Saunders Comprehensive Review for the NCLEX-PN®
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
1 — Pediatric mg/kg → mL
Order: Ampicillin 5 mg/kg IM. Child weight = 18 kg. Available:
Ampicillin 50 mg/mL.
A. 1.6 mL
B. 1.8 mL (correct)
C. 2.0 mL
D. 0.9 mL
Solution (step-by-step / dimensional analysis):
Dose required = 5 mg/kg × 18 kg = 90 mg.
Volume = (90 mg) × (1 mL / 50 mg) = 90/50 = 1.8 mL.
Why B is correct: calculation yields 1.8 mL.
Why others are wrong: A (1.6 mL) is too small (80 mg), C (2.0
mL) would give 100 mg (exceeds ordered 90 mg), D (0.9 mL) is
half the required volume.
,Safety checks / note: verify weight in kg on chart, check allergy
to penicillins, verify IM site and syringe size.
2 — Adult mg/kg → tablets
Order: Phenytoin 0.7 mg/kg PO. Patient weight = 154 lb.
Available: 25 mg tablets. How many tablets to give?
A. 1 tablet
B. 2 tablets (correct)
C. 3 tablets
D. 1.5 tablets
Solution:
Convert weight: 154 lb ÷ 2.2 = 70.0 kg.
Dose mg = 0.7 mg/kg × 70 kg = 49 mg.
Tablets needed = 49 mg ÷ 25 mg/tablet = 1.96 tablets → round
to 2 tablets (since tablets cannot be safely cut to give exact 1.96
unless scored and clinically acceptable; check facility policy).
Why B is correct: 1.96 ≈ 2 tablets; 2 tablets = 50 mg which is
within rounding tolerance.
Why others are wrong: A (1 tablet = 25 mg) is subtherapeutic; C
(3 tablets = 75 mg) is excessive; D (1.5 tablets = 37.5 mg) still
under the ordered dose.
Safety checks / note: confirm tablet scoring and facility policy
for splitting; verify maximum daily dose and serum levels if
required.
,3 — IV infusion (mL/hr, pump)
Order: Normal saline 1,000 mL IV to run over 8 hours using
pump. What mL/hr should the pump be set to?
A. 100 mL/hr
B. 125 mL/hr (correct)
C. 150 mL/hr
D. 80 mL/hr
Solution:
mL/hr = 1000 mL ÷ 8 hr = 125 mL/hr.
Why B is correct: direct division gives 125 mL/hr. Other options
are incorrect arithmetic.
Safety checks / note: verify IV site patency and that rate is
appropriate for patient’s cardiac status.
4 — IV drip (gtt/min)
Order: 500 mL D5W to infuse over 4 hours using tubing with 15
gtt/mL. What is the drop rate (gtt/min)?
A. 26 gtt/min
B. 31 gtt/min (rounded) — Correct: 31 gtt/min
C. 62 gtt/min
D. 15 gtt/min
Solution:
Total minutes = 4 hr × 60 = 240 min.
mL/min = 500 mL ÷ 240 min = 2.083333... mL/min.
, gtt/min = 2.083333... mL/min × 15 gtt/mL = 31.25 gtt/min →
rounded to 31 gtt/min (round to nearest whole drop).
Why B is correct: rounding 31.25 to 31 gtt/min.
Why others wrong: A (26) too low, C (62) double, D (15) far too
low.
Safety checks / note: verify drop factor and use infusion pump
if available for accuracy; if manual, re-check every 15 minutes.
5 — Reconstitution (simple)
Order: Ceftriaxone 375 mg IM. Vial: 500 mg powder;
reconstitute with 2 mL sterile water → after reconstitution
concentration = 250 mg/mL. How many mL will you give?
A. 0.75 mL
B. 1.0 mL
C. 1.5 mL (correct)
D. 2.0 mL
Solution:
Concentration = 500 mg ÷ 2 mL = 250 mg/mL.
Volume needed = 375 mg × (1 mL / 250 mg) = 1.5 mL.
Why C is correct: direct concentration calculation. Other
options incorrect by arithmetic.
Safety checks / note: reconstitute per manufacturer, use
correct syringe size, label vial with concentration/time, discard
excess appropriately.
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
1 — Pediatric mg/kg → mL
Order: Ampicillin 5 mg/kg IM. Child weight = 18 kg. Available:
Ampicillin 50 mg/mL.
A. 1.6 mL
B. 1.8 mL (correct)
C. 2.0 mL
D. 0.9 mL
Solution (step-by-step / dimensional analysis):
Dose required = 5 mg/kg × 18 kg = 90 mg.
Volume = (90 mg) × (1 mL / 50 mg) = 90/50 = 1.8 mL.
Why B is correct: calculation yields 1.8 mL.
Why others are wrong: A (1.6 mL) is too small (80 mg), C (2.0
mL) would give 100 mg (exceeds ordered 90 mg), D (0.9 mL) is
half the required volume.
,Safety checks / note: verify weight in kg on chart, check allergy
to penicillins, verify IM site and syringe size.
2 — Adult mg/kg → tablets
Order: Phenytoin 0.7 mg/kg PO. Patient weight = 154 lb.
Available: 25 mg tablets. How many tablets to give?
A. 1 tablet
B. 2 tablets (correct)
C. 3 tablets
D. 1.5 tablets
Solution:
Convert weight: 154 lb ÷ 2.2 = 70.0 kg.
Dose mg = 0.7 mg/kg × 70 kg = 49 mg.
Tablets needed = 49 mg ÷ 25 mg/tablet = 1.96 tablets → round
to 2 tablets (since tablets cannot be safely cut to give exact 1.96
unless scored and clinically acceptable; check facility policy).
Why B is correct: 1.96 ≈ 2 tablets; 2 tablets = 50 mg which is
within rounding tolerance.
Why others are wrong: A (1 tablet = 25 mg) is subtherapeutic; C
(3 tablets = 75 mg) is excessive; D (1.5 tablets = 37.5 mg) still
under the ordered dose.
Safety checks / note: confirm tablet scoring and facility policy
for splitting; verify maximum daily dose and serum levels if
required.
,3 — IV infusion (mL/hr, pump)
Order: Normal saline 1,000 mL IV to run over 8 hours using
pump. What mL/hr should the pump be set to?
A. 100 mL/hr
B. 125 mL/hr (correct)
C. 150 mL/hr
D. 80 mL/hr
Solution:
mL/hr = 1000 mL ÷ 8 hr = 125 mL/hr.
Why B is correct: direct division gives 125 mL/hr. Other options
are incorrect arithmetic.
Safety checks / note: verify IV site patency and that rate is
appropriate for patient’s cardiac status.
4 — IV drip (gtt/min)
Order: 500 mL D5W to infuse over 4 hours using tubing with 15
gtt/mL. What is the drop rate (gtt/min)?
A. 26 gtt/min
B. 31 gtt/min (rounded) — Correct: 31 gtt/min
C. 62 gtt/min
D. 15 gtt/min
Solution:
Total minutes = 4 hr × 60 = 240 min.
mL/min = 500 mL ÷ 240 min = 2.083333... mL/min.
, gtt/min = 2.083333... mL/min × 15 gtt/mL = 31.25 gtt/min →
rounded to 31 gtt/min (round to nearest whole drop).
Why B is correct: rounding 31.25 to 31 gtt/min.
Why others wrong: A (26) too low, C (62) double, D (15) far too
low.
Safety checks / note: verify drop factor and use infusion pump
if available for accuracy; if manual, re-check every 15 minutes.
5 — Reconstitution (simple)
Order: Ceftriaxone 375 mg IM. Vial: 500 mg powder;
reconstitute with 2 mL sterile water → after reconstitution
concentration = 250 mg/mL. How many mL will you give?
A. 0.75 mL
B. 1.0 mL
C. 1.5 mL (correct)
D. 2.0 mL
Solution:
Concentration = 500 mg ÷ 2 mL = 250 mg/mL.
Volume needed = 375 mg × (1 mL / 250 mg) = 1.5 mL.
Why C is correct: direct concentration calculation. Other
options incorrect by arithmetic.
Safety checks / note: reconstitute per manufacturer, use
correct syringe size, label vial with concentration/time, discard
excess appropriately.
