Saunders Comprehensive Review for the NCLEX-PN®
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
Item 1 — Gentamicin (weight-based; convert lb → kg)
Stem: A child weighs 22 lb. The physician orders gentamicin 7
mg/kg IV once. The vial on the floor stock is 10 mg/mL. How
many mL should you administer? Round to the nearest tenth
(0.1 mL).
A. 3.2 mL
B. 7.0 mL ← Correct
C. 1.4 mL
D. 0.7 mL
Solution (dimensional analysis):
1 kg = 2.2 lb → 22 lb ÷ 2.2 = 10.0 kg
Dose = 7 mg/kg × 10.0 kg = 70 mg
Concentration = 10 mg / 1 mL → Volume = 70 mg × (1 mL / 10
mg) = 7.0 mL
,Rationale (correct): 7.0 mL gives the required 70 mg (7 mg/kg ×
10 kg).
Rationale (incorrect):
• A (3.2 mL) — would deliver 32 mg (calculation error or
used 3.2 mL ×10 mg/mL = 32 mg).
• C (1.4 mL) — would deliver 14 mg (likely used kg = 2.0,
mis-conversion).
• D (0.7 mL) — delivers 7 mg (decimal place error; violates
trailing zero rules if documented as .7 mL rather than 0.7
mL).
Safety checks: Verify weight (kg) on chart, confirm allergy
history, use leading zero (0.7 mL if needed), and have a
second RN verify dose for pediatric aminoglycoside. Evolve
Item 2 — Heparin bolus (units/kg)
Stem: An adult patient weighs 70 kg. Order: heparin 80
units/kg IV bolus. Heparin concentration available: 10,000 units
per mL. How many mL will you draw up? Round to nearest
hundredth (0.01 mL).
A. 0.56 mL ← Correct
B. 5.6 mL
C. 0.08 mL
D. 56.0 mL
,Solution:
Dose = 80 units/kg × 70 kg = 5,600 units
Volume = 5,600 units × (1 mL / 10,000 units) = 0.56 mL
Rationale (correct): 0.56 mL contains 5,600 units. Document
with an appropriate syringe and leading zero if needed (0.56
mL).
Rationale (incorrect):
• B (5.6 mL) = 56,000 units (tenfold error).
• C (0.08 mL) = 800 units (mis-multiplication).
• D (56.0 mL) = 560,000 units (gross calculation error).
Safety checks: Heparin is a high-alert drug — double-check
concentration, verify infusion orders, and have second RN
check if institution policy requires. Evolve
Item 3 — Ampicillin (pediatric mg/kg; convert vial
concentration)
Stem: Infant weight 4.5 kg. Order: ampicillin 50 mg/kg IV.
Available: 250 mg vial reconstituted to 2 mL (i.e., 250 mg/2
mL). How many mL do you administer? Round to nearest tenth.
A. 0.9 mL
B. 1.8 mL ← Correct
C. 2.5 mL
D. 3.6 mL
, Solution:
Dose = 50 mg/kg × 4.5 kg = 225 mg
Concentration = 250 mg / 2 mL = 125 mg/mL
Volume = 225 mg × (1 mL / 125 mg) = 1.8 mL
Rationale (correct): 1.8 mL delivers 225 mg.
Rationale (incorrect):
• A (0.9 mL) delivers 112.5 mg (half the dose).
• C (2.5 mL) delivers 312.5 mg (overdose).
• D (3.6 mL) delivers 450 mg (double dose).
Safety checks: Confirm pediatric weight from recent
measurement, verify diluent and final concentration on
vial label before administration. Evolve
Item 4 — IV flow rate (mL/hr)
Stem: Order: D5W 1000 mL IV to infuse over 8 hours. What is
the infusion rate in mL/hr? Round to whole number.
A. 125 mL/hr ← Correct
B. 80 mL/hr
C. 250 mL/hr
D. 12.5 mL/hr
Solution: 1000 mL ÷ 8 hr = 125 mL/hr
Rationale (correct): Straightforward volume/time calculation.
Rationale (incorrect): B and D are mis-divisions; C doubles the
rate.
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
Item 1 — Gentamicin (weight-based; convert lb → kg)
Stem: A child weighs 22 lb. The physician orders gentamicin 7
mg/kg IV once. The vial on the floor stock is 10 mg/mL. How
many mL should you administer? Round to the nearest tenth
(0.1 mL).
A. 3.2 mL
B. 7.0 mL ← Correct
C. 1.4 mL
D. 0.7 mL
Solution (dimensional analysis):
1 kg = 2.2 lb → 22 lb ÷ 2.2 = 10.0 kg
Dose = 7 mg/kg × 10.0 kg = 70 mg
Concentration = 10 mg / 1 mL → Volume = 70 mg × (1 mL / 10
mg) = 7.0 mL
,Rationale (correct): 7.0 mL gives the required 70 mg (7 mg/kg ×
10 kg).
Rationale (incorrect):
• A (3.2 mL) — would deliver 32 mg (calculation error or
used 3.2 mL ×10 mg/mL = 32 mg).
• C (1.4 mL) — would deliver 14 mg (likely used kg = 2.0,
mis-conversion).
• D (0.7 mL) — delivers 7 mg (decimal place error; violates
trailing zero rules if documented as .7 mL rather than 0.7
mL).
Safety checks: Verify weight (kg) on chart, confirm allergy
history, use leading zero (0.7 mL if needed), and have a
second RN verify dose for pediatric aminoglycoside. Evolve
Item 2 — Heparin bolus (units/kg)
Stem: An adult patient weighs 70 kg. Order: heparin 80
units/kg IV bolus. Heparin concentration available: 10,000 units
per mL. How many mL will you draw up? Round to nearest
hundredth (0.01 mL).
A. 0.56 mL ← Correct
B. 5.6 mL
C. 0.08 mL
D. 56.0 mL
,Solution:
Dose = 80 units/kg × 70 kg = 5,600 units
Volume = 5,600 units × (1 mL / 10,000 units) = 0.56 mL
Rationale (correct): 0.56 mL contains 5,600 units. Document
with an appropriate syringe and leading zero if needed (0.56
mL).
Rationale (incorrect):
• B (5.6 mL) = 56,000 units (tenfold error).
• C (0.08 mL) = 800 units (mis-multiplication).
• D (56.0 mL) = 560,000 units (gross calculation error).
Safety checks: Heparin is a high-alert drug — double-check
concentration, verify infusion orders, and have second RN
check if institution policy requires. Evolve
Item 3 — Ampicillin (pediatric mg/kg; convert vial
concentration)
Stem: Infant weight 4.5 kg. Order: ampicillin 50 mg/kg IV.
Available: 250 mg vial reconstituted to 2 mL (i.e., 250 mg/2
mL). How many mL do you administer? Round to nearest tenth.
A. 0.9 mL
B. 1.8 mL ← Correct
C. 2.5 mL
D. 3.6 mL
, Solution:
Dose = 50 mg/kg × 4.5 kg = 225 mg
Concentration = 250 mg / 2 mL = 125 mg/mL
Volume = 225 mg × (1 mL / 125 mg) = 1.8 mL
Rationale (correct): 1.8 mL delivers 225 mg.
Rationale (incorrect):
• A (0.9 mL) delivers 112.5 mg (half the dose).
• C (2.5 mL) delivers 312.5 mg (overdose).
• D (3.6 mL) delivers 450 mg (double dose).
Safety checks: Confirm pediatric weight from recent
measurement, verify diluent and final concentration on
vial label before administration. Evolve
Item 4 — IV flow rate (mL/hr)
Stem: Order: D5W 1000 mL IV to infuse over 8 hours. What is
the infusion rate in mL/hr? Round to whole number.
A. 125 mL/hr ← Correct
B. 80 mL/hr
C. 250 mL/hr
D. 12.5 mL/hr
Solution: 1000 mL ÷ 8 hr = 125 mL/hr
Rationale (correct): Straightforward volume/time calculation.
Rationale (incorrect): B and D are mis-divisions; C doubles the
rate.
