Review ATI LPN Pharmacology and dosage calculation

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ATI LPN Pharmacology and dosage calculation

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Total Questions : 45

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Question 1:

Order: Levaquin 350 mg is added to 500 mL D5W to infuse over 8 hours. Drop factor: 10 gtt/mL. For IV reconstitute with 1o mL. of diluent to get 100 mg per 10 mL. (Consider the medication added in the volume of fluid.) Calculate the rate in gtt/min at which the IV should infuse

A. 7 gtt/min B. 11 gtz/min C. 10 gtt/min D. 100 gtt/min

Answer and Explanation

Choice B:

Given:
Volume of fluid: 500 mL
Infusion time: 8 hours
Drop factor: 10 gtt/mL
Medication volume: 10 mL (added to the fluid)

Step 1: Calculate the total volume to be infused:
Total volume = Volume of fluid + Volume of medication
Total volume = 500 mL + 10 mL
Total volume = 510 mL

Step 2: Calculate the infusion rate in mL/hr:
Infusion rate (mL/hr) = Total volume (mL) / Infusion time (hr)
Infusion rate (mL/hr) = 510 mL / 8 hr
Infusion rate (mL/hr) = 63.75 mL/hr

Step 3: Calculate the infusion rate in gtt/min:
Infusion rate (gtt/min) = Infusion rate (mL/hr) x Drop factor (gtt/mL) / 60 min/hr
Infusion rate (gtt/min) = 63.75 mL/hr x 10 gtt/mL / 60 min/hr
Infusion rate (gtt/min) = 10.625 gtt/min

Step 4: Round to the nearest whole number:
Infusion rate (gtt/min) ≈ 11 gtt/min

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Question 2:

Calculate the flow rate in gtt/min using the formula method. Administer 2.500 mL. D5 0.33% NS in 8 hr. The drop factor is 15 grt/mL

A. 78 gtt/min B. 65 gtt/min C. 70 grimin D. 60 git/min

Answer and Explanation

Choice A:

Given:
Volume of fluid: 2500 mL
Infusion time: 8 hours
Drop factor: 15 gtt/mL

Formula:
Flow rate (gtt/min) = (Volume (mL) / Time (hr)) x Drop factor (gtt/mL) / 60 min/hr

Step 1: Calculate the infusion rate in mL/hr:
Infusion rate (mL/hr) = Volume (mL) / Time (hr)
Infusion rate (mL/hr) = 2500 mL / 8 hr
Infusion rate (mL/hr) = 312.5 mL/hr

Step 2: Calculate the flow rate in gtt/min:
Flow rate (gtt/min) = (Infusion rate (mL/hr) x Drop factor (gtt/mL)) / 60 min/hr
Flow rate (gtt/min) = (312.5 mL/hr x 15 gtt/mL) / 60 min/hr
Flow rate (gtt/min) = 4687.5 gtt/hr / 60 min/hr
Flow rate (gtt/min) = 78.125 gtt/min

Step 3: Round to the nearest whole number:
Flow rate (gtt/min) ≈ 78 gtt/min

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Question 3:

Samantha Hudson a two-year-old child in the ER with parents at the bedside. She came in not feeling well, irritable, crying all night, and not eating or drinking. Orders: Vistaril 15 mg IM q4h, Stat x 1 for nausea.

Available: Vistaril 50 mg/ml

How many mL will you administer to Samantha now?

A. 1 mL B. 0.5 mL C. 0.3 mL D. 0.2 mL

Answer and Explanation

Choice C:

Given:

Desired dose of Vistaril: 15 mg

Concentration of Vistaril: 50 mg/mL

Step 1: Set up the proportion:

Desired dose (mg) / Volume to administer (mL) = Concentration (mg/mL)

Step 2: Substitute the values:

15 mg / Volume = 50 mg/mL

Step 3: Solve for the unknown volume:

Volume = 15 mg / 50 mg/mL

Step 4: Calculate the volume:

Volume = 0.3 mL

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Question 4:

A person with digoxin toxicity would have which of these symptoms? (Select All that Apply)

A. Vomiting B. Nausea C. Blurred Vision D. Headache E. Muscle aches

Answer and Explanation

Choice A:

Vomiting:Vomiting is a common symptom of digoxin toxicity. It occurs as a result of the toxic effects of digoxin on the gastrointestinal system. It is often one of the first symptoms that precede more severe signs of toxicity, such as arrhythmias and changes in vision. Vomiting, nausea, and anorexia are classic early signs of digoxin toxicity.

Choice B:

Nausea:Nausea is another early sign of digoxin toxicity. It occurs due to the direct effects of the drug on the gastrointestinal tract and the central nervous system. Along with vomiting, nausea is a frequently observed symptom and often occurs before more severe manifestations like arrhythmias or confusion.

Choice C:

Blurred Vision:Blurred vision, or seeing yellow or green halos around lights, is a hallmark sign of digoxin toxicity. This visual disturbance occurs due to the effect of digoxin on the optic nerve and the retina. This symptom is particularly important in identifying digoxin toxicity, as it is not commonly seen in other conditions.

Choice D:

Headache:While headache may occur in a variety of clinical conditions, it is not typically a direct symptom of digoxin toxicity. Although some patients may experience headache due to general discomfort or the effects of vomiting and nausea, it is not a classic or primary indicator of digoxin toxicity. Therefore, headache is not as strongly associated with digoxin toxicity as vomiting, nausea, and blurred vision are.

Choice E:

Muscle aches: Muscle aches are not a typical symptom of digoxin toxicity. While generalized weakness may occur due to the cardiac effects of digoxin, muscle aches are not specifically associated with toxicity.

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Question 5:

A patient asks the nurse to explain the medications they are taking. Which medication would be considered an angiotensin converting enzyme inhibitor?

A. simvastatin B. losartan C. Quinapril D. Metoprolol

Answer and Explanation

Choice A:

Simvastatin:Simvastatin is a medication used to lower cholesterol levels by inhibiting HMG-CoA reductase, an enzyme involved in the production of cholesterol in the liver. It is not an angiotensin-converting enzyme (ACE) inhibitor. Therefore, it does not have a direct effect on blood pressure or the renin-angiotensin system.

Choice B:

Losartan:Losartan is an angiotensin II receptor blocker (ARB), not an ACE inhibitor. Like ACE inhibitors, ARBs are used to treat conditions like hypertension and heart failure, but they work differently by blocking the receptors that angiotensin II binds to, rather than inhibiting the enzyme that converts angiotensin I to angiotensin II.

Choice C:

Quinapril:
Quinapril is an ACE inhibitor. ACE inhibitors block the enzyme angiotensin-converting enzyme, which converts angiotensin I into angiotensin II, a potent vasoconstrictor. By inhibiting this conversion, ACE inhibitors like quinapril help lower blood pressure, reduce strain on the heart, and treat conditions like hypertension and heart failure.

Choice D:

Metoprolol:Metoprolol is a beta-blocker, not an ACE inhibitor. It works by blocking beta-adrenergic receptors in the heart, which helps to lower heart rate and blood pressure. It is often used in the management of hypertension, heart failure, and to prevent heart attacks, but it does not affect the renin-angiotensin system like ACE inhibitors.

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Question 6:

A doctor orders nine units /kg/hr for a Heparin infusion. The patient weighs 76 kg. You're supplied with a Heparin bag that reads 50 untis/mL. How many mL/hr will you administer? |Round your answer to the nearest tenths)

A. 13 mL/hr B. 13.66 mL/hr C. 13.6 mL/hr D. 13.7 mL/hr

Answer and Explanation

Choice D:

Given:

Ordered dose of Heparin: 9 units/kg/hr

Patient weight: 76 kg

Concentration of Heparin: 50 units/mL

Step 1: Calculate the total dose of Heparin:

Total dose (units/hr) = Ordered dose (units/kg/hr) x Patient weight (kg)

Total dose (units/hr) = 9 units/kg/hr x 76 kg

Total dose (units/hr) = 684 units/hr

Step 2: Calculate the infusion rate in mL/hr:

Infusion rate (mL/hr) = Total dose (units/hr) / Concentration (units/mL)

Infusion rate (mL/hr) = 684 units/hr / 50 units/mL

Infusion rate (mL/hr) = 13.68 mL/hr

Step 3: Round to the nearest tenth:

Infusion rate (mL/hr) ≈ 13.7 mL/hr

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Question 7:

Nonpharmacological treatment of heart failure includes:

A. High protein diet B. Limit salt intake C. 50 pound weight loss D. Decrease Water intake

Answer and Explanation

Choice A:

High protein diet:A high-protein diet is generally not a recommended nonpharmacological treatment for heart failure. While adequate protein intake is important for overall health, heart failure management typically focuses more on regulating sodium, fluid, and caloric intake. In some cases, a high-protein diet could place additional strain on the kidneys or exacerbate other conditions that may complicate heart failure.

Choice B:

Limit salt intake:Limiting salt (sodium) intake is a crucial nonpharmacological strategy in managing heart failure. Excessive sodium can cause the body to retain water, leading to fluid overload, which can worsen heart failure symptoms such as edema, shortness of breath, and elevated blood pressure. Reducing sodium intake helps prevent these complications and aids in controlling symptoms.

Choice C:

50 pound weight loss:While weight loss may be beneficial for some individuals, especially those who are obese, a sudden or extreme weight loss of 50 pounds is not typically advised for someone with heart failure unless supervised by a healthcare provider. Rapid weight loss can lead to dehydration or electrolyte imbalances, which may exacerbate heart failure symptoms.

Choice D:

Decrease Water intake:While fluid restriction may be necessary for some individuals, especially those with severe fluid retention or in advanced stages of heart failure, it is not a blanket recommendation. The approach to fluid intake should be based on the individual’s condition, including factors such as kidney function and the presence of edema.

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Question 8:

Order: Zosyn 1.3g in 100mL. D5W IVPB q8h to infuse over 30 min. Drop factor: 60 gtt/mL. Determine rate in gtt/min.

A. 75 gtt/min B. 150 gtt/min C. 100 gt/min D. 200 gtt/min

Answer and Explanation

Choice D:

Given:

Volume of fluid: 100 mL

Infusion time: 30 minutes

Drop factor: 60 gtt/mL

Formula:

Flow rate (gtt/min) = (Volume (mL) / Time (min)) x Drop factor (gtt/mL)

Step 1: Calculate the infusion rate in mL/min:

Infusion rate (mL/min) = Volume (mL) / Time (min)

Infusion rate (mL/min) = 100 mL / 30 min

Infusion rate (mL/min) = 3.33 mL/min

Step 2: Calculate the flow rate in gtt/min:

Flow rate (gtt/min) = Infusion rate (mL/min) x Drop factor (gtt/mL)

Flow rate (gtt/min) = 3.33 mL/min x 60 gtt/mL

Flow rate (gtt/min) = 200 gtt/min

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Question 9:

Calculate the flow rate in mL/hr. (Equpment used is programmable in whole mL/hr) 180 mL 0.45% NS in 40 min by infusion group

A. 4.5 mL/hr B. 270 mL/hr C. 180 mL/hr D. 200 mL/hr

Answer and Explanation

Choice B:

Given:

Volume of fluid: 180 mL

Infusion time: 40 minutes

Step 1: Convert infusion time to hours:

Infusion time (hr) = 40 min / 60 min/hr

Infusion time (hr) = 0.67 hr

Step 2: Calculate the infusion rate in mL/hr:

Infusion rate (mL/hr) = Volume (mL) / Infusion time (hr)

Infusion rate (mL/hr) = 180 mL / 0.6667 hr

Infusion rate (mL/hr) = 269.987 mL/hr

Step 3: Round to the nearest whole number:

Infusion rate (mL/hr) ≈ 270 mL/hr

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Question 10:

Before administering digoxin, it is Important for the nurse to do which of the following?

A. Check the weight of the patient B. Check the skin for bruising C. Check the apical pulse D. Check the temperate of the patient

Answer and Explanation

Choice A:

Check the weight of the patient:While weight monitoring is important in managing heart failure and tracking fluid retention, it is not the most critical action before administering digoxin. Digoxin primarily affects heart rate and rhythm, so the priority assessment is related to the cardiovascular system.

Choice B:

Check the skin for bruising:Checking for bruising is not a necessary step before administering digoxin. Bruising could be an indication of an underlying bleeding disorder or anticoagulant therapy, but it is not directly related to the administration of digoxin. The primary concern with digoxin is its effect on the heart, particularly heart rate and rhythm.

Choice C:

Check the apical pulse:
It is crucial to check the apical pulse before administering digoxin, as one of the major effects of the drug is to slow the heart rate (negative chronotropy). If the heart rate is below 60 beats per minute (bpm), the nurse should hold the medication and consult the healthcare provider, as digoxin can further decrease the heart rate and lead to bradycardia or other complications.

Choice D:

Check the temperature of the patient:Although monitoring vital signs, including temperature, is important in overall patient care, temperature does not specifically impact the administration of digoxin. A normal or abnormal temperature would not typically influence the decision to give digoxin unless the patient had a fever due to an underlying infection that could complicate the clinical picture. The priority is assessing the pulse to ensure safe administration of the medication.

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Total Questions : 45

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ATI LPN Pharmacology and dosage calculation

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