21.

The healthcare provider prescribes propofol (Diprivan) at 8 mcg/kg/minute for a

client during conscious sedation. The drug is dispensed as a econdary infusion

labled, 0.9% normal saline 50 ml with propofol 100 mg/50 ml The client's weight is

198 pounds. The nurse should program the infusion pump to deliver how many

ml/hour? (Enter numeric value only. If rounding is required, round to the nearest

tenth.)

Rationale
The client's weight in kg is 90 kg (198 pounds / 2.2 pounds).
Next, determine the total mcg in the NS infusion (1 mg : 1000 mcg :: 100 mg :
100,000 mcg)
and the IV concentration per ml (100,000 mcg : 50 ml :: X mcg : 1 ml). 100,000 / 50
= 2000 mcg/ml.
Then, calculate the prescribed dose (mcg/kg/min) x 60 min/hour x kilograms
divided by concentration (mcg/ml).
8 x 90 x 60 divided by 2000 = 21.6 ml/hour

Fill in the blank

10.5

An adult client with myasthenia gravis is receiving pyridostigmine (Mestinon) 126

mg PO every 4 hours. The drug is available as 60 mg in 5 ml syrup. How many ml

should the nurse administer? (If rounding is required, round to the nearest tenth.)

Rationale
Using the formula, Desired dose / dose on Hand x Quantity of volume on hand
(D/H x Q)
126 mg / 60 mg x 5 ml = 10.5 ml
Fill in the blank

4.9

A client who weighs 65 kg is receiving an infusion of Dextrose 5% in Water (D5W)

250 ml with dopamine 400 mg at 12 ml/hour. How many mcg/kg/minute is the

client receiving? (Enter numeric value only. If rounding is required, round to the

nearest tenth.)

Rationale
Using the formula, mg/ml x 1000 ml x ml/hour / 60 / kg = mcg/kg/minute
400/250 x 1000 x 12 / 60 / 65 = 4.9 mcg/kg/minute
The solution on hand is 1.6 mg/ml x 12 hours = 19.2 mg
19.2 mg x 1000 mcg = 19,200 mcg / 65 kg = 295.38 / 60 minutes = 4.92 = 4.9

Fill in the blank

75
The healthcare provider prescribes a continuous infusion of dextrose 5% in

water with isoproterenol (Isuprel) 2 mg in 500 ml at a rate of 5 mcg/minute for a

client with cardiac arrhythmia. The nurse should program the infusion pump to

deliver how many ml/hour? (Enter numeric value only. If rounding is required,

round to the nearest hundredth.)

Rationale
First using the known conversion 1 mg = 1000 micrograms.
Next, calculate the number of micrograms in solution: 1mg = 1000 mcg :: 2 mg =
2000 mcg
Then calculate how many ml of solution contain 5 mcg dose/minute: 2000 mcg :
500ml :: 5 mcg : X ml
2000/5 :: 500/X
X = 1.25 ml/minute
Calculating ml/hour: 1.25 ml x 60 minutes = 75 ml/hour

Fill in the blank

A client with Parkinson’s disease is receiving benztropine (Cogentin) 3.5 mg PO

twice daily. The medication is available in 0.5 mg tablets. How many tablets

should the nurse administer for each dose? (Enter numeric value only.)

Rationale
Using D/H: 3.5 mg / 0.5 mg = 7 tablets
Fill in the blank

2.5

The healthcare provider prescribes furosemide (Lasix) 25 mg IV. The drug is

available in a solution of 40 mg/4ml. How many ml should the nurse administer?

(Enter numeric value only. If rounding is required, round to the nearest tenth.)

Rationale
Using the formula D/H x Q: 25 mg/40 mg x 4 ml = 2.5 ml

Fill in the blank

A client with coronary artery disease receives a prescription for clopidogrel

(Plavix) 300 mg PO. The medication is available in 75 mg tablets. How many

tablets should the nurse administer? (Enter numeric value only.)

Rationale
Using the formula, Desired/Have: 300 mg/75 mg = 4 tablets

Fill in the blank

25.8

A client weighing 86 kg is receiving dopamine at 8 mcg/kg/minute. The drug is

dispensed as dopamine 800 mg/500 ml. The nurse should program the infusion

pump to deliver how many ml/hour? (Enter numeric value only. If rounding is

required, round to the nearest tenth.)

Rationale
First, change the concentration of dispensed dopamine to mcg/ml. 1 mg : 1000
mcg :: 800 mg : X mcg = 800,000 mcg/500 ml = 1600 mcg/ ml.
Using the formula, prescribed dose (8 mcg/kg/minute) x 60 minute/hour x weight
(86 kg) divided by the concentration of the available drug (1600 mcg/ml) = 8 x 60 x
86 divided by 1600 = 25.8 ml/hour

Fill in the blank

40

A client with acute decompensated heart failure (HF) is to receive an IV infusion

of 0.9% normal saline with inamrinone (Inocor) 0.1 grams/100 ml at a rate of 8

mcg/kg/minute. The client' s current weight is 183 lbs. The nurse should program
the infusion pump to deliver how many ml/hour? (Enter numeric value only. If

rounding is required, round to the nearest whole number.)

Rationale
First convert the weight into kilograms: 183 pounds/2.2 kg = 83 kg
Next calculate the number of mcg/kg/minute: 8 x 83 = 664 mcg/min
Calculate the number of mcg/hour: 664 x 60 minutes = 39,840 mcg/hour
Now calculate the number of ml/hour needed to administer 39,840 mcg/hour:
100,000 mcg : 250 ml :: 39,840 mcg : X = 100,000/39,840 :: 250/X and 100,000X =
3,984,000
X = 39.84 (rounded to) 40 ml/hour

Fill in the blank

0.3

The healthcare provider prescribes thiamine HCL 0.03 grams IM TID for a client

with beriberi. Thiamine is available for injection 100 mg/ml. The nurse should

prepare to administer how many ml? (Enter numeric value only. If rounding is

required, round to the nearest tenth.)

Rationale
Using the known conversion: 1 gram = 1000 mg as 0.03 gram = 30 mg
Next, using the Desired / Have x 1 ml formula:
30 mg / 100 mg x 1 ml = 0.3 ml

Fill in the blank

 12

Oxytocin (Pitocin) 4 milliunits/minute IV is prescribed for a client with an

ineffective contraction pattern. To administer the prescribed dosage, the nurse

adds 20 units of oxytocin to Ringer's Lactate 1,000 ml . The infusion pump should

be set to deliver how many ml/hour. (Enter numeric value only.)

Rationale
4 milliunits/min x 1 unit/1000 milliunits x 1000 ml/20 units x 60 min/hr =
240,000/20,000 = 12 ml/hour

Amoxicillin 500 mg PO every 8 hours is prescribed for a client with an

infection. The drug is available in a suspension of 125 mg/5ml. How
many ml should the nurse administer with each dose?

<p> <div> <font> <span> <b>Amoxicillin 500 mg PO every 8 hours is prescribed for a
client with an infection. The drug is available in a suspension of 125 mg/5ml. How many
ml should the nurse administer with each dose? </b> </span> </font> </div> </p>
20 ml.
4 ml.
100 ml.
10 ml.
Rationale120
500 : X :: 125 : 5
125X = 2,500
X = 20 ml
Fill in the blank

120

A client experiencing ventricular tachycardia receives a prescription a

continuous infusion of dextrose 5% in water (D5W) 1000 ml with

lidocaine (Xylocaine) 2 grams at a rate of 4 mg per minute. The nurse should

program the infusion pump to deliver how many ml/hour? (Enter numeric value

only. If rounding is required, round to the nearest whole number.)

Rationale
First convert solution gram/ml to milligrams/ml: 2 gm/1000 ml = 2000 mg/1000 ml
= 2 mg/ml
Next calculate the number of mg/hour for the dose: 4 mg X 60 minutes = 240
mg/hour
Next calculate the number of ml/hour needed to administer 240 mg/hour: 2000
mg: 1000 ml :: 240 mg : X ml
2000/240 = 1000/X
X = 120 ml/hour

Fill in the blank

140

The nurse is preparing a tube feeding of Ensure 280 ml (50% solution). Full

strength Ensure is available in a 240 ml can. The nurse should use how many ml

of Ensure to prepare the feeding? (Enter numeric value for only. If rounding is

required, round to nearest whole number.)

Rationale
Using the formula D/H (Desired % / % on Hand) x Total volume desired:
50/100 x 280ml = 0.5 x 280 ml = 140 ml Ensure + 140 ml water = 280 ml (50%
solution)
Fill in the blank

167

A client with hypernatremia is to receive an IV infusion of 1000 ml 5% dextrose in

water to be infused over 6 hours. The nurse should program the infusion pump to

deliver how many ml/hour? (Enter numeric value only. If rounding is required,

round to the nearest whole number.)

Rationale
Calculate using the ratio: 1000 ml : 6 hours :: X ml : 1 hour
1000/X :: 6/1
6X = 1000
X = 167 ml/hour

Fill in the blank

188

A client admitted to the unit from the emergency room receives a prescription for

an IV infusion of 0.9% sodium chloride 1,000 ml at 750 ml/4 hours. The IV

administration set delivers 60 gtts/ml. The nurse should regulate the infusion to
deliver how many gtts/minute? (Enter numeric value only. If rounding is required,

round to the nearest whole number.)

Rationale
First convert hours to minutes: 4 hours x 60 = 240 minutes
Using formula Volume/Time x gtt factor: 750 ml/240 min = 3.125 x 60gtts = 187.5
(rounding to) 188 gtts/minute

Fill in the blank

1.8

A client who has heart failure with paroxysmal atrial tachycardia is receiving

digoxin (Lanoxin) 0.45 mg IV as the inital digitalizing dose. The pharmacy

provides 0.25 mg/ml. How many ml should the nurse administer? (Enter numeric

value only. If rounding is required, round to the nearest tenth.)

Rationale
Using the formula D/H x Q = 0.45 mg/0.25 mg x 1 mL = 1.8 ml

A client is receiving Dextrose 5% in Water (D5W) 1,000 ml at 75 ml/hour.

The nurse hangs the bag of IV fluids at 0300. At what time, based on the
24-hour clock, should the infusion be completed?
<p> <b> <b>A client is receiving </b> <b> <b>Dextrose 5% in Water </b>
<b>(D₅W) </b> </b> <b>1,000 ml at 75 ml/hour. The nurse hangs the bag
of IV fluids at 0300. At what time, based on the 24-hour clock, should the infusion be
completed?</b> <br/> </b> </p>
 1620.
1630.
0420.
0430.
Rationale
Calculate the number of hours an IV bag of 1,000 ml should infuse, 1,000 ml / 75
ml/hour = 13.3 hr = 13 hours 20 minutes.

Calculate the time, 0300 AM + 1320 = 1620 by the 24-hour clock (or 4:20 PM).

Fill in the blank

650

A client is receiving acetaminophen (Tylenol) 0.65 gram PO every 6 hours PRN

for pain. Acetaminophen is available in 325 mg tablets. How many milligrams

should the nurse administer? (Enter numeric value only.)

Rationale
Using the known equivalent, 1 gram = 1000 mg, the nurse should first convert the
dose to the same unit of measurement, which is 0.65 grams = 650 mg.

Fill in the blank

1.5
The nurse plans to administer labetalol hydrochloride (Trandate) 0.3 grams PO to

a client with hypertension. Trandate is available in 200 mg scored tablets. How

many tablets should the nurse administer? (Enter numeric value only.)

Rationale
First convert grams to milligrams using the known conversion: 1 gram = 1000 mg.
0.1 gram = 100 mg as 0.3 gram = 300 mg
Next using the formula, Desired/Available x 1 tablet =
300 mg/200 mg x 1 = 1.5 tablets

Fill in the blank

35

The healthcare provider prescribes an infusion of Dextrose 5% in

Water (D5W) with sodium nitoprusside (Nitropress) 100 mg/250 ml at a rate of 4

mcg/kg/minute for a client in hypertensive crisis. The client's current weight is

130 pounds. The nurse should program the infusion pump to deliver how many

ml/hour? (Enter numeric value only. If rounding is required, round to the nearest

whole number.)

Rationale
First convert the weight into kilograms: 130 pounds/2.2 kg = 59 kg
Next calculate the number of mcg/kg/minute: 4 x 59 = 236 mcg/minute
Calculate the number of mcg/hour: 236 x 60 minutes = 14,160 mcg/hour
Now calculate the number of ml/hour needed to administer 14,160 mcg/hour:
100,000 mcg : 250 ml :: 14,160 mcg : X
100,000/14,160 :: 250/X
100,000X = 3,540,000
X = 35.4 (rounded to) 35 ml/hour
Fill in the blank

0.13

The healthcare provider prescribes phytonadione (AquaMEPHYTON) 250 mcg IM

to be administered to an infant within 1 hour of admission to the nursery. A 0.5 ml

ampule labeled 2 mg in 1 ml is available. The nurse should administer how many

ml? (Enter numeric value only. If rounding is required, round to the nearest

hundredth.)

Rationale
Change mcg to mg, 1000 mcg = 1 mg
Use ratio and proportion to calculate the dose: 2 mg : 1 ml :: 0.25 mg : X ml
2X = 0.25 mg
X = 0.125 =0.13 ml

Fill in the blank

37.3

The nurse needs to calculate a client's oral temperature of 99.2??? Fahrenheit to

Celsius. What temperature in Celsius should the nurse document? (Enter numeric

value only. Round to the nearest tenth.)

Rationale
Use the formula to convert Fahrenheit to Celsius, Fahrenheit temperature (99.2)
minus 32 divided by 1.8 = 37.3 degrees Celsius.
Fill in the blank

A healthcare provider prescribes an IV infusion of 0.9% normal saline 1,000 ml

with oxytocin (Pitocin) 30 units at a rate of 1 mu/minute for a client at 42-weeks

gestation. The nurse should program the infusion pump to deliver how many

ml/hour? (Enter numeric value only. If rounding is required, round to the nearest

whole number.)

Rationale
First calculate the number of units/hour: 0.001 units/minute x 60 minutes = 0.06
units/hour
Next calculate the number of ml/hour needed to administer 0.06 units/hour: 30
units: 1000ml :: 0.06 units : X =
30/0.06 :: 1000/X
30X = 60
X = 2 ml/hour

40

A client with acute decompensated heart failure (HF) is to receive an IV infusion of 0.9% normal saline
with inamrinone (Inocor) 0.1 grams/100 ml at a rate of 8 mcg/kg/minute. The client' s current weight is
183 lbs. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric
value only. If rounding is required, round to the nearest whole number.)

Rationale
First convert the weight into kilograms: 183 pounds/2.2 kg = 83 kg

Next calculate the number of mcg/kg/minute: 8 x 83 = 664 mcg/min

Calculate the number of mcg/hour: 664 x 60 minutes = 39,840 mcg/hour

Now calculate the number of ml/hour needed to administer 39,840 mcg/hour:

100,000 mcg : 250 ml :: 39,840 mcg : X = 100,000/39,840 :: 250/X and 100,000X = 3,984,000

X = 39.84 (rounded to) 40 ml/hour

Fill in the blank

206

A client who had a small bowel resection two weeks ago is receiving 3/4 strength Ensure feedings 275
ml every 4 hours via nasogastric tube. Full strength Ensure is available in a 240 ml can. The nurse should
use how many ml of Ensure to prepare the feeding? (Enter numeric value only. Round to nearest whole
number if needed.)

Rationale

Using the formula Desired % / on Hand % x Volume Desired = 75/100 x 275 = 0.75 x 275 = 206 Ensure

206 ml Ensure + 69 ml water = 275 ml (75% solution)

Fill in the blank

3.2

A client receives a prescription for tobramycin sulfate (Nebcin) 0.128 grams IV every 8 hours.
Tobramycin is available in liquid concentration of 40 mg/ml. How many ml should the nurse administer?
(Enter numeric value only. If rounding is required, round to the nearest tenth.)

Rationale

First using the known conversion: 1 gram = 1000 mg = 0.128 gram = 128 mg

Next use the Desired/Have x 1 ml = 128 mg/40 mg x 1ml = 3.2 ml

Fill in the blank

1.5

A client with multiple sclerosis and muscle spasms receives a prescription for baclofen (Kemstro) 30 mg
PO daily. The medication is supplied from the pharmacy in 20 mg scored tablets. How many tablets
should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest
tenth.)

Rationale

Use ratio and proportion, 30 mg : X tablets = 20 mg : 1 tablet

20X = 30

X = 1.5

Amoxicillin 500 mg PO every 8 hours is prescribed for a client with an infection. The drug is available in a
suspension of 125 mg/5ml. How many ml should the nurse administer with each dose?

<p> <div> <font> <span> <b>Amoxicillin 500 mg PO every 8 hours is prescribed for a client with an
infection. The drug is available in a suspension of 125 mg/5ml. How many ml should the nurse
administer with each dose? </b> </span> </font> </div> </p>

20 ml.

Rationale

500 : X :: 125 : 5

125X = 2,500

X = 20 ml

Fill in the blank

188

A client admitted to the unit from the emergency room receives a prescription for an IV infusion of 0.9%
sodium chloride 1,000 ml at 750 ml/4 hours. The IV administration set delivers 60 gtts/ml. The nurse
should regulate the infusion to deliver how many gtts/minute? (Enter numeric value only. If rounding is
required, round to the nearest whole number.)

Rationale

First convert hours to minutes: 4 hours x 60 = 240 minutes

Using formula Volume/Time x gtt factor: 750 ml/240 min = 3.125 x 60gtts = 187.5 (rounding to) 188
gtts/minute

Fill in the blank

0.3

The healthcare provider prescribes thiamine HCL 0.03 grams IM TID for a client with beriberi. Thiamine
is available for injection 100 mg/ml. The nurse should prepare to administer how many ml? (Enter
numeric value only. If rounding is required, round to the nearest tenth.)

Rationale

Using the known conversion: 1 gram = 1000 mg as 0.03 gram = 30 mg

Next, using the Desired / Have x 1 ml formula:

30 mg / 100 mg x 1 ml = 0.3 ml

Fill in the blank

35

The healthcare provider prescribes an infusion of Dextrose 5% in Water (D5W) with sodium
nitoprusside (Nitropress) 100 mg/250 ml at a rate of 4 mcg/kg/minute for a client in hypertensive crisis.
The client's current weight is 130 pounds. The nurse should program the infusion pump to deliver how
many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

Rationale

First convert the weight into kilograms: 130 pounds/2.2 kg = 59 kg

Next calculate the number of mcg/kg/minute: 4 x 59 = 236 mcg/minute

Calculate the number of mcg/hour: 236 x 60 minutes = 14,160 mcg/hour

Now calculate the number of ml/hour needed to administer 14,160 mcg/hour: 100,000 mcg : 250 ml ::
14,160 mcg : X

100,000/14,160 :: 250/X

100,000X = 3,540,000

X = 35.4 (rounded to) 35 ml/hour

Fill in the blank

60

The healthcare provider prescribes a continuous feeding of half strength Osmolite 240 ml to be infused
every 4 hours for a client with a gastrostomy tube (GT). The nurse should program the enteral pump to
deliver how many ml/hour? (Enter numeric value only).

Rationale

The continuous feeding is regulated using the prescribed volume/time, ml/hour.

240 ml/4 hour = 60 ml/hour

Fill in the blank

16.8

The healthcare provider prescribes an intermittent infusion of nafcillin (Unipen) 800 mg IV for a
pediatric client. The drug is dispensed in a concentration of 250 mg/ml, and the recommended infusion
concentration is 40 mg/ml. When adding the prescribed dose to the volume control device, how many
ml of IV solution should the nurse add to dilute? (Enter numeric value only. If rounding is required,
round to the nearest tenth.)

Rationale

First, calculate the amount of milliliters of medication needed to provide 800 mg of nafcillin. Prescribed
dose (800 mg) divided by dose on hand (250 mg/ml) equals 3.2 ml

Next, determine the recommended concentration using equivalent fractions. 800 mg/X = 40 mg/1 ml
40X = 800 = 20 ml (the total volume at the recommended concentration)

20 ml (total volume) minus the 3.2 ml (800 mg dose) equals an additional 16.8 ml of fluid to be added to
the volume control device to obtain the recommended concentration.

Fill in the blank

83

A client returning from surgery has a prescription for an IV of 0.9% sodium chloride to be infused at 250
ml over 3 hours. The nurse should program the infusion pump to deliver how many ml/hour? (Enter
numeric value only. If rounding is required, round to the nearest whole number.)

Rationale

250 ml : 3 hours :: X : 1 hour

250/X :: 3/1

250: 3X

X = 83 ml/hour

Fill in the blank

12

Oxytocin (Pitocin) 4 milliunits/minute IV is prescribed for a client with an ineffective contraction

pattern. To administer the prescribed dosage, the nurse adds 20 units of oxytocin to Ringer's Lactate
1,000 ml . The infusion pump should be set to deliver how many ml/hour. (Enter numeric value only.)

Rationale

4 milliunits/min x 1 unit/1000 milliunits x 1000 ml/20 units x 60 min/hr = 240,000/20,000 = 12 ml/hour

Fill in the blank

36

A client scheduled for a stress echocardiogram is to receive an IV infusion of Dextrose 5% in Water

(D5W) with dobutamine (Dobutrex) 0.5 grams/250 ml at a rate of 1,200 mcg/minute. The nurse should
program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is
required, round to the nearest whole number.)

Rationale

First calculate the number of mcg/hour: 1,200 x 60 minutes = 72,000 mcg/hour

Next calculate the number of ml/hour needed to administer 72,000 mcg/hour

500,000 mcg : 250 ml :: 72,000 mcg : X

500,000 / 72,000 :: 250 / X

500,000X = 18,000,000

X = 36 ml/hour

Fill in the blank

0.8

A 9-month-old infant receives a prescription for digoxin 40 mcg PO daily. Digoxin Oral Solution, USP 50
mcg (0.05 mg) per ml is available. How many ml should the nurse administer? (Enter the numerical value
only. If rounding is required, round to the nearest tenth.)

Rationale

Using ratio and proportion, 40 mcg : X ml :: 50 mcg : 1 ml = 0.8 ml

Fill in the blank

0.5

A client receives a prescription for levothyroxine sodium (Synthroid) 0.05 mg by mouth once daily. The
medication is available in scored tablets labeled 0.1 mg. How many tablets should the nurse administer?
(If rounding is required, round to the nearest tenth.)

Rationale
Using the formula, Desired / Available x 1 tablet =

0.05/0.1 x 1 = 0.5

Fill in the blank

A client with coronary artery disease receives a prescription for clopidogrel (Plavix) 300 mg PO. The
medication is available in 75 mg tablets. How many tablets should the nurse administer? (Enter numeric
value only.)

Rationale

Using the formula, Desired/Have: 300 mg/75 mg = 4 tablets

Fill in the blank

100

An IV infusion of 0.9% normal saline 500 ml with ammonium chloride 0.2 mEq/ml is prescribed for a
client who was admitted for an amphetamine overdose. How many mEq of ammonium chloride should
the nurse use to prepare the solution? (Enter numeric value only. If rounding is required, round to the
nearest whole number.)

Rationale

0.2 mEq x 500 ml = 100 mEq

Fill in the blank

5.7

A child weighing 28.4 kg is in hypertensive crisis. The healthcare provider prescibes methyldopa
(Aldomet) 40 mg/kg/day IV in 4 divided doses. The pharmacy provides a 50 mg/ml injection vial. How
many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the
nearest tenth.)

Rationale

First calculate the total mg dose/day: 40 mg x 28.4 kg = 1136 mg/day

Next divide the total mg into the 4 dosages for the day: 1136 mg/4 doses = 284 mg/dose

Using the Desired/Have formula: 284 mg/50mg x 1 ml = 5.68 ml/ dose, rounded to 5.7 ml.

Fill in the blank

A client with a Trichomonas vaginalis infection receives a prescription for metronidazole (Flagyl) 1 gram.
The medication is available in 500 mg tablets. How many tablets should the nurse administer? (Enter
numeric value only.)

Rationale

1 gram = 1000 mg

1 tablet :: 500 mg = X tablets :: 1000 mg

X = 1000/500 = 2 tablets

Fill in the blank

200

The nurse is preparing to administer vancomycin (Vancocin) 750 mg in 250 ml of Dextrose 5% in Water
(D5W) over 75 minutes. The secondary infusion pump should be programmed to administer how many
ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

Rationale

250 ml of the antibiotic is to infuse over 75 minutes or 1.25 hours

250 ml divided by 1.25 hour equals = 200 ml/hour

The healthcare provider prescribes diltiazem (Cardizem) 0.87 mg PO four times daily for an infant who
weighs 22 pounds. The recommended maximum dose is 3.5 mg/kg/day. What action should the nurse
take?

<p> <div> <font> <span> <b>The healthcare provider prescribes diltiazem (Cardizem) 0.87 mg PO four
times daily for an infant who weighs 22 pounds.</b> </span> </font> <font> <span> <b> The
recommended maximum dose is 3.5 mg/kg/day.</b> </span> </font> <font> <span> <b/> </span>
</font> <font> <span> <b> What action should the nurse take? </b> </span> </font> </div> </p>

Notify the healthcare provider.

Rationale

Calculate the recommended maximum dose, 22 pounds = 10 kg, so 3.5 mg x 10 kg = 35 mg.

Calculate the prescribed daily dose. 0.87 mg x 4 doses = 3.48 = 3.5 mg/day.

The prescribed daily dose 3.5 mg/day is below the recommended dose of 35 mg, which may be a
misplaced decimal in the prescription.

The healthcare provider should be notified for clarification of the dosage.

Fill in the blank

10

The nurse programs an IV infusion pump of Ringer's Lactated 1,000 ml with oxytocin (Pitocin) 40 units
to be delivered at 15 ml/hour. How many milliunits/minute is the client receiving? (Enter numeric value
only, whole number.)

Rationale

Convert units to milliunits, 40 x 1,000 = 40,000 milliunits. Using D/H x Q = 15 ml/hour: X/40,000
milliunits x 1,000 ml = 15 ml/hour (60 minutes)

X/40 =15/60

60X = 600

X = 10
120

A client experiencing ventricular tachycardia receives a prescription a continuous infusion of dextrose

5% in water (D5W) 1000 ml with lidocaine (Xylocaine) 2 grams at a rate of 4 mg per minute. The nurse
should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding
is required, round to the nearest whole number.)

Rationale

First convert solution gram/ml to milligrams/ml: 2 gm/1000 ml = 2000 mg/1000 ml = 2 mg/ml

Next calculate the number of mg/hour for the dose: 4 mg X 60 minutes = 240 mg/hour

Next calculate the number of ml/hour needed to administer 240 mg/hour: 2000 mg: 1000 ml :: 240 mg :
X ml

2000/240 = 1000/X

X = 120 ml/hour

Fill in the blank

140

The nurse is preparing a tube feeding of Ensure 280 ml (50% solution). Full strength Ensure is available
in a 240 ml can. The nurse should use how many ml of Ensure to prepare the feeding? (Enter numeric
value for only. If rounding is required, round to nearest whole number.)

Rationale

Using the formula D/H (Desired % / % on Hand) x Total volume desired:

50/100 x 280ml = 0.5 x 280 ml = 140 ml Ensure + 140 ml water = 280 ml (50% solution)

Fill in the blank

0.8

Heparin protocol is prescribed for a client weighing 90 kg. Per protocol, the heparin loading dose is 60
units/kg IV rounded to the nearest 100 units, with a maximum loading dose of 4,000 units. The heparin
vial is labeled 5,000 units/ml. How many ml should the nurse administer? (Enter the numeric value only.
If rounding is required, round to the nearest tenth.)

false Item 51164 By Sheila Duncan Heparin Protocol:

Heparin loading dose: 60 units/kg IV, rounded to the nearest 100 units, followed by a maintenance
infusion of 12 units/kg/hr, rounded to the nearest 100 units/hr. The maximum bolus is 4,000 units and
the maximum initial infusion is 1000 units/hr.

Rationale

Determine the client loading dose: 60 units x 90 kg = 5,400 unit.

Per protocol, use the maximum loading dose of 4,000 units, and calculate the client's dose using the
formula D/H x Q = 4,000 units / 5,000 units x 1 ml = 4/5 = 0.8 ml

or Use ratio and proportion: 5,000 : 1 ml :: 4,000 : X

X = 0.8 ml