HESI Dosage Calculation real exam

HESI Dosage Calculation Real Exam 50 Real HESI QUESTIONS WITH ANSWERS! EACH PAGE HAS A QUESTION, IF THE SCREENSHOT IS NOT CLEAR, THE QUESTION WILLBE RE-TYPED YOU MUST UNDERSTAND HOW EACH QUESTIONIS SOLVED, FOR THAT I INCLUDED THE WAY OF SOLVING IT, YOU MIGHT FIND DIFFERENT NUMBERS IN THE EXAM. Dose is 0.5 mg x kg Child’s weight is in pounds, so we have to convert it to kg 1 Kg = 2.2 pounds (lb) X kg = 42 lb X = 42*1/2.2 = 19 kg So the dose is 0.5 mg x 19 kg = 9.5 mg ---------------- that’s the 1st part to get into the final part of the question which is how many ml should be administered? In other words, to get 9.5 mg delivered, how many mL should be given? The key answer is how much solution, ampule, syrup …. you have (in other words, the fixed amount of medicine that would be supplied for you from the pharmacy) So here we have 25 mg / mL in each ampule, and we need to give 9.5 mg, if you arrange it in an equation, it will be: 25 mg ---- 1 mL 9.5 mg ---- x mL (x is always the missing amount that you need to know) X = 9.5 x 1/25 = 0.381 --> round to nearest tenth = 0.4 Question: the healthcare provider prescribes captopril 37.5 mg PO daily. The medication is available in 25 mg tablets. How many tablets should the nurse administer? (Enter numeric only, if rounding is required, round to the nearest tenth). This should be the easiest questions and sometimes you don’t even need to use the calculator, imagine you have a medicine regardless of its name, and it comes in strength of 25 mg, you need to give 37.5 mg, both are same units, so your main concern is how to get 37.5 out of 25? just divide them! And you will get 1.5 tablets! Easy and straight! After you have the answer, just double check yourself, and imagine you have the medicine next to you, and you have 1 tablet of 25 mg and half tablet of 25 mg which is 12.5mg, add them together, 25 + 12.5 = 37.5, which what we need! So your answer is correct! Let’s move to the next question! Question: The PN administers amoxicillin/clavulanate 500 mg PO every 8 hours to a client with a staphylococcus infection. In a 24 hour period. How many mg of amoxicillin/clavulanate should the client receive? (Enter the numerical value only. If rounding is required, round to the whole number.) If you don’t have a good pharmacology/microbiology background, don’t freak out! Just ignore the name of medications/bacteria. 99% they have nothing to do in calculation questions! Just understand the question and you will have the answer by your self! You are talking a medicine with a strength of 500 mg every 8 hours, how many mg you will take in 24 hours? So in other word, how many 8 hours are there in 24 hours? 3! 500 mg x 3 = 1500 mg! Easy! Next… Question: A client is prescribed carbidopa-levodopa 20/200 mg PO BID. The pharmacy delivers carbidopa-levodopa 10/100 mg tablets. The nurse should administer how many tablets at each dose? (Enter the numeric value only. If rounding is required, round to the whole number.) To answer these questions, you should understand the question correctly, make sure you understand the different between how many tablet should be taken at each dose vs how many tablets should be taken per day or every 24 hours. Some questions might trick you with this. So back to our question, you need to give a medicine with a strength of 20/200 but the pharmacy supplied you with a strength of 10/100 of the same medicine, how many tablets you will administer in each dose? The answer is 2 ! and that what the question asked for! Assume the question asks for the 24 dosage? The answer would be 2 tablets BID, which is 4 tablets. Practice make it easy! Let’s move to the next one! Question: The PN/RN plants to administer 1 mg of naloxone IM, the label of the 10 mL vial indicates that the drug concentration is 0.4 mg/ml. How many mL should the PN administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Again, to answer such questions, you should understand the question very well! Always find the fixed amount which is the vial/suspension/IV bag/syrup … and compare the required value to it. Here, we have the 10 mL vial with concentration of 0.4 mg/1 mL as the fixed amount, and we need to administer 1 mg out of it, to get 1 mg, let do our equation: 0.4 mg 1 mL 1 mg x mL X = 1 x 1 /0.4 = 2.5 mL So if you take 2.5 mL out of the 10 mL vial, the strength that you will be getting is 1 mg, and that’s the answer. Question: The RN/PN is preparing a prescribing dose of erythromycin ethylsuccinate 500 mg PO daily for a child who weighs 44 pounds. The recommended dose is 30 to 50 mg/kg/day in 4 divided doses. The label of the reconstituted medication reads “200 mg / 5 mL”. How many mL should the PN administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.) This question looks so HARD! I know! Don’t be stressed out! Half of the information on it, wont be used at all! Find your fixed amount that the pharmacy supplied, and compare it to the given dose, and the acquirement, you will find that you don’t need anything further! The weight and recommended dose, were added just to make the question looks harder! The pharmacy supplies a medication with a label of 200 mg / 5 mL You need to give 500 mg, the dose hasn’t specify that it has to be per kg, so you just take the dose and compare it to the fixed amount. 200 mg in 5 mL 500 mg in x mL X = 500 * 5 / 200 = 12.5 mL… that’s the answer. The healthcare provider prescribes nitroglycerin 0.6 mg SL PRN for chest pain for a client with chronic stable angina. The medication is available in 0.4 mg tablets. How many tablets should the nurse administer if the client experiences chest pain? Fixed tablet we have is 0.4 mg We need to give 0.6 mg That’s 0.6/0.4 = 1.5 tablets. Don’t forget that usually HESI questions ask only for numeric values, so the answer is 1.5 An infant receives a prescription for digoxin injection 26 microgram. The medication is available in a solution of 0.1 mg/mL. How many mL should the nurse administer? Your fixed vial has 0.1 mg per 1 mL But the question is asking you to give 26 microgram! Whenever you have different units, you cant compare and make a direct equation, you have to have the same units. So lets convert 26 microgram into mg! Each 1 mg = 1000 microgram X mg = 26 microgram X - 26/1000 = 0.026 mg So now we can make an equation with the fixed amount we have in the vial. 0.1 mg is available in 1 mL 0.026 mg is available in x X = 0.026 x 1 / 0.1 = 0.26 mL The questions asks us to round the nearest hundredth, and the answer we got is already in the hundredth, so we just put it as is: 0.26 Q.: A client ingests three 8-ounce cans of a nutritional supplement in one day. How many mL of nutrition supplement should the nurse add to the client’s fluid intake for the day? If you know that 1 ounce oz = 30 mL, this question should be easy! Intake = 3 * 8 * 30 = 720 P. S. You should know the following as well: 1 cup = 240 mL 1 tablespoon = 15 mL 1 teaspoon = 5 mL 1 pint = 473 mL Q. After a client experience a tonic-clonic seizure. The healthcare provider prescribes phenytoin sodium suspension of 300 mg orally daily. The pharmacy provides phenytoin sodium suspension 125mg/5mL. How many mL should the nurse administer? Again, we have a fixed amount that is supplied from the pharmacy, which is 125 mg in 5 mL, we need to give 300 mg and found out how many mL to give, all same units, just make the equation and go. 125 mg --- 5 mL 300 mg --- x mL X = 300 x 5 / 125 = 12 R. The healthcare provider prescribes ampicillin 1 gram PO every 6 hours for a client with an upper respiratory infection. The pharmacy provides ampicillin 250 mg capsules. How many capsules should the nurse administer? Your fixed amount that is supplied from the pharmacy is 250 mg per capsule. The dose is 1 gram, units are not similar, lets convert 1 gram into mg: 1 gram = 1000 mg So we need to give 1000 mg and we have 250 mg per capsule, if you can’t figure it out, just divide 1000 by 250 and you will get the answer, which is 4 R. A client reports that she ingested 1/2 of a liter of a prep solution for a colonoscopy. How many mL of fluid intake should the nurse document? To answer this, you should know that 1 Liter = 1000 mL. So half a liter is 500 mL. The answer is 500 Some of the question are just common sense and just answer them within seconds. 13 Q. A home care client has an ongoing prescription for metoprolol 75 mg PO daily. During a home visit, the nurse notes that the maledictions container states that each tablet contains 25 mg and there are 9 tablets remaining. The nurse notifies the client that these are enough tablets left. How many days are left to provide the correct dose? To answer this question, you should calculate the daily dose per tablets, since that what the nurse wants to tell the client about! The daily dose is 75 mg. Each tablet contains 25 mg. You need 3 tablets per dose (daily) 75/25=3 The container has 9 tablets, that’s good for 3 days as 9/3 = 3 The answer is 3 Q. the nurse is demonstrating to a client about ways to measure a take home prescription for magnesium hydroxide 15 mL one time per day. Using a calibrated plastic medication cup for return demonstration. How many ounces should the nurse ask the client to measure? You should know that 1 ounce = 30 mL The client needs to take 15 mL, same units, so we could just do a simple math, and you will get that the amount is equal 0.5 ounce. The answer is 0.5 Q. A client receives a prescription for progesterone 15 mg IM daily. The medication is labeled “50 mg/mL” how many mL should the nurse administer? Fixed amount = 50 mg / 1 mL Required dose is 15 mg 50 mg 1 mL 15 mg x mL X = 15 x 1/50 = 0.3 The questions asks to round to the nearest tenth and that what we get in the answer already. Q. A child experiencing an allergic reaction receives a prescription for epinephrine 0.01 mg/kg subcutaneous. The child weights 66 pounds, and the medication is labeled 1mg/mL. How many mL should the nurse administer to this child? Hence the required dose here is in kg, and we have the weight of the client in pounds, so the 1st thing to do is to convert the weight of the client to kg. 1 kg = 2.2 pounds X kg= 66 pounds X = 66 x1 / 2.2 = 30 kg (note, when converting a weight from pound to kg, the answer should be always about half the amount) The requested dose is 0.01 mg / kg = 0.01 mg x 30 kg = 0.3 mg That’s the dose in mg, but the question needs the dose in mL, to get it, you should compare your mg to the fixed amount available to use, which is 1mg/1mL 1 mg -- 1 mL 0.3 mg -- x mL X = 0.3 mL And that’s the answer, 0.3. so many steps but with practice it should be easy… R. an adult client with acute rheumatoid arthritis is admitted to the hospital. The healthcare provider prescribes ketorolac 15 mg IM STAT. The pharmacy provides a vial of ketorolac 60 mg/ 2 mL. How many mL should the nurse administer? Here, you have the same medication, units, and it looks straight forward. What is supplied from the pharmacy is always the fixed amount. The requested dose is 15 mg. 60 mg --- 2 mL 15 mg --- x mL X = 2 * 15 / 60 = 30/60 = 0.5 mL The answer is 0.5 and it does make sense if you think about it logically, you have a 2 mL vial that has 60 mL, if you give 0.5 mL that is 25% of it you would give 15 mg. If you could’t think about it logically just do the math, with practice you would achieve the level of doing things by logic and sense! :) Q. An older adult client receives a prescription for lorazepam 1 mg PO at bedtime. The medication is available in 0.5 mg tablets. How many tablets should the nurse administer? This should be answered in less than a minute, so you save sometime for harder questions! You need to give a medicine with a strength of 1 mg, but the strength you have is 0.5 mg per tablet, how many tablets you should give to achieve the desired dose? Yes, 2 tablets! As 2 * 0.5 = 1 ! Q. The healthcare provider prescribes neostigmine bromide 0.25 mg IM every 4 to 6 hours for a client with bladder atony. The vial is labeled “Neostigmine bromide 1 mg/mL”. How many mL should the nurse administer with each dose? “the vial is labeled” means that what the pharmacy sent to you, means that’s the fixed value. The question is asking the amount you need per dose, so there is no need to calculate the daily dose here. You will need to administer 0.25 mg in every dose, compare it to the fixed value to get the mL: 1 mg 1 mL 0.25 mg x mL X = 0.25 * 1 / 1 = 0.25 mL The answer us 0.25 as the question is asking to round to the nearest hundred. Q. Guaifenesin 2 teaspoons by mouth is prescribed for an adult client with a persistent cough. How many mL should the nurse administer? Each teaspoon is 5 mL, if you will be giving 2 teaspoons, it is 2 x 5 = 10 Q. A client receives a prescription for midazolam 3 mg IM on call to the operating room. The drug is available in 5 mg/mL. The nurse should administer how many mL? The fixed amount is 5 mg / 1 mL We need 3 mg, just do proportional! 5 mg --- 1 mL 3 mg --- x mL X = 3*1/5 = 0.6 Q. The healthcare provider prescribes cefaclor oral suspension 400 mg PO for a child with tonsillitis and who weights 44 pounds. The pharmacy provides the medication labeled 715 mg / 5 mL. The nurse verifies that the recommended dose range is 20 to 40 mg/kg. How many mL should the nurse administer to this child? The dose is giving in mg and not related to the weight, so no need to calculate the weight in these types of questions, it is just included to make the question looks more complex! The dose is 400 mg The pharmacy provides 715 mg in 5 mL which is the fixed strength. 715 mg 5 mL 400 mg x mL X = 400 * 5/715 = 2.797 The question asks to round to the nearest tenth, the answer would be: 2.8 Q. A client receives a prescription of dexamethasone 3.0 mg PO. The nurse accesses the Pyxis MedStation medication dispensing unit that provides a unit dose of 0.75 mg/tablet. How many tablets should the nurse retrieve for administration to the client? Pyxis MedStation or unit dose are considered as a form of inpatient pharmacy ---> the fixed dose. So we have 0.75 mg in 1 tablet as a fixed dose We need to get 3 mg 0.75 mg -- 1 tablet 3 mg -- x tablet X = 3*1/0.75 = 4 tablets. The answer is 4 Q. The healthcare provider prescribes atropine 0.5 mg IM STAT for a client with bradycardia. The available dose is labeled, atropine 0.4 mg/mL. How man mL should the nurse administer? The fixed strength is 0.4 mg / 1 mL , we need to find how many ml to get 0.5 mg 0.4 mg --- 1 mL 0.5 mg --- x mL X = 1*0.5 / 0.4 = 1.25 Q. the healthcare provider prescribes calcium citrate 1 gram chewable tablets for a client with hypocalcemia. The pharmacy delivers calcium citrate 250 mg/chewable tablet. How many tablets should the nurse administer? The fixed strenght is 250 mg per 1 tablet We need 1 gram, units are not the same, so we convert 1 gram into mg, * 1000 = 1000 mg 250 mg --- 1 tablet 1000 mg --- x tablet X = 1000*1 / 250 = 4 tablets The answer is 4 Q. the healthcare provider prescribed enoxaparin (Levonox) 1 mg/kg/day subcutaneously for a client in the memory care unit. The client weights 157 pounds. The medication is available in 100 mg/mL. How many mL should the nurse administer? The required dose has weight, so we have to convert the weight. Weight in Kg = 157 / 2.2 = 71.36 kg Prescribed dose = 1 mg x 71.36 = 71.36 mg per day. We need to find the amount in mL for this amount. The fixed amount is 100 mg in 1 mL. 100 mg --- 1 mL 71.36 mg --- x mL X = 71.36 * 1 /100 = 0.7136 The question asks to round to the nearest tenth. Answer is 0.7 Q. The healthcare provider prescribes erythromycin 300 mg PO QID. The medication label reads “erythromycin 100mg/5 mL.” How many mL should the nurse administer at each dose? Medication label reads = the supplied one which is the fixed dose. We need to get mL per dose, so we ignore QID (which is 4 times aday). Hence, if the question asks for the daily dose, we would consider QID. So each 100 mg are included in 5 mL, we need to find out how many mL to get 300 mg. 100 mg --- 5 mL 300 mg --- x mL X = 300 * 5 / 100 = 15 Q. a home care client with hypertension has a prescription for lisinopril 60 mg PO every day. The drug is available in 20 mg tablets. And the nurse counts 24 tablets left in the container. The nurse remind the client that there are sufficient tablets left for how many days? The fixed strength is 20 mg per tablet The dose is 60 mg per day which is 3 tablets per day. The container has 24 tablets left, divide it by 3 = 8 days To double check, 8 days x 3 tablets per day = 24 tablet So the answer is 8 The prescription above has many medications, focus on the one you have from the pharmacy/pyxis as it is the fixed strength. Metoclopromide is available as 10 mg in 2 mL vials. The order for vomitting is 7.5 mg, we need to know how many mL you need to withdraw and administer. 10 mg --- 2 mL 7.5 mg --- x mL X = 7.5 * 2/10 = 1.5 mL The answer is to the nearest tenth, so the answer is 1.5 Q. A client with Zollinger-Ellison syndrome has a prescription for famotidine suspension 160 mg every 6 hours. The suspension is labeled “40mg/5mL”. How many mL should the nurse administer? Round to whole number. Available suspension is the fixed dose (40mg in 5 mL) We can do equation: 40 mg --- 5 mL 160 mg --- x mL X = 160 * 5 / 40 = 20 mL The answer is 20 Q. the nurse is preparing a prescribed medication dose of 35 mg IM. A prefilled syringe labeled “50 mg/mL” is available. How many mL should the nurse administer? The prefilled syringe is the syringe that would be supplied by the pharmacy and it should be the fixed strength you have. We can do proportional in this questions as well. 50 mg --- 1 mL 35 mg --- x mL X = 35x1/50 = 0.7 R. The healthcare provider prescribes 3 ounces of medication to be administered orally. How many milliliters should the nurse dispense to the client? 1 ounce = 30 mL (fixed) 3 ounces = 30 x 3 = 90 mL The answer is 90 Q. A client with TB who weight 172 pounds receives a prescription of ethambutol 25 mg/kg/day. The medication is available in 400 mg tablets. How many tablets should the nurse administer? The requested dose has weight, so we have to convert the weight and use it in kg 1 kg = 2.2 pounds X kg = 172 pounds X = 172x1 / 2.2 = 78.18 kg The prescribed dose is 25mg/kg/day = 25 x 78.18 = 1,954.5 mg Each tablet of ethambutol has 400 mg (fixed) 400 mg --- 1 tablet 1954.5 x tablet X = 1954.5*1 / 400 = 4.886 (the question asks to round to a whole number) The answer is 5 Q. a child with vericella receives a prescription for acetaminophen elixir 80 mg PRN every 4 hours for a rectal temperature above 101.4 F, the available medication is labeled “120 mg/5 mL”. How many mL should the nurse administer? Again, don’t pay attention to diseases and medication names in calculation questions. Here you have the fixed strength of 120 mg in 5 mL and you need to know how many mL to withdraw from it to get 80 mg. We will do proportional method. 120 mg --- 5 mL 80 mg --- x mL X = 80 * 5 / 120 = 3.333 mL (round to the nearest tenth) The answer is 3.3 Q. The nurse is administering teripartide rDNA origin (Forteo) 20 mg to a client with osteoporosis. The medication is labeled “600 mcg/ 2.4 mL). How many mL should the nurse administer? Here we have a fixed strength but its unit is not the same as the required dose (mcg and mg). You can convert either, and I will do it below in the two ways: 1 mg = 1000 mcg The requested dose is 20 mg = 20 x 1000 = 20000 mcg 600 mcg --- 2.4 mL 20000 mcg --- x mL X = 20000 * 2.4/600 = 80 mL, the answer is If you convert the fixed, it will be: 0.6 mg --- 2.4 mL 20 mg --- x mL X = 20*2.4/0.6 = 80 Q. the healthcare provider prescribes digoxin 125 mcg PO daily. Digoxin elixir is available as 0.5mg/mL. How many mL should the nurse administer? we have a fixed strength but its unit is not the same as the required dose (mcg and mg). 1 mg = 1000 mcg Requested dose = 125 mcg = 0.125 mg We can do proportional with the fixed available strength that has 0.5 mg in each 1 mL: 0.5 mg --- 1 mL 0.125 mg --- x mL X = 0.125 * 1 / 0.5 = 0.25 mL (round to the nearest tenth). The answer is 0.3 Q. A client with hypertension receives a prescription for losinpril 35 mg/day. The drug is available in 10 mg tablets. How many tablets should the nurse administer? Each tablet has 10 mg (fixed) 10 mg --- 1 tablet 35 mg --- x tablet X = 35*1 / 10 = 3.5 tablets (round to the nearest tenth) The answer is 3.5 Q. a child who weights 55 pounds is administered to the hospital for a repair of an inguinal hernia. The healthcare provider prescribes morphine sulfate 1.25 mg IM q4 hours as needed for postoperative pain. The recommended dosage is 0.05 mg/kg. The medication syringe is labeled 2 mg/mL. How many mL should the nurse administer to the child? The prescribed dose is not related to the weight and it is 1.25 mg, so we don’t need to convert or consider the weight to answer this question. The available syringe has 2 mg in each 1 mL (fixed) We need to administer 1.25 mg and we want to know how many mL to give. 2 mg --- 1 mL 1.25 mg x mL X = 1.25 * 1 / 2 = 0.625 (round to the nearest tenth) The answer is 0.6 Q. a client has a prescription for lorazepam 1 mg for anxiety. The medication is supplied as 0.5 mg tablets. How many tablets should the client take? The supplied tablets has 0.5 mg in each tablet (fixed), we need to give 1 mg. It is obvious that the answer is 2! if we need to do it in a proportional way: 0.5 mg --- 1 tablet 1 mg --- x tablet X = 1*1 / 0.5 = 2 Q. a client is discharged after a successful cardiac conversion for atrial fibrillation, and the healthcare provider prescribes digoxin 250 micrograms PO daily. The available strength is 0.5 mg tabs. How many tablets should the nurse confirm with the client to take daily? The requested dose = 250 microgram = 0.25 mg The available strength is the fixed value which is 0.5 mg in each tablet. 0.5 mg --- 1 tablet 0.25 mg --- x tablet X = 0.25*1 / 0.5 = 0.5 tablet The answer is 0.5 The available vial is the fixed strength which is 30 mg in 1 mL We need to give 45 mg and we want to know how many mL to withdraw in the syringe. 30 mg 1 mL 45 mg x mL X = 45*1 / 30 = 1.5 mL The answer is 1.5 the requested dose is 20 mg four time daily (20 x 4 = 80 mg daily) The medication is available 10 mg per tablet. We need to calculate how many tablets the patient should receive per day. 10 mg --- 1 tablet 80 mg --- x tablet X = 80*1 /10 = 8 tablets The answer is 8 The requested dose is 0.75 gm PO every 12 hours The pharmacy supplies 250 mg per tablet The units are not equal, so we need to convert gm to mg 1 gm = 1000 mg The requested dose is 750 mg, we need to figure out how many tablets to give 250 mg --- 1 tablet 750 mg --- x tablet X = 750*1 / 250 = 3 Q. the healthcare provider prescribes ceftazidime 1 gram every 8 hours. The label on the 1 gram vial reads “reconstitute with 100 mL sterile water”. this dilution provides a concentration of how many mg/mL? The dose is in gram and the final concentration is in mg, so we need to convert the units. 1 gram = 1000 mg So the vial has 1000 mg of ceftazidime, when you reconstitute, you add sterile water into the power to make the diluted medicine. So when we add 100 mL, the final concentration would be 1000 mg in 100 mL The final part of the question, is to figure out how many mg in each 1 mL, as if you read the question, you will notice that this is the requirement, and when the volume is 1 mL, it is written as /mL. To solve this, we can do proportional. 1000 mg --- 100 mL X mg --- 1 mL X = 1000*1 / 100 = 10 mg So the answer is 10 Q. the nurse is preparing to give fentanyl 0.075 mg IM to a client who is scheduled for colonoscopy. The medication is labeled 50 mcg/mL. How many mL should the nurse administer? The requested unit dosen’t match with the available strength 1 mg = 1000 mcg So the requested dose is 75 mcg The available medicine (fixed strength) is 50 mcg in 1 mL, and we need to know how many mL to withdraw to get the requested dose of 75 mcg. We can do proportional: 50 mcg --- 1 mL 75 mcg --- x mL X = 75 * 1 / 50 = 1.5 -- -- R. A client with multiple sclerosis (MS) is receiving interferon beta-1b 0.1875 mg subcutaneously QOD. The nurse reconstitutes the vial by slowly injecting 1.2 ml of diluent into the interferon vial for a reconstituted solution of 0.25 mg/1 ml. How many ml should the nurse administer? (Enter numerical value only. If required, round to the nearest hundredth.) The final concentration is the fixed strength which is 0.5 mg in 1 mL We need to give 0.1875 mg and calculate how many mL to inject. 0.25 mg --- 1 mL 0.1875 mg --- x mL X = 0.1875 * 1 / 0.25 = 0.75 Good luck and remember that practice makes you good in calculation! :) This package is prepared for you, sharing is not allowed, it is copy righted!