 mg/ dose
YES the ordered dose is safe.
8a.
14 lb = 6.36 kg
2.2
30 mg
8b.
X
6.36 kg =
190.8 mg/ day
The maximum safe dose is 189 mg/ day.
The patient is to receive
35 mg X 6 doses = 210 mg/ day so →
9a.
2000 mL =
14 h
143 mL/ h
9b.
143 mL
60 min
10 gtt/mL =
X
10a. 100 mL = X__
30 min
60 min
10b. 200 mL
60 min
X
11b. 167 mL
60 min
X
200 gtt/ min
X = 167 mL/ h
20 gtt/mL =
12a. 1000 mL = X
10 h
1h
24 gtt/ min
X = 200 mL/ h
60 gtt/mL =
11a. 1000 mL = X__
6h
60 min
NO the ordered dose is not safe.
56 gtt/ min
X = 100 mL/ h
100 mL/ h X 4h = 400 mL should be infused
out of a 1000 mL bag so there should be 600 mL left
IV is AHEAD
in the bag. But there is 400 mL left so →
(so IV needs to be slowed down)
12b. 400 mL = X
6h
1h
X = 67 mL/ h
12c. It is usually acceptable practice to slow an YES, the new flow rate is acceptable.
IV, even to TKO →
13a. 500 mL = X
4h
1h
X = 125 mL/ h
125 mL/ h X 2h = 250 mL should be infused
out of a 500 mL bag so there should be 250 mL left in
IV is BEHIND
the bag. But there is 350 mL left so →
(so IV needs to be speeded up)
13b. 350 mL = X
2h
1h
X = 175 mL/ h
13c. Ordered rate is 125 mL/h.
New rate = 175 mL/ h
which is more than the
25% of 125 mL is 31 mL.
Therefore could safely ↑ flow rate by 31
mL to 156 mL/h →
14a. 8 mg
1 mg
X 1 mL =
acceptable 156 mL/h →
NO, the new flow
rate is not
acceptable.
8 mL
14b. Maximum rate is 6 mg/ min so
6 mg = 8 mg
min
X
X = 1.33 min
NOTE: Students are generally
required to give an IV medication
over a minimum of 2 minutes so you
should bump this answer up to
2
minutes. Because the drug
monograph gives you only a
minimum time for administering the
med, it is acceptable for you to
decide to do this.
14c. 2 min = 8 15 sec “blocks” so
15a. 500 mg
50 mL
=
8 mL
=
8 “blocks”
10 mg/ mL
15b. 80 mg X 1 mL =
10 mg
8 mL/h
16a. 10 units =
100 mL
0.1 units/ mL
16b.
10 mL/h
1 unit X 1 mL =
0.1 unit
1 mL/ 15 sec