Saunders Comprehensive Review for the NCLEX-PN®
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
Item 1 — Weight-based oral dose (mg/kg)
A 5-year-old child weighing 44 lb is prescribed amoxicillin 40
mg/kg/day divided q8h. The suspension on the unit is
amoxicillin 400 mg/5 mL. What volume (mL) should the nurse
administer per dose?
A. 2.5 mL
B. 5.0 mL
C. 6.7 mL
D. 7.3 mL
Correct answer: C (6.7 mL)
Step-by-step calculation (dimensional analysis):
1. Convert weight from lb to kg: 44 lb ÷ 2.2 lb/kg = 20.0 kg
(do the division digit-by-digit: 44/2.2 = 20.0).
2. Calculate total daily dose: 40 mg/kg/day × 20.0 kg = 800
mg/day.
, 3. Dose per administration (q8h → 3 doses/day): 800 mg/day
÷ 3 = 266.666... mg per dose.
4. Using suspension concentration: 400 mg / 5 mL = x mg / y
mL → find mL for 266.666... mg:
(266.666... mg) × (5 mL / 400 mg) = 266.666... × 0.0125
mL/mg = 3.33333... mL.
Wait — that's per dose if total daily 800 mg divided by 3
gives 266.67 mg → calculation above yields 3.33 mL. But
answer choices show larger values; we must recheck: The
stem asked 40 mg/kg/day divided q8h → yes 800 mg/day ÷
3 = 266.67 mg/dose → 400 mg/5 mL gives 5 mL/400 mg =
0.0125 mL/mg → 266.67 × 0.0125 = 3.333 mL. That value is
not in options; this indicates an error in provided options.
To resolve with a correct original multiple-choice set we’ll
adjust: correct mL is 3.33 mL.**
Corrected options (use these):
A. 2.0 mL
B. 3.3 mL ← correct
C. 4.2 mL
D. 6.7 mL
Rounding rule: Round to nearest tenth of a mL for oral liquid
admin → 3.3 mL.
Rationale:
, • Correct (3.3 mL): proper conversion lb→kg, total mg/day,
divide into 3 doses, then dimensional analysis with
mg→mL yields 3.33 mL → rounded to 3.3 mL.
• Distractors: A and C are arithmetic errors (incorrect unit
conversion or wrong division by number of doses). D (6.7
mL) erroneously used the full 800 mg/day without dividing
by 3.
Safety note: Verify child’s weight in kg from the chart/EMR,
confirm allergies, and use an oral syringe to measure 3.3 mL.
Item 2 — mg/kg single dose (IM)
A 70-kg adult is ordered gentamicin 2 mg/kg IV single dose. The
vial available contains 40 mg/mL. How many mL should the
nurse give?
A. 1.0 mL
B. 2.5 mL
C. 3.5 mL
D. 4.0 mL
Correct answer: D (4.0 mL)
Calculation:
1. Dose (mg) = 2 mg/kg × 70 kg = 140 mg.
2. Concentration: 40 mg per 1 mL → mL needed = 140 mg ×
(1 mL / 40 mg) = = 3.5 mL. Wait—3.5 mL
, calculated. Options show 3.5 mL as C. Re-evaluate: 140/40
= 3.5. So correct answer should be C (3.5 mL).**
Correct answer (corrected): C (3.5 mL)
Rounding rule: Round to nearest 0.1 mL for parenteral meds →
3.5 mL.
Rationale:
• Correct (3.5 mL): mg/kg calculation (2 × 70 = 140 mg) then
convert mg→mL.
• Incorrect (1.0, 2.5, 4.0 mL): incorrect arithmetic or
misreading concentration (e.g., 40 mg/ mL mistaken for
100 mg/mL).
Safety note: Check creatinine and peak/trough policies for
gentamicin dosing; verify infusion route and rate if given IV.
Item 3 — IV infusion rate (mL/hr)
A patient is prescribed dopamine 5 mcg/kg/min. The patient
weighs 60 kg. Dopamine is supplied in an IV bag: 400 mg in 250
mL. (Note: 1 mg = 1000 mcg.) What infusion rate in mL/hr
should the nurse set? (Round to the nearest whole mL/hr.)
A. 22 mL/hr
B. 28 mL/hr
C. 45 mL/hr
D. 60 mL/hr
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
Item 1 — Weight-based oral dose (mg/kg)
A 5-year-old child weighing 44 lb is prescribed amoxicillin 40
mg/kg/day divided q8h. The suspension on the unit is
amoxicillin 400 mg/5 mL. What volume (mL) should the nurse
administer per dose?
A. 2.5 mL
B. 5.0 mL
C. 6.7 mL
D. 7.3 mL
Correct answer: C (6.7 mL)
Step-by-step calculation (dimensional analysis):
1. Convert weight from lb to kg: 44 lb ÷ 2.2 lb/kg = 20.0 kg
(do the division digit-by-digit: 44/2.2 = 20.0).
2. Calculate total daily dose: 40 mg/kg/day × 20.0 kg = 800
mg/day.
, 3. Dose per administration (q8h → 3 doses/day): 800 mg/day
÷ 3 = 266.666... mg per dose.
4. Using suspension concentration: 400 mg / 5 mL = x mg / y
mL → find mL for 266.666... mg:
(266.666... mg) × (5 mL / 400 mg) = 266.666... × 0.0125
mL/mg = 3.33333... mL.
Wait — that's per dose if total daily 800 mg divided by 3
gives 266.67 mg → calculation above yields 3.33 mL. But
answer choices show larger values; we must recheck: The
stem asked 40 mg/kg/day divided q8h → yes 800 mg/day ÷
3 = 266.67 mg/dose → 400 mg/5 mL gives 5 mL/400 mg =
0.0125 mL/mg → 266.67 × 0.0125 = 3.333 mL. That value is
not in options; this indicates an error in provided options.
To resolve with a correct original multiple-choice set we’ll
adjust: correct mL is 3.33 mL.**
Corrected options (use these):
A. 2.0 mL
B. 3.3 mL ← correct
C. 4.2 mL
D. 6.7 mL
Rounding rule: Round to nearest tenth of a mL for oral liquid
admin → 3.3 mL.
Rationale:
, • Correct (3.3 mL): proper conversion lb→kg, total mg/day,
divide into 3 doses, then dimensional analysis with
mg→mL yields 3.33 mL → rounded to 3.3 mL.
• Distractors: A and C are arithmetic errors (incorrect unit
conversion or wrong division by number of doses). D (6.7
mL) erroneously used the full 800 mg/day without dividing
by 3.
Safety note: Verify child’s weight in kg from the chart/EMR,
confirm allergies, and use an oral syringe to measure 3.3 mL.
Item 2 — mg/kg single dose (IM)
A 70-kg adult is ordered gentamicin 2 mg/kg IV single dose. The
vial available contains 40 mg/mL. How many mL should the
nurse give?
A. 1.0 mL
B. 2.5 mL
C. 3.5 mL
D. 4.0 mL
Correct answer: D (4.0 mL)
Calculation:
1. Dose (mg) = 2 mg/kg × 70 kg = 140 mg.
2. Concentration: 40 mg per 1 mL → mL needed = 140 mg ×
(1 mL / 40 mg) = = 3.5 mL. Wait—3.5 mL
, calculated. Options show 3.5 mL as C. Re-evaluate: 140/40
= 3.5. So correct answer should be C (3.5 mL).**
Correct answer (corrected): C (3.5 mL)
Rounding rule: Round to nearest 0.1 mL for parenteral meds →
3.5 mL.
Rationale:
• Correct (3.5 mL): mg/kg calculation (2 × 70 = 140 mg) then
convert mg→mL.
• Incorrect (1.0, 2.5, 4.0 mL): incorrect arithmetic or
misreading concentration (e.g., 40 mg/ mL mistaken for
100 mg/mL).
Safety note: Check creatinine and peak/trough policies for
gentamicin dosing; verify infusion route and rate if given IV.
Item 3 — IV infusion rate (mL/hr)
A patient is prescribed dopamine 5 mcg/kg/min. The patient
weighs 60 kg. Dopamine is supplied in an IV bag: 400 mg in 250
mL. (Note: 1 mg = 1000 mcg.) What infusion rate in mL/hr
should the nurse set? (Round to the nearest whole mL/hr.)
A. 22 mL/hr
B. 28 mL/hr
C. 45 mL/hr
D. 60 mL/hr
