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Exam Review

Rn Hesi Dosage Calculations III

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Total Questions : 56

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Question 1:

The healthcare provider prescribes epoetin alfa 8,200 units SUBQ for a client with chronic kidney disease (CKD). The 2 mL multidose vial is labeled, "Each 1 mL of solution contains 10,000 Units of epoetin alfa." How many mL should the nurse administer? (Enter the numerical value only. If rounding is required, round to the nearest tenth).

Answer and Explanation
Correct Answer: "0.8" mL

Explanation

Here's how to calculate the volume the nurse should administer:

Concentration of epoetin alfa: 10,000 units/mL (given on the vial label)

Prescribed dose: 8,200 units

We need to find the volume (in mL) that contains the prescribed dose (8,200 units) of epoetin alfa.

Dosage calculation:

Volume to administer (mL) = Dose (units) / Concentration (units/mL)

Volume to administer (mL) = 8,200 units / 10,000 units/mL

Volume to administer (mL) = 0.82 mL (round to nearest tenth as requested)

Therefore, the nurse should administer 0.8 mL.


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Question 2:

The healthcare provider prescribes penicillin G benzathine 1,800,000 units intramuscular (IM) for a client with a bacterial infection. The prefilled syringe is labeled, "Penicillin G benzathine 1,200,000 units/2 mL." How many mL should the nurse administer to this client? (Enter numerical value only, rounded to the nearest whole number.)

Answer and Explanation
Correct Answer: "3" ML

Explanation

Concentration of penicillin G benzathine: 1,200,000 units/2 mL (given on the syringe label)

Prescribed dose: 1,800,000 units

We need to find the volume (in mL) that delivers the prescribed dose (1,800,000 units) considering the available concentration.

Dosage calculation:

To administer the prescribed dose, we need to find the volume that contains at least 1,800,000 units.

Since the available concentration is 1,200,000 units/2 mL, one prefilled syringe provides 1,200,000 units.

We can calculate the number of syringes needed to deliver the prescribed dose:

Number of syringes = Prescribed dose (units) / Concentration per syringe (units)

Number of syringes = 1,800,000 units / 1,200,000 units/syringe

Number of syringes = 1.5 (round up to 2 since a partial dose wouldn't be sufficient)

2 mL per syringe x 2 syringes = 4 mL

However, the prefilled syringes likely come in whole-number doses. Checking the available options:

A single prefilled syringe provides 1,200,000 units (which is not enough).

Two prefilled syringes would provide a total of 2,400,000 units (more than enough).

Therefore, to ensure at least the prescribed dose is administered, the nurse should administer 3 mL.

This is achieved by using one and a half (rounded up to two) prefilled syringes.


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Question 3:

A child who weighs 44 pounds with otitis media receives a prescription for azithromycin 10 mg/kg once, then 10 mg/kg daily for 4 days. The medication is available in a solution containing 200 mg/5mL. How many mL should the nurse administer on the first day of the treatment regimen? (Enter numeric value only.)

Answer and Explanation
Correct Answer: "5" mL

Explanation

Here's how to calculate the volume of medication the nurse should administer on the first day:

1. Convert child's weight to kilograms (kg):

We know 1 kg = 2.205 pounds.

Child weight (kg) = 44 pounds / 2.205 pounds/kg = 20 kg (round to nearest whole number for this calculation).

2. Calculate the total azithromycin medication for the first day (mg):

Prescribed dosage (mg/kg): 10 mg/kg

Child weight (kg): 20 kg (rounded value from step 1)

Total medication on day 1 (mg) = Dosage (mg/kg) x Client weight (kg)

Total medication on day 1 (mg) = 10 mg/kg x 20 kg = 200 mg

3. Determine the volume (mL) needed based on the medication concentration:

Medication concentration (mg/mL): 200 mg/5 mL (given)

Total medication on day 1 (mg): 200 mg (calculated in step 2)

Volume to administer (mL) = Total medication (mg) / Concentration (mg/mL)

Volume to administer (mL) = 200 mg / 200 mg/5 mL

Volume to administer (mL) = 5 mL

Therefore, the nurse should administer 5 mL of the azithromycin solution on the first day.


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Question 4:

A client is receiving heparin IV at a rate of 1,800 units/hour. The IV solution is labeled, "Heparin sodium 20,000 units in 5% dextrose Injection 500 mL." After receiving the partial thromboplastin time (PTT) result, the healthcare provider prescribes an increase of 5 ml/hour in the IV rate. The nurse should set the infusion pump to deliver how many ml/hour? (Enter numeric value only.)

Answer and Explanation
Correct Answer: "50" mL/hr

Explanation

First, we need to find out how many mL/hr the infusion pump is currently delivering.

Given:

The client is receiving 1,800 units/hour of heparin.

The available medication is 20,000 units/500 mL.

We can set up the proportion as follows:

1,800units/ xmL ​= 20,000units​/500mL

Solving for x gives us the volume in mL that the infusion pump is currently delivering per hour.

Cross-multiplying and solving for x:

X = 1,800units×500mL​/20,000units

After performing the calculation, we find that x equals 45 mL/hr.

Given that the healthcare provider prescribes an increase of 5 mL/hr in the IV rate, the nurse should set the infusion pump to deliver:

Newrate(mL/hr) = Currentrate(mL/hr) + Increase(mL/hr) = 45mL/hr+5mL/hr

After performing the calculation, we find that the new rate equals 50 mL/hr.

So, the nurse should set the infusion pump to deliver 50 mL/hr.


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Question 5:

The pharmacy delivers an IV infusion of sodium chloride 100 mL with regular insulin 50 units for a client in diabetic ketoacidosis. The prescription rate is 10 units/hour. How many mL/hour should the nurse program the infusion pump? (Enter numeric value only.)

Answer and Explanation
Correct Answer: "20" mL/hr

Explanation

First, we need to find out how many mL of the solution contains 10 units of insulin, which is the prescribed rate per hour.

Given:

The solution contains 50 units of insulin in 100 mL.

The prescription rate is 10 units/hour.

We can set up the proportion as follows:

10units​/ xmL = 50units​/100mL

Solving for x gives us the volume in mL that contains 10 units of insulin.

Cross-multiplying and solving for x:

X = 10units×100mL​/50units

After performing the calculation, we find that x equals 20 mL.

So, the nurse should program the infusion pump to deliver 20 mL/hr. This is because 20 mL of the solution contains the prescribed 10 units of insulin.


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Question 6:

The healthcare provider prescribes cyanocobalamin injection 100 mcg IM every 3 days for a client with pernicious anemia. The vial is labeled, "1 mg/mL." How many mL should the nurse administer? (Enter numerical value only. If rounding is required, round to the nearest tenth.)

Answer and Explanation
Correct Answer: "0.1" mL

Explanation

Here's how to calculate the volume the nurse should administer:

1. Dose of cyanocobalamin (vitamin B12): 100 mcg

2. Concentration of cyanocobalamin in the vial: 1 mg/mL (given on the vial label)

We need to find the volume (in mL) that contains the prescribed dose (100 mcg) of cyanocobalamin.

Calculation:

Volume to administer (mL) = Dose (mcg) / Concentration (mcg/mL)

Note: Since both the medication dose and concentration are given in mcg units, we can directly perform the calculation without converting units.

Volume to administer (mL) = 100 mcg / 1 mg/mL

Conversion:

1 mg is equal to 1000 mcg. Therefore, 1 mg/mL is the same as 1000 mcg/mL.

Volume to administer (mL) = 100 mcg / (1000 mcg/mL)

Volume to administer (mL) = 0.1 mL (round to nearest tenth as requested)

Therefore, the nurse should administer approximately 0.1 mL of the cyanocobalamin injection.


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Question 7:

The healthcare provider prescribes ganciclovir 375 mg intravenously (IV) every 12 hours to infuse over 90 minutes. The pharmacy delivers ganciclovir 375 mg in a 150 mL IV bag. How many mL/hour should the nurse program the infusion pump? (Enter a whole number only.)

Answer and Explanation
Correct Answer: "100" mL/hr

Explanation

The nurse should set the infusion pump to deliver the entire 150 mL over the course of 90 minutes.

First, convert the time from minutes to hours because the rate is required in mL/hr.

90 minutes is 1.5 hours (since 1 hour = 60 minutes).

Therefore, the IV pump should be set to deliver:

Rate(mL/hr)=Time(hr)Totalvolume(mL)​=1.5hr150mL​

After performing the calculation, we find that the rate equals 100 mL/hr.

So, the nurse should set the infusion pump to deliver 100 mL/hr. This is rounded to the nearest whole number as per the instructions.


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Question 8:

The healthcare provider prescribes 0.075 mg of levothyroxine PO daily. The medication is labeled, "50 mcg tablets." How many tablets should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

Answer and Explanation
Correct Answer: "1.5" tablets

Explanation

First, we need to convert the prescribed dose from mg to mcg because the available medication is labeled in mcg.

1 mg is equal to 1,000 mcg. So, 0.075 mg is equal to 75 mcg.

Given:

The prescription is for 75 mcg of levothyroxine.

The available medication is 50 mcg/tablet.

We can set up the proportion as follows:

75mcg/ xtablet ​= 50mcg/1tablet ​

Solving for x gives us the number of tablets that the nurse should administer.

Cross-multiplying and solving for x:

X = 75mcg×1tablet​/50mcg

After performing the calculation, we find that x equals 1.5 tablets.

So, the nurse should administer 1.5 tablets of the medication. This is rounded to the nearest tenth as per the instructions.


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Question 9:

Heparin 5,000 units IV is prescribed as a loading dose, to be administered over 5 minutes for a client with thrombophlebitis. The vial is labeled, "10,000 units/mL." How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

Answer and Explanation
Correct Answer: "0.5" mL

Explanation

Here's how to calculate the volume of heparin the nurse should administer:

1. Heparin dose: 5,000 units (given)

2. Heparin concentration: 10,000 units/mL (given on the vial label)

We need to find the volume (mL) containing the prescribed dose (5,000 units) of heparin.

Calculation:

Volume to administer (mL) = Dose (units) / Concentration (units/mL)

Volume to administer (mL) = 5,000 units / 10,000 units/mL

Volume to administer (mL) = 0.5 mL (round to nearest tenth as requested)

Therefore, the nurse should administer 0.5 mL of heparin.


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Question 10:

An adolescent with meningococcal meningitis is receiving a continuous IV infusion of penicillin G, which is prescribed as 20 million units in a total volume of 2 liters of normal saline every 24 hours. The pharmacy delivers 10 million units/liter of normal saline. How many mL/hour should the nurse program the infusion pump? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

Answer and Explanation
Correct Answer: "83" mL/hr

Explanation

The nurse should set the infusion pump to deliver the entire 2 liters (2000 mL) over the course of 24 hours.

Therefore, the IV pump should be set to deliver:

Rate(mL/hr) = Totalvolume(mL) / Time(hr) ​= 2000mL ​/ 24hr

After performing the calculation, we find that the rate equals 83.33 mL/hr.

So, the nurse should set the infusion pump to deliver 83 mL/hr (rounded to the nearest whole number).

This is because 83 mL of the solution contains the prescribed dose of penicillin G every hour.


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