PRACTICE EXERCISES SAFE AND ACCURATE MEDICATION ADMINISTRATION Please read and interpret the following orders: 1. Vantin (Cefpodoxime) 200 mg PO every 12 hours for 10 days a. Write the generic name: ______________________________. b. Write the trade name: _______________________________. c. What is the dosage of the drug? _________________________. d. What is the route of the drug? _____________________________. e. What is the frequency of the drug? _________________________. 2. Please read the label and answer the following questions. a. What is the trade name of the drug? ______________________.. b. What is the strength of the drug? ________________________. c. What is the form of the medication? ______________________.. d. What is class narcotic is this medication? ______________________. 3. Please read the following orders and determine the missing component: a. Wellbutrin XL (bupropion hydrochloride) PO QD. ________________________________________. 1 b. Glucotrol (glipizide) 1 tab before breakfast. ___________________________________________. c. Ambien (zolpidem tartrate)10 mg PO. _________________________________________________. d. Ibuprofen PO stat________________________________________________________________ . e. Timoptic (timolol) maleate 1 drop BID_____________________________________________. 4. Please read the following orders and interpret. a. A drug is ordered 15 mg daily. How many mg should the nurse administer? _________________________________________________. b. A drug is ordered 5 mg BID. How many mg should the nurse administer per dose_______________ and per day _________________________. c. A drug is ordered 2 mg every 12 hours. How many mg should the nurse administer per dose _____________and per day________________. d. A drug is ordered 4 mg every 6 hours. If the first dose is administered at 0700 and what time is the next dose due? ___________________. e. A client must receive a drug every 8 hours. If the first dose was administered at 1700, at what time should the next dose be administered? _____ f. A client was admitted to the ER at 0300 on Monday and was discharged 7 hours later. At what time did the client leave the emergency room?___ g. A drug is ordered 20 mg daily in two divided doses. How many mg should the nurse administer per dose ___________________ and per day_________________. 5. READ AND INTERPRET THE MAR 2 a. What is the frequency of Dilantin: ____________________________ b. How many doses of Bactrim were administered by Nurse Gordon from 12/7-12/10? _______________________ c. What drug should be taken 30 minutes before breakfast? ________________________________ d. Which drug was administered at 2000 on 12/10________________________________ 6. Please read the MAR and answer the following questions. 3 a. What is the route and frequency of Duragesic? b. What are the special instructions for metformin? 4 DIMENSIONAL ANALYSIS: HOUSEHOLD and METRIC SYSTEM Please solve the problems and apply the rounding rules. 1. If an infant weigh 8 lb and 5 ounces at birth. What is the weight in ounces? 2. What is the height in inches of a person that is 5 foot 6 inches? 3. If a client drinks 4 ounces of water every 6 hours. What is the total amount of water that the client drinks in 24 hours? 4. Read the label and determine: a. How many grams are in each tablet? 5 b. How many mg is in the entire container? 5. Read the label below and determine how many mg are contained in 2 tablets of Isentress? 6. A client output for a shift is 1250 mL. What is this amount in L (liters)? (round to the nearest 10th place). 7. The client’s output totaled 7.5 L in 24 hours. What is the client’s output in mL? 8. Determine the nurse of mg in 3 tablets of Levothyroxine tablets. Available is Levothyroxine 25 mcg tablet. 9. An infant weighs 0.50 kg. What is the infant weight in grams? 10. The prescription reads: Administer 2 teaspoons of medication every 4 hour. a. How many mL is the client receiving per dose? 6 b. How many mL is the client receiving per day? 11. A client is directed to drink 12 ounces of a laxative in preparation for a procedure. How many cups should the nurse indicate the client to drink? 12. The client weights 75 lbs. What is the client’s weight in Kg? 13. The order reads: administer 250 mg of Atgam every 12 hours. How many teaspoons should the nurse administer per dose? 14. A client is receiving 45 ml of a medication every 12 hours. How many tablespoons (tbs) should the nurse administer? 15. An infant drinks 240 mL every 4 hours. How many ounces is the infant drinking? 7 16. Read the label and determine: a. How many mg is contained in the entire container of Norvir? b. The order reads: administer Norvir 1.2 grams by mouth once a day. Please shade in the amount in the medication cup. 8 17. Determine how many teaspoons are contained in 10 mg of Namenda. Available is Namenda 2 mg / mL. 18. Please calculate how many mL are contained in 7.5 teaspoons of a medication. 19. A client weighs 300 lbs. What is the client’s weight in kg? 20. The order reads: Administer Biaxin 1,500 mg PO every 12 hours. a. How many mL should the nurse administer? b. Please shade in the amount in the cup. 9 10 ORAL MEDICATIONS AND MEDICATION PER WEIGHT 1. Order reads: tadafil 40 mg PO three times a day. The medication is available in three different strengths. These are the strength available: Tadafil 5 mg Tadafil 10 mg Tadafil 20 mg a. How many tablets should the nurse administer? b. Which combination of tablets should the nurse choose? 2. The prescriber orders Bosulif 500 mg PO daily to be given with food. Read the label and determine a. How many tablets should the nurse administer per dose? b. How many tablets are in the entire container? c. How many grams are contained in the entire container? 11 3. The prescriber ordered lithium citrate 0.6 grams po TID. The recommended maintenance dose range is 600 mg to 1200 mg in three divided doses. Read the label and determine: a. Determine if the prescribe dose is safe. b. If the dose is safe, determine many mL should the nurse administer. 12 4. The licensed prescriber orders furosemide 50 mg PO daily. Read the label and determine: a. How mL should the nurse administer to the client? b. Please shade the amount in the cups provided. 13 5. The prescriber ordered potassium chloride 30 meq po daily in two divided doses. Read the label and determine the number of mL that the nurse should administer per dose? 6. Order: Digoxin 0.75 mg PO stat. How many tablets should the nurse administer per dose? Available is 0.25 mg/ tab 7. A drug is ordered 6 mg/ kg po BID. How many tablets will a client receive is he weighs 148 lb and the strength of the tablet is 200 mg/ tab? 8. The order reads: Narcan 0.01 mg/ kg subcut state for a neonate who weighs 3,300 grams. The strength available is 0.4 mg/mL. How many mL will the nurse administer? 9. Order: Rocephin 1 gm IV q 12 hours. The client is a child who weighs 30 lbs. The recommended dose is 50-75 mg/kg/day once a day. Is the dose safe for this client? 14 10. Order: Erythromycin 125 mg PO every 4 hours. The child weighs 14.5 kg. The recommended dosage is 30 -50 mg/ kg. a. Is this dose safe for this client? b. If the dose is safe, please calculate how many mL should the nurse administer per dose if available is 125 mg/ mL. 11. The prescriber ordered 150 mg/ m2 of a drug PO q 6 hrs for 5 days for a client who has a BSA of 1.4 m2. How many grams will the client receive in 5 days? a. A drug is ordered 200 mg/ m2 PO BID. How many mL should the nurse administer if the client BSA is 1.34 m2? The concentration available is 5mg/mL. b. Calculate the BSA for a person who is 153 cm tall and who weighs 72 kg. 15 PARENTERAL MEDICATION ADMINISTRATION 12. Order reads: Meperidine 175 mg IM q 4 hrs PRN. a. Read the label and calculate how many mL should the nurse administer. b. Shade in the amount in the correct syringe. 16 2. Order: Streptomycin 820 mg IM daily. Please read the label, calculate the amount of mL to be administer and shade in the syringe provided. . 17 3. The nurse is caring for a client with a prescription to receive 40 mg of a drug IM every 12 hours. The strength of the drug is 10 mg/ mL. a. How many mL should the nurse administer? b. Please shade the correct amount in the correct syringe (s) provided. 18 4. The client weighs 56 Kg. The order is insulin aspart 0.5 units/ kg subcut daily 10 min ac. a. How many units should the nurse administer? b. Please shade the amount in the syringe provided. 5. Prescriber orders: Administer Humulin R subcut as per the following sliding scale. For glucose less than 160 mg/dl………………..no insulin Glucose 160 mg/dl-220 mg/dl…………………..give 2 units Glucose 221 mg/dl-280 mg/dl…………………..give 4 units Glucose 281 mg/dl- 340 mg/dl…………………give 6 units Glucose 341 mg/dl- 400 mg/dl………………….give 8 unitc Glucose greater than 400 mg/dl……………….Notify MD How many units should the nurse administer for the following glucose level. Please fill in the syringe. a. 155mg/dl? _________________________ b. 300 mg/dl? ________________________ 19 c. 500 mg/dl? ________________________ d. 320 mg/dl?________________________ 6. Administer 10 units of NPH insulin and 15 units of Regular insulin. Please shade in the amount of insulin in the syringe. Identify each insulin in the syringe provided. 20 SOLUTIONS 1. Which of the following is not considered a solution strength? 1:1000, 0.25%, 50 mL, ¼, 5 mg/ 2 mL, 200 mg 2. Read the label and determine how many mL of lidocaine viscous solution will contain 20 mg? 21 3. Use the IV bag shown in the picture to answer the questions. a. What is the name of the fluid in the bag? ______________________. b. What meaning of 5% dextrose? ______________________________. c. What is the size of the bag in the picture? ______________________. d. How many mg of dextrose is contained in 20 mL? _________________. e. How many grams of dextrose are contained in ½ of a liter of this fluid?_______________. 4. How many mg of fluconazole is contained in 400 mL of 0.2 % solution? 5. How would you prepare 1000 mL of a 20 % solution from a pure drug in solid form? 22 PARENTERAL MEDICATION ADMINISTRATION 1. The prescriber orders fentanyl 60 mcg IM prn for pain. Read the label and answer the questions. a. How many mL should the nurse administer? b. Please shade in the amount in the syringe provided? 23 2. The prescriber orders: Unasyn 2 g IV q 6 hrs. Use the information in packet to answer the questions. a. How much diluent must be added to the vial? b. What is the reconstituted volume in the vial? c. What is the strength of the reconstituted solution? d. How many mL of this antibiotic should the nurse administer? 24 3. Use the label to answer the following questions. a. How much diluent must be added to the vial to prepared 500,000 units/ mL strength? b. What strength would be available if you added 18.2 mL of diluent? c. The prescriber ordered penicillin G 2 million units IM every 4 hours. Which dose strength would you use? d. How many mL of this antibiotic should the nurse administer? 25 4. The order reads: heparin 6,000 units sub cut 8 hours. a. How many mL should the nurse administer? b. Please shade in the correct amount in the syringe? 5. Order: Simulet 10 mg/ m2 for 2 doses. Calculate how many mg of this medication should the nurse administer for a child who weighs 20 lb and is 26 inches long. 6. The order reads: Phenergan 12.5 mg IM every 4 hours. The vial is labeled 50 mg/1 mL. How many mL should the nurse administer? 26 7. Order: amikacin 8 mg/ kg IM every 12 hours. The strength of the vial is 250 mg/ mL. a. How many mL should the nurse administer for a child who weighs 54 lbs. b. Please select the correct syringe. 27 FLOW RATES AND DURATION OF ENTERAL AND INTRAVENOUS INFUSIONS. 1. A client is to receive 1 unit (500 mL) of packed red blood cells over 4 hours. What is the rate in mL/ hr? 2. Order: 500 mL NS IV running at 75 ml/hr. How many mL will infuse in 3 hours? 3. NS is infusing intravenously at 80 mL/ hr. How long will it take to 600 mL to infuse? 4. Order reads: Lactated ringer half of a litter is infusing from 1000 to 1600. What is the pump rate in mL/ hr? 5. A bolus of Normal Saline 15 mL/ kg over 3 hour is ordered for a 5-year-old client that weighs 18 kg. a. How many mL should the client receive? b. What is the rate in mL/hr? 6. Find the flow rate in gtt/ min for 650 mL to be infused in 5 hours with a drop factor of 15 gtt/ ml. 7. An IV solution is infusing at 32 gtt/ min. How many mL of this solution would the client receive in 6 hours if a microdrop tubing is used? 28 8. Please read the following bag and answer the questions. a. What is the total amount of fluid in the bag? ____________________________. b. How much fluid have infused? __________________________. c. Calculate the rate in mL/ hr for the remaining fluid in the bag. Infuse the solution in 4 hours. 9. An IV is infusing at a rate in 33 gtt/ min. The drop factor is 10gtt/ mL. Calculate the flow rate in mL/ hr. 10. An infusion of 400 mL of packed red blood cells that ran at 75 mL/hr. The bag was hung at 1620 on Friday. a. How long will the infusion last? b. At what time will the infusion be completed? 29 FLOW RATE AND DOSAGE RATES FOR INTRAVENOUS MEDICATIONS 1. Order: Ampicillin sodium 500 mg IVPB every 6 hours in 30 min. Find the dosage rate in mg/ min. 2. The concentration in the IV bag is 150 mg/ 200 mL. If the IV begins on Monday at 0800 and it must infuse with a dosage rate of 1.5 mg/ min. a. What is the infusion rate in mL/ hr? b. When will the IV finish? 3. An IV at 15 gtt/ min. The concentration in the IV bag is 40 mg in 250 mL NS. The drop factor is 10gtt/ mL. What is the dosage rate in mg/ min? 4. An IV is infusing at 80 mL/ hr. The concentration in the IV bag is 40 mg in 200 mL NS. What is the dosage rate in mg/ hr? 5. An IVPB infusion begins at 2000 on Thursday. The bag contains 150 mg of a drug in 200 mL of NS. The patient is receiving 3 mg/ min. When will the infusion finish? 6. Order desmopressin acetate 0.3 mcg/ kg IVPB on call for surgery. The label reads 4 mcg/ mL and the patient weighs 80 kg. a. How many mcg should the nurse administer to this patient? b. If the fluid is in 50 mL of NS to be infused in 30 min, please calculate the rate in mL/ hr. 30 7. The physician ordered Platinol 100 mg/ m2 IV to infuse over 8 hours. The patient’s BSA is 1.66 m2. a. How many mg of this medication should the patient receive? b. If the medication is diluted in 500 mL of D51/2 NS, what is the infusion rate in mL/hr? 31 ANSWER SHEET c. 2 mg per dose and 4 mg per day. d. 1900 SAFE AND ACCURATE MEDICATION ADMINISTRATION e. 2200 1. a. Vantin b. Cefpodoxime f. 1000 g. 10mg per dose and 20 mg per day. 5. c. 200mg a. T.I.D d. By mouth or PO b. 4 doses e. Every 12 hours c. Humulin N insulin 2. d. Bactrim a. Xanax 6. b. 0.5 mg a. Transdermal c. tablets b. With breakfast and dinner d. 4 3. a. Dosage DIMENSIONAL ANALYSIS: HOUSEHOLD AND METRIC SYSTEM b. Route c. Frequency d. Dosage e. Route 4 a. 15 mg once a day b. 5 mg per 1. 133 oz 2. 66 inches 3. 16 oz 4. a. 0.01 grams b. 1 grams dose and 10 mg per day 32 5. 800 mg b 6. 1.3 L 7. 7,500 mL 8. 0.075 mg 9. 500 mg 10. a. 10 mL b. 60 mL 11. 1.5 cup 12.34 kg 13. 1 tsp 14. 3 Tbs 15. 8 oz 16. 19.2 grams 17. 15 mL 18. 1 tsp 19. 1.5 tsp 20. 136 Kg 21. a. 30 mL ORAL MEDICATION AND MEDICATION PER WEIGHT. 1. a. Use the 20 mg strength and administer 2 tabs 2. a. 1 tab b. 30 tabs c. 15 grams 3. a. 600 mg, yes, it is safe b. 10 mL 33 4. SYRINGES a. 5 mL 1. b. a. 1.8 mL b. 2. 2.1 mL 3. 4 mL 5. 22.5 mL 6. 3 tabs 7. 2 tabs 8. 0.08 mL 9. Not safe, its an overdose 4. 10. a. 28 units a. Yes, it is safe b. b. 1 mL 11. 4.2 grams 12. 6 mL 13. 1.75 m2 34 5. PARENTERAL MEDICATIONS a. No insulin 1. b. 6 units a. 1.2 mL b. c. 4 units and notify MD 2. a. 6.4 mL d. 8 units b. 8 mL c. 3 g/ 8 mL d. 5.3 mL 6. Administer 25 units 3. a. 8.2 mL b. 250,000 units/ mL SOLUTIONS 1. 50 mL and 200 mg are not considered solutions. 2. 1 mL 3. a. Dextrose 5 % Water (D5%W) c. 250,00 units/ mL d. 0.8 mL 4. a. 0.6 mL b. b. Dextrose 5 grams/ 100 mL c. 1000 mL d. 1000 mg 5. 4 mg e. 25 grams 4. 0.8 grams 5. 200 grams 35 6. a. 0.5 mL b. 10. a. The infusion will last 5 hrs and 20 min b. Infusion will end at 2340 7. 0.78 mL FLOW RATE AND DOSAGE RATES FOR INTRAVENOUS MEDICATIONS 1. 16.7 mg/ min 2. FLOW RATES AND DURATION OF ENTERAL AND INTRAVENOUS INFUSIONS. 1. 125 mL/hr 2. 225 mL/hr 3. 7.5 hours 4. 83 mL/hr 5. a. 270 mL/hr b. 90 mL/hr 6. 33 gtt/ min 7. 192 mL a. 120 mL/hr b. Monday at 0940 3. 0.24 mg/min 4. 16 mg/hr 5. 50 min 6. a. 24 mcg b. 100 mL/ hr 7. a. 166 mg b. 63 mL/hr. 8. a. 500 mL b. 200 mL c. 75 mL/hr 9. 198 mL/ hr 36 37
