DRUG CALCULATION MASTERY: CRITICAL CARE &
COMPLEX CALCULATIONS
COMPLETE PRACTICE QUESTION BANK
100 Expert-Level Critical Care Medication Calculations
Nursing & Pharmacy Exam Preparation
Perfect for: NCLEX-RN • NCLEX-PN • CCRN • PCCN • Pharmacy
Technician • Nursing School Finals • Clinical Competency Exams
Topics Covered: Vasopressors • Inotropes • Sedatives • Antiarrhythmics •
Heparin Protocols • Emergency Multi-Drug Scenarios • Sodium Bicarbonate •
Phenytoin Loading • Titrated Infusions • Propofol Sedation • Fentanyl Infusions •
Diltiazem Drips • Amiodarone Protocols
Skill Level: Advanced → Expert
Total Questions: 100
Every question includes step-by-step solutions, clinical context, and safety notes.
Designed by critical care educators for maximum exam success.
TABLE OF CONTENTS
Section Questions Topic
1 1–10 Vasopressor Infusions
2 11–20 Inotrope Infusions
3 21–30 Propofol Sedation
4 31–40 Amiodarone Protocols
5 41–50 Diltiazem Drips
6 51–60 Heparin Protocols
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,Section Questions Topic
7 61–70 Opioid Infusions
8 71–80 Sodium Bicarbonate
9 81–90 Phenytoin Loading
10 91–100 Multi-Drug Emergency Protocols
HOW TO USE THIS DOCUMENT
1. Attempt each question independently before checking the answer.
2. Show all your work — examiners award partial credit for correct
methodology.
3. Review the safety notes — critical care medication errors can be fatal.
4. Time yourself — aim for 4–5 minutes per question on exam day.
5. Flag difficult questions for later review.
CLINICAL SAFETY REMINDERS
• Always verify the order against the medication administration record
(MAR).
• Use an infusion pump for all critical care medications — never gravity
drip.
• Double-check vasopressor calculations — these are high-alert
medications.
• Monitor hemodynamics continuously during vasopressor and inotrope
infusions.
• Have reversal agents available for sedatives and opioids.
• Check compatibility before mixing medications in the same line.
• Label all lines clearly — color-coded labels are recommended.
• When in doubt, ask — patient safety is everyone’s responsibility.
nursing
,Question 1: Critical Care – Inotrope Infusion
Patient: Mrs. Wilson, 62 years old, weight 65 kg, acute decompensated heart
failure
Order: Dobutamine 5 mcg/kg/min IV
Available: Dobutamine 250 mg in 250 mL D5W
Question: At what rate (mL/hr) will you set the infusion pump?
Answer
Step 1: Calculate the ordered dose. - Dose = 5 mcg/kg/min × 65 kg = 325
mcg/min
Step 2: Determine the concentration of the solution. - 250 mg = 250,000 mcg -
Concentration = 250,000 mcg / 250 mL = 1000 mcg/mL
Step 3: Calculate the rate in mL/min. - Rate (mL/min) = 325 mcg/min / 1000
mcg/mL = 0.3250 mL/min
Step 4: Convert to mL/hr. - Rate (mL/hr) = 0.3250 mL/min × 60 min/hr = 19.5
mL/hr
Answer: 19.5 mL/hr
Question 2: Critical Care – Propofol Sedation
Patient: Mrs. Lopez, 63 years old, weight 70 kg, mechanically ventilated
Order: Propofol 50 mcg/kg/min IV continuous infusion
Available: Propofol 10 mg/mL (1% solution) in a 50 mL vial
Question: At what rate (mL/hr) will you set the infusion pump?
Answer
Step 1: Calculate the ordered dose. - Dose = 50 mcg/kg/min × 70 kg = 3500
mcg/min
Step 2: Determine the concentration. - Concentration = 10 mg/mL = 10,000
mcg/mL
Step 3: Calculate the rate. - Rate = ,000 × 60 = 21000.0 mL/hr
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, Note: Propofol contains 1.1 kcal/mL (lipid emulsion). Monitor triglyceride levels
with prolonged use.
Answer: 21000.0 mL/hr
Question 3: Critical Care – Fentanyl Infusion
Patient: Mrs. Evans, 41 years old, weight 60 kg, post-operative pain
management
Order: Fentanyl 0.5 mcg/kg/hr IV continuous infusion
Available: Fentanyl 250 mcg in 50 mL NS
Question: At what rate (mL/hr) will you set the infusion pump?
Answer
Step 1: Calculate the ordered dose. - Dose = 0.5 mcg/kg/hr × 60 kg = 30.0
mcg/hr
Step 2: Determine the concentration. - Concentration = 250 mcg / 50 mL = 5.0
mcg/mL
Step 3: Calculate the rate. - Rate = 30.0 mcg/hr / 5.0 mcg/mL = 6.0 mL/hr
Answer: 6.0 mL/hr
Question 4: Critical Care – Amiodarone Protocol
Patient: Mrs. Evans, 64 years old, ventricular tachycardia
Order: Amiodarone 150 mg IV push over 10 minutes, then 0.5 mg/min for 24
hours
Available: Amiodarone 150 mg/3.0 mL vial for bolus; Amiodarone 12.0 mg in
250 mL D5W for infusion
Question: a) How many mL for the loading dose? b) At what rate (mL/hr) for the
maintenance infusion?
Answer
Part a – Loading dose:
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COMPLEX CALCULATIONS
COMPLETE PRACTICE QUESTION BANK
100 Expert-Level Critical Care Medication Calculations
Nursing & Pharmacy Exam Preparation
Perfect for: NCLEX-RN • NCLEX-PN • CCRN • PCCN • Pharmacy
Technician • Nursing School Finals • Clinical Competency Exams
Topics Covered: Vasopressors • Inotropes • Sedatives • Antiarrhythmics •
Heparin Protocols • Emergency Multi-Drug Scenarios • Sodium Bicarbonate •
Phenytoin Loading • Titrated Infusions • Propofol Sedation • Fentanyl Infusions •
Diltiazem Drips • Amiodarone Protocols
Skill Level: Advanced → Expert
Total Questions: 100
Every question includes step-by-step solutions, clinical context, and safety notes.
Designed by critical care educators for maximum exam success.
TABLE OF CONTENTS
Section Questions Topic
1 1–10 Vasopressor Infusions
2 11–20 Inotrope Infusions
3 21–30 Propofol Sedation
4 31–40 Amiodarone Protocols
5 41–50 Diltiazem Drips
6 51–60 Heparin Protocols
nursing
,Section Questions Topic
7 61–70 Opioid Infusions
8 71–80 Sodium Bicarbonate
9 81–90 Phenytoin Loading
10 91–100 Multi-Drug Emergency Protocols
HOW TO USE THIS DOCUMENT
1. Attempt each question independently before checking the answer.
2. Show all your work — examiners award partial credit for correct
methodology.
3. Review the safety notes — critical care medication errors can be fatal.
4. Time yourself — aim for 4–5 minutes per question on exam day.
5. Flag difficult questions for later review.
CLINICAL SAFETY REMINDERS
• Always verify the order against the medication administration record
(MAR).
• Use an infusion pump for all critical care medications — never gravity
drip.
• Double-check vasopressor calculations — these are high-alert
medications.
• Monitor hemodynamics continuously during vasopressor and inotrope
infusions.
• Have reversal agents available for sedatives and opioids.
• Check compatibility before mixing medications in the same line.
• Label all lines clearly — color-coded labels are recommended.
• When in doubt, ask — patient safety is everyone’s responsibility.
nursing
,Question 1: Critical Care – Inotrope Infusion
Patient: Mrs. Wilson, 62 years old, weight 65 kg, acute decompensated heart
failure
Order: Dobutamine 5 mcg/kg/min IV
Available: Dobutamine 250 mg in 250 mL D5W
Question: At what rate (mL/hr) will you set the infusion pump?
Answer
Step 1: Calculate the ordered dose. - Dose = 5 mcg/kg/min × 65 kg = 325
mcg/min
Step 2: Determine the concentration of the solution. - 250 mg = 250,000 mcg -
Concentration = 250,000 mcg / 250 mL = 1000 mcg/mL
Step 3: Calculate the rate in mL/min. - Rate (mL/min) = 325 mcg/min / 1000
mcg/mL = 0.3250 mL/min
Step 4: Convert to mL/hr. - Rate (mL/hr) = 0.3250 mL/min × 60 min/hr = 19.5
mL/hr
Answer: 19.5 mL/hr
Question 2: Critical Care – Propofol Sedation
Patient: Mrs. Lopez, 63 years old, weight 70 kg, mechanically ventilated
Order: Propofol 50 mcg/kg/min IV continuous infusion
Available: Propofol 10 mg/mL (1% solution) in a 50 mL vial
Question: At what rate (mL/hr) will you set the infusion pump?
Answer
Step 1: Calculate the ordered dose. - Dose = 50 mcg/kg/min × 70 kg = 3500
mcg/min
Step 2: Determine the concentration. - Concentration = 10 mg/mL = 10,000
mcg/mL
Step 3: Calculate the rate. - Rate = ,000 × 60 = 21000.0 mL/hr
nursing
, Note: Propofol contains 1.1 kcal/mL (lipid emulsion). Monitor triglyceride levels
with prolonged use.
Answer: 21000.0 mL/hr
Question 3: Critical Care – Fentanyl Infusion
Patient: Mrs. Evans, 41 years old, weight 60 kg, post-operative pain
management
Order: Fentanyl 0.5 mcg/kg/hr IV continuous infusion
Available: Fentanyl 250 mcg in 50 mL NS
Question: At what rate (mL/hr) will you set the infusion pump?
Answer
Step 1: Calculate the ordered dose. - Dose = 0.5 mcg/kg/hr × 60 kg = 30.0
mcg/hr
Step 2: Determine the concentration. - Concentration = 250 mcg / 50 mL = 5.0
mcg/mL
Step 3: Calculate the rate. - Rate = 30.0 mcg/hr / 5.0 mcg/mL = 6.0 mL/hr
Answer: 6.0 mL/hr
Question 4: Critical Care – Amiodarone Protocol
Patient: Mrs. Evans, 64 years old, ventricular tachycardia
Order: Amiodarone 150 mg IV push over 10 minutes, then 0.5 mg/min for 24
hours
Available: Amiodarone 150 mg/3.0 mL vial for bolus; Amiodarone 12.0 mg in
250 mL D5W for infusion
Question: a) How many mL for the loading dose? b) At what rate (mL/hr) for the
maintenance infusion?
Answer
Part a – Loading dose:
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