Saunders Comprehensive Review for the NCLEX-PN®
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
1
A 22-lb child is ordered 5 mg/kg amoxicillin PO. The pharmacy
supplies 10 mg scored tablets. How many tablets should the
nurse administer?
A. 2 tablets
B. 1 tablet
C. 0.5 tablet
D. 5 tablets
Solution (dimensional analysis)
1. Convert weight:
22 lb×1 kg2.20462 lb=9.98 kg22 \text{ lb} \times \dfrac{1\
\text{kg}}{2.20462\ \text{lb}} = 9.98\
\text{kg}22 lb×2.20462 lb1 kg=9.98 kg (round to 2 decimals
for intermediate use).
, 2. Calculate total dose:
5 mg/kg×9.98 kg=49.90 mg5\ \text{mg/kg} \times 9.98\
\text{kg} = 49.90\ \text{mg}5 mg/kg×9.98 kg=49.90 mg.
3. Tablets needed:
49.90 mg10 mg/tablet=4.99 tablets\dfrac{49.90\
\text{mg}}{10\ \text{mg/tablet}} = 4.99\
\text{tablets}10 mg/tablet49.90 mg=4.99 tablets.
Final answer (rounding for tablets)
Round to nearest half or whole tablet per facility; 4.99 ≈ 5
tablets.
Answer: D. 5 tablets
Rationale
• Correct: 5 tablets is the dose required to deliver ~49.9 mg
when only 10 mg tablets are available.
• Distractors: A (2 tablets = 20 mg) and B (1 tablet = 10 mg)
and C (0.5 tablet = 5 mg) are all well below the ordered
dose.
• Safety checks: Confirm pediatric weight in kg from the
medical record, verify allergy status to penicillins, and
consider whether tablet splitting is allowed; if tablet
splitting for 4.99 tablets seems impractical, consult
pharmacy for liquid formulation.
2
,A client is to receive 1000 mL normal saline IV over 8 hours
using tubing with a drop factor of 20 gtt/mL. What rate in
gtt/min should the nurse set?
A. 21 gtt/min
B. 42 gtt/min
C. 125 gtt/min
D. 167 gtt/min
Solution
1. Calculate mL/hr: 1000 mL÷8 hr=125.0 mL/hr1000\
\text{mL} \div 8\ \text{hr} = 125.0\
\text{mL/hr}1000 mL÷8 hr=125.0 mL/hr.
2. Convert to gtt/min:
125.0 mL/hr×20 gtt/mL60 min/hr=41.666 gtt/min\dfrac{12
5.0\ \text{mL/hr} \times 20\ \text{gtt/mL}}{60\
\text{min/hr}} = 41.666\
\text{gtt/min}60 min/hr125.0 mL/hr×20 gtt/mL
=41.666 gtt/min.
3. Round to nearest whole drop: 42 gtt/min.
Final answer
Answer: B. 42 gtt/min
Rationale
• Correct: 42 gtt/min rounds 41.667 to whole drops.
• Distractors: A (21) is about half the needed rate; C and D
are much higher.
, • Safety checks: Reconfirm drop factor on tubing, use
infusion pump if available for accuracy, check IV site
patency.
3
Dopamine ordered at 5 mcg/kg/min by continuous infusion for
a 70-kg patient. Pharmacy sends a bag containing 400 mg
dopamine in 250 mL. What mL/hr should the pump be set to
deliver the ordered dose?
A. 6.5 mL/hr
B. 13.1 mL/hr
C. 21.0 mL/hr
D. 0.8 mL/hr
Solution
1. Calculate mcg/min: 5 μg/kg/min×70 kg=350 μg/min5\
\mu\text{g/kg/min} \times 70\ \text{kg} = 350\
\mu\text{g/min}5 μg/kg/min×70 kg=350 μg/min.
2. Convert to mg/hr:
350 μg/min×1 mg1000 μg=0.35 mg/min350\
\mu\text{g/min} \times \dfrac{1\ \text{mg}}{1000\
\mu\text{g}} = 0.35\
\text{mg/min}350 μg/min×1000 μg1 mg=0.35 mg/min.
0.35 mg/min×60 min/hr=21.0 mg/hr0.35\ \text{mg/min}
\times 60\ \text{min/hr} = 21.0\
\text{mg/hr}0.35 mg/min×60 min/hr=21.0 mg/hr.
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
1
A 22-lb child is ordered 5 mg/kg amoxicillin PO. The pharmacy
supplies 10 mg scored tablets. How many tablets should the
nurse administer?
A. 2 tablets
B. 1 tablet
C. 0.5 tablet
D. 5 tablets
Solution (dimensional analysis)
1. Convert weight:
22 lb×1 kg2.20462 lb=9.98 kg22 \text{ lb} \times \dfrac{1\
\text{kg}}{2.20462\ \text{lb}} = 9.98\
\text{kg}22 lb×2.20462 lb1 kg=9.98 kg (round to 2 decimals
for intermediate use).
, 2. Calculate total dose:
5 mg/kg×9.98 kg=49.90 mg5\ \text{mg/kg} \times 9.98\
\text{kg} = 49.90\ \text{mg}5 mg/kg×9.98 kg=49.90 mg.
3. Tablets needed:
49.90 mg10 mg/tablet=4.99 tablets\dfrac{49.90\
\text{mg}}{10\ \text{mg/tablet}} = 4.99\
\text{tablets}10 mg/tablet49.90 mg=4.99 tablets.
Final answer (rounding for tablets)
Round to nearest half or whole tablet per facility; 4.99 ≈ 5
tablets.
Answer: D. 5 tablets
Rationale
• Correct: 5 tablets is the dose required to deliver ~49.9 mg
when only 10 mg tablets are available.
• Distractors: A (2 tablets = 20 mg) and B (1 tablet = 10 mg)
and C (0.5 tablet = 5 mg) are all well below the ordered
dose.
• Safety checks: Confirm pediatric weight in kg from the
medical record, verify allergy status to penicillins, and
consider whether tablet splitting is allowed; if tablet
splitting for 4.99 tablets seems impractical, consult
pharmacy for liquid formulation.
2
,A client is to receive 1000 mL normal saline IV over 8 hours
using tubing with a drop factor of 20 gtt/mL. What rate in
gtt/min should the nurse set?
A. 21 gtt/min
B. 42 gtt/min
C. 125 gtt/min
D. 167 gtt/min
Solution
1. Calculate mL/hr: 1000 mL÷8 hr=125.0 mL/hr1000\
\text{mL} \div 8\ \text{hr} = 125.0\
\text{mL/hr}1000 mL÷8 hr=125.0 mL/hr.
2. Convert to gtt/min:
125.0 mL/hr×20 gtt/mL60 min/hr=41.666 gtt/min\dfrac{12
5.0\ \text{mL/hr} \times 20\ \text{gtt/mL}}{60\
\text{min/hr}} = 41.666\
\text{gtt/min}60 min/hr125.0 mL/hr×20 gtt/mL
=41.666 gtt/min.
3. Round to nearest whole drop: 42 gtt/min.
Final answer
Answer: B. 42 gtt/min
Rationale
• Correct: 42 gtt/min rounds 41.667 to whole drops.
• Distractors: A (21) is about half the needed rate; C and D
are much higher.
, • Safety checks: Reconfirm drop factor on tubing, use
infusion pump if available for accuracy, check IV site
patency.
3
Dopamine ordered at 5 mcg/kg/min by continuous infusion for
a 70-kg patient. Pharmacy sends a bag containing 400 mg
dopamine in 250 mL. What mL/hr should the pump be set to
deliver the ordered dose?
A. 6.5 mL/hr
B. 13.1 mL/hr
C. 21.0 mL/hr
D. 0.8 mL/hr
Solution
1. Calculate mcg/min: 5 μg/kg/min×70 kg=350 μg/min5\
\mu\text{g/kg/min} \times 70\ \text{kg} = 350\
\mu\text{g/min}5 μg/kg/min×70 kg=350 μg/min.
2. Convert to mg/hr:
350 μg/min×1 mg1000 μg=0.35 mg/min350\
\mu\text{g/min} \times \dfrac{1\ \text{mg}}{1000\
\mu\text{g}} = 0.35\
\text{mg/min}350 μg/min×1000 μg1 mg=0.35 mg/min.
0.35 mg/min×60 min/hr=21.0 mg/hr0.35\ \text{mg/min}
\times 60\ \text{min/hr} = 21.0\
\text{mg/hr}0.35 mg/min×60 min/hr=21.0 mg/hr.
