TEST BANK
CALCULATING DRUG DOSAGES A PATIENT-SAFE APPROACH TO NURSING AND MATH
ANDRA LUZ MARTINEZ DE CASTILLO AND MARYANNE WERNER-MCCULLOUGH
2nd Edition
TEST BANK
,Castillo/Werner-McCullough: Calculating Drug Dosages: A Patient-Safe Approach to Nursing and Math,,2e
Test Bank
Table of Contents:
I. Safety in Medication Administration
Chapter 1. Safety in Medication Administration
Chapter 2. The Drug Label
II. Systems of Measurement
Chapter 3. The Metric System
Chapter 4. The Household System
III. Methods of Calculation
Chapter 5. Linear Ratio and Proportion
Chapter 6. Fractional Ratio and Proportion
Chapter 7. Dimensional Analysis
Chapter 8. Formula Method
IV. Administration of Medications
Chapter 9. Calculating Oral Medication Doses
Chapter 10. Syringes and Needles
Chapter 11. Calculating Parenteral Medication Dosages
Chapter 12. Preparing Powdered Parenteral Medications
Chapter 13. Administration of Insulin
V. IV Therapy and Administration of Intravenous Medications
Chapter 14. Intravenous Infusion and Infusion Rates
Chapter 15. Calculating Infusion and Completion Time
Chapter 16. Administering IV Push Medications
VI. Verifying Safe Dose and Critical Care Calculations
Chapter 17. Verifying Safe Dose
Chapter 18. Titration of Intravenous Medications
VII. Intake and Output
Chapter 19. Calculating Intake and Output
Chapter 20. Calculating Parenteral Intake
VIII. Dosages for Pediatric and Older Adult Populations
Chapter 21. Considerations for the Pediatric Patient
Chapter 22. Considerations for the Older Adult
,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e
Chapter 1: Safety in Medication Administration
Castillo: Calculating Drug Dosages: A Patient-Safe Approach to Nursing and Math 2nd Edition
MULTIPLE CHOICE
1. The following medication order is in the patient’s medication administration record (MAR):
methylPREDnisolone 40 mg PO daily at 0900.
After reading the order, the nurse correctly determines:
A “PO” is an inappropriate abbreviation.
B the medication order is written correctly.
C 40 mg should be written as 40mg.
D tall man lettering indicates that the drug is a narcotic.
ANS: B
Feedback
The medication order has all the required components (drug name, dose, route, and
frequency of administration) for a drug order. “PO” is an appropriate abbreviation;
40 mg is written correctly with a space between the dose and the unit of
measurement. Tall man lettering is used to distinguish the drug from another drug
with a similar name.
2. Which of the following accurately describes the “Boxed Warning” found on a drug label?
A It is primarily is used to identify the safe dose for the patient.
B It is commonly found on all drug labels.
C It identifies serious potential risks and side effects related to drug use.
D It protects the patient by providing information to decrease side effects.
ANS: C
Feedback
A drug label with a boxed warning provides information to healthcare professionals
and patients regarding the serious risks and side effects related to the drug. The
Boxed Warning is not the primary source for identifying the patient’s drug dosage.
The warning is found on specific prescription medications and does not provide
information to reduce or decrease side effects.
3. When practicing safety in the administration of medication, for which of the following
medication orders should a nurse seek clarification before the administration of the
medication?
1
,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e
A Regular insulin 5 u subcut now.
B Enoxaparin 80 mg subcut every 12 hours.
C Benadryl 50 mg PO PRN every 6 hr for itching.
D Ondansetron 4 mg IVP stat.
ANS: A
Feedback
The “u” should never be used in a medication order; rather, for safety, the word
“units” should be spelled out. The other answer options contain the required
components needed to safely carry out the medication order.
4. A nurse is reviewing a drug label with a drug name written with tall man lettering. Which
statements shows the nurse has a correct understanding of tall man lettering on a drug label?
A “The tall man lettering means this is a high alert drug.”
B “The tall man lettering helps me distinguish this drug with other drugs that
have similar names.”
C “The tall man lettering means that this drug must have a Boxed Warning.”
D “The tall man lettering helps me quickly identify that this drug is an injectable
drug.”
ANS: B
Feedback
Tall man lettering highlights a portion of the drug name to help distinguish from
similar drug names. It is not used to identify high alert drugs, highlight a boxed
warning, or identify injectable drugs.
5. The following medication orders are found in the patient’s MAR:
Metformin HCl 500 mg PO daily at 0900.
Hydrochlorothiazide 25 mg PO every 12 hr at 0900 and 2100.
Digoxin .25 mg PO daily at 0900.
In reading the medication orders for the 0700–1500 shift, the nurse determines that which of
the following is the priority nursing intervention?
A Clarify the metformin HCl order.
B Clarify the hydrochlorothiazide order.
C Clarify the digoxin order.
D Prepare to administer the 0900 medications.
ANS: C
2
,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e
Feedback
The digoxin medication order is lacking a zero before the decimal fraction (.25).
Safe practice recommends using a zero before a decimal point when the dose is less
than one. The metformin HCl and the hydrochlorothiazide orders are written
correctly. The order should be clarified before preparing the 0900 medications.
6. In zthe zadministration zof zmedications, zwhen zshould zthe znurse zdocument zthe
zadministration zof zmedications?
A 30 zminutes zbefore zadministering zto zthe zpatient.
B Immediately zbefore zadministering zto zthe
zpatient.
C At zthe zend zof zthe zshift.
D Immediately zafter zadministering zto zthe zpatient.
ANS: zD
Feedback
The zlast z“Right zof zMedication zAdministration” zis zthe zdocumentation zof
zmedications. zThe zdocumentation zis zdone zimmediately zafter zadministering zthe
zmedications zto zthe
patient.
7. The zfollowing zmedication zis zordered zfor zthe zpatient:
Calcitriol zOral zSolution z2 zµg zPO zDaily
After zreading zthe zorder, zwhat zis zthe zinitial zaction zneeded zby zthe znurse?
A Clarify zthe zwritten zmedication zdose zof z2 zµg.
B Look zup zthe zdose zin za zdrug zreference zbook.
C Transcribe zthe zmedication zorder zonto zthe
zMAR.
D Ask zthe zpatient zthe zdaily zdose ztaken zat zhome.
ANS: zA
Feedback
The zinitial zaction zis zfor zthe znurse zto zclarify zthe zdrug zdose zbecause zit zis zwritten
zwith zthe zerror-prone zletter/symbol z“µ.” zTo zavoid zmedication zerrors, zit zis
zrecommended
that zthe z“µ” znot zbe zused zin zmedication zorders. zInstead zthe zabbreviation z“mcg” zis
zto zbe zused zfor zmicrogram.
3
,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e
8. Recommendations zby zthe zInstitute zof zMedicine zfor zreducing zmedication zerrors zhelp
zenhance zsafe znursing zpractice zby:
4
,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e
A shifting zprimary zresponsibility zfor zdrug ztherapy zonto zpatients zand
zfamilies.
B referring zpatients zand zfamilies zto zthe zpharmacist zfor zdrug ztherapy
zquestions.
C answering zdrug ztherapy zquestions zwhen za znew zprescription zis zordered.
D promoting zongoing zcommunication zbetween zpatients zand zhealthcare
providers.
ANS: zD
Feedback
The zInstitute zof zMedicine zrecommendations zinclude zthe zestablishment zof
zcollaborative zpartnership zbetween zpatients zand zhealthcare zproviders zto zassist zin
educating, zconsulting, zand zlistening zto zpatient’s zconcerns. zOngoing zcommunication
zbetween zpatients zand zhealthcare zproviders zkeeps zthe zfocus zon zthe zneeds zof zthe
individual zpatient zand zpromotes zsafety.
9. In zconsulting za zdrug zreference zbook, zthe znurse zreads zthat zcertain zmedications zare
zclassified zas z“high-alert” zmedications. zIn zthe zadministration zof zhigh-alert zmedications,
zwhat zis zthe zpriority zaction zof zthe znurse?
A Inform zthe zpatient zof zthe zharmful zside zeffects.
B Double-check zthe zdose zwith zanother znurse zprior zto zadministering zthe
zdrug.
C Provide zdrug zliterature zto zthe zfamily zto zassist zwith zmonitoring zfor
zharmful
effects.
D Seek zassistance zfrom zthe zpharmacist zto zexplain zthe zeffects zof zthe zdrug.
ANS: zB
Feedback
High-alert zmedications zhave zan zincreased zrisk zof zpatient zharm. zSafe zpractice zin
zthe zadministration zof zhigh-alert zmedications zrequires zthe znurse zto zdouble zcheck
zthe zdose zwith zanother znurse zprior zto zthe zadministration zof zthe zdrug. zInforming
zthe zpatient zand zfamily zof zthe zdrug’s zharmful zeffects zmay zbe zindicated zfor zsome
zpatients, zbut zthe zprevention zof za zmedication zerror zis zcritical. zDrug zliterature zmay
zbe zhelpful zfor zsome zfamilies, zbut znot zall. zThe znurse zshould zseek zassistance zfrom
zthe zpharmacist zwhenever
there zis za zquestion, zbut zthis zis znot zspecific zfor zhigh-alert zmedications.
10. All zof zthe zfollowing zmedication zorders zare zfound zin za zpatient’s zMAR. zSelect zthe
zmedication zorder zthat zrequires zclarification zbefore zadministration.
A Captopril z12.5 zmg zPO zat z0700 zand z1700
B Regular zinsulin z7 zunits zsubcut z30 zminutes zbefore
zbreakfast.
5
, Castillo/Werner-McCullough: Calculating Drug Dosages, 2e
C Ketorolac z15 zmg zIM zstat
D Morphine zsulfate z45.0 zmg zPO zevery z5 zhr zfor zpain.
6
CALCULATING DRUG DOSAGES A PATIENT-SAFE APPROACH TO NURSING AND MATH
ANDRA LUZ MARTINEZ DE CASTILLO AND MARYANNE WERNER-MCCULLOUGH
2nd Edition
TEST BANK
,Castillo/Werner-McCullough: Calculating Drug Dosages: A Patient-Safe Approach to Nursing and Math,,2e
Test Bank
Table of Contents:
I. Safety in Medication Administration
Chapter 1. Safety in Medication Administration
Chapter 2. The Drug Label
II. Systems of Measurement
Chapter 3. The Metric System
Chapter 4. The Household System
III. Methods of Calculation
Chapter 5. Linear Ratio and Proportion
Chapter 6. Fractional Ratio and Proportion
Chapter 7. Dimensional Analysis
Chapter 8. Formula Method
IV. Administration of Medications
Chapter 9. Calculating Oral Medication Doses
Chapter 10. Syringes and Needles
Chapter 11. Calculating Parenteral Medication Dosages
Chapter 12. Preparing Powdered Parenteral Medications
Chapter 13. Administration of Insulin
V. IV Therapy and Administration of Intravenous Medications
Chapter 14. Intravenous Infusion and Infusion Rates
Chapter 15. Calculating Infusion and Completion Time
Chapter 16. Administering IV Push Medications
VI. Verifying Safe Dose and Critical Care Calculations
Chapter 17. Verifying Safe Dose
Chapter 18. Titration of Intravenous Medications
VII. Intake and Output
Chapter 19. Calculating Intake and Output
Chapter 20. Calculating Parenteral Intake
VIII. Dosages for Pediatric and Older Adult Populations
Chapter 21. Considerations for the Pediatric Patient
Chapter 22. Considerations for the Older Adult
,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e
Chapter 1: Safety in Medication Administration
Castillo: Calculating Drug Dosages: A Patient-Safe Approach to Nursing and Math 2nd Edition
MULTIPLE CHOICE
1. The following medication order is in the patient’s medication administration record (MAR):
methylPREDnisolone 40 mg PO daily at 0900.
After reading the order, the nurse correctly determines:
A “PO” is an inappropriate abbreviation.
B the medication order is written correctly.
C 40 mg should be written as 40mg.
D tall man lettering indicates that the drug is a narcotic.
ANS: B
Feedback
The medication order has all the required components (drug name, dose, route, and
frequency of administration) for a drug order. “PO” is an appropriate abbreviation;
40 mg is written correctly with a space between the dose and the unit of
measurement. Tall man lettering is used to distinguish the drug from another drug
with a similar name.
2. Which of the following accurately describes the “Boxed Warning” found on a drug label?
A It is primarily is used to identify the safe dose for the patient.
B It is commonly found on all drug labels.
C It identifies serious potential risks and side effects related to drug use.
D It protects the patient by providing information to decrease side effects.
ANS: C
Feedback
A drug label with a boxed warning provides information to healthcare professionals
and patients regarding the serious risks and side effects related to the drug. The
Boxed Warning is not the primary source for identifying the patient’s drug dosage.
The warning is found on specific prescription medications and does not provide
information to reduce or decrease side effects.
3. When practicing safety in the administration of medication, for which of the following
medication orders should a nurse seek clarification before the administration of the
medication?
1
,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e
A Regular insulin 5 u subcut now.
B Enoxaparin 80 mg subcut every 12 hours.
C Benadryl 50 mg PO PRN every 6 hr for itching.
D Ondansetron 4 mg IVP stat.
ANS: A
Feedback
The “u” should never be used in a medication order; rather, for safety, the word
“units” should be spelled out. The other answer options contain the required
components needed to safely carry out the medication order.
4. A nurse is reviewing a drug label with a drug name written with tall man lettering. Which
statements shows the nurse has a correct understanding of tall man lettering on a drug label?
A “The tall man lettering means this is a high alert drug.”
B “The tall man lettering helps me distinguish this drug with other drugs that
have similar names.”
C “The tall man lettering means that this drug must have a Boxed Warning.”
D “The tall man lettering helps me quickly identify that this drug is an injectable
drug.”
ANS: B
Feedback
Tall man lettering highlights a portion of the drug name to help distinguish from
similar drug names. It is not used to identify high alert drugs, highlight a boxed
warning, or identify injectable drugs.
5. The following medication orders are found in the patient’s MAR:
Metformin HCl 500 mg PO daily at 0900.
Hydrochlorothiazide 25 mg PO every 12 hr at 0900 and 2100.
Digoxin .25 mg PO daily at 0900.
In reading the medication orders for the 0700–1500 shift, the nurse determines that which of
the following is the priority nursing intervention?
A Clarify the metformin HCl order.
B Clarify the hydrochlorothiazide order.
C Clarify the digoxin order.
D Prepare to administer the 0900 medications.
ANS: C
2
,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e
Feedback
The digoxin medication order is lacking a zero before the decimal fraction (.25).
Safe practice recommends using a zero before a decimal point when the dose is less
than one. The metformin HCl and the hydrochlorothiazide orders are written
correctly. The order should be clarified before preparing the 0900 medications.
6. In zthe zadministration zof zmedications, zwhen zshould zthe znurse zdocument zthe
zadministration zof zmedications?
A 30 zminutes zbefore zadministering zto zthe zpatient.
B Immediately zbefore zadministering zto zthe
zpatient.
C At zthe zend zof zthe zshift.
D Immediately zafter zadministering zto zthe zpatient.
ANS: zD
Feedback
The zlast z“Right zof zMedication zAdministration” zis zthe zdocumentation zof
zmedications. zThe zdocumentation zis zdone zimmediately zafter zadministering zthe
zmedications zto zthe
patient.
7. The zfollowing zmedication zis zordered zfor zthe zpatient:
Calcitriol zOral zSolution z2 zµg zPO zDaily
After zreading zthe zorder, zwhat zis zthe zinitial zaction zneeded zby zthe znurse?
A Clarify zthe zwritten zmedication zdose zof z2 zµg.
B Look zup zthe zdose zin za zdrug zreference zbook.
C Transcribe zthe zmedication zorder zonto zthe
zMAR.
D Ask zthe zpatient zthe zdaily zdose ztaken zat zhome.
ANS: zA
Feedback
The zinitial zaction zis zfor zthe znurse zto zclarify zthe zdrug zdose zbecause zit zis zwritten
zwith zthe zerror-prone zletter/symbol z“µ.” zTo zavoid zmedication zerrors, zit zis
zrecommended
that zthe z“µ” znot zbe zused zin zmedication zorders. zInstead zthe zabbreviation z“mcg” zis
zto zbe zused zfor zmicrogram.
3
,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e
8. Recommendations zby zthe zInstitute zof zMedicine zfor zreducing zmedication zerrors zhelp
zenhance zsafe znursing zpractice zby:
4
,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e
A shifting zprimary zresponsibility zfor zdrug ztherapy zonto zpatients zand
zfamilies.
B referring zpatients zand zfamilies zto zthe zpharmacist zfor zdrug ztherapy
zquestions.
C answering zdrug ztherapy zquestions zwhen za znew zprescription zis zordered.
D promoting zongoing zcommunication zbetween zpatients zand zhealthcare
providers.
ANS: zD
Feedback
The zInstitute zof zMedicine zrecommendations zinclude zthe zestablishment zof
zcollaborative zpartnership zbetween zpatients zand zhealthcare zproviders zto zassist zin
educating, zconsulting, zand zlistening zto zpatient’s zconcerns. zOngoing zcommunication
zbetween zpatients zand zhealthcare zproviders zkeeps zthe zfocus zon zthe zneeds zof zthe
individual zpatient zand zpromotes zsafety.
9. In zconsulting za zdrug zreference zbook, zthe znurse zreads zthat zcertain zmedications zare
zclassified zas z“high-alert” zmedications. zIn zthe zadministration zof zhigh-alert zmedications,
zwhat zis zthe zpriority zaction zof zthe znurse?
A Inform zthe zpatient zof zthe zharmful zside zeffects.
B Double-check zthe zdose zwith zanother znurse zprior zto zadministering zthe
zdrug.
C Provide zdrug zliterature zto zthe zfamily zto zassist zwith zmonitoring zfor
zharmful
effects.
D Seek zassistance zfrom zthe zpharmacist zto zexplain zthe zeffects zof zthe zdrug.
ANS: zB
Feedback
High-alert zmedications zhave zan zincreased zrisk zof zpatient zharm. zSafe zpractice zin
zthe zadministration zof zhigh-alert zmedications zrequires zthe znurse zto zdouble zcheck
zthe zdose zwith zanother znurse zprior zto zthe zadministration zof zthe zdrug. zInforming
zthe zpatient zand zfamily zof zthe zdrug’s zharmful zeffects zmay zbe zindicated zfor zsome
zpatients, zbut zthe zprevention zof za zmedication zerror zis zcritical. zDrug zliterature zmay
zbe zhelpful zfor zsome zfamilies, zbut znot zall. zThe znurse zshould zseek zassistance zfrom
zthe zpharmacist zwhenever
there zis za zquestion, zbut zthis zis znot zspecific zfor zhigh-alert zmedications.
10. All zof zthe zfollowing zmedication zorders zare zfound zin za zpatient’s zMAR. zSelect zthe
zmedication zorder zthat zrequires zclarification zbefore zadministration.
A Captopril z12.5 zmg zPO zat z0700 zand z1700
B Regular zinsulin z7 zunits zsubcut z30 zminutes zbefore
zbreakfast.
5
, Castillo/Werner-McCullough: Calculating Drug Dosages, 2e
C Ketorolac z15 zmg zIM zstat
D Morphine zsulfate z45.0 zmg zPO zevery z5 zhr zfor zpain.
6
