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TEST BANK CALCULATING DRUG DOSAGES A PATIENT-SAFE APPROACH TO NURSING AND MATH ANDRA LUZ MARTINEZ DE CASTILLO AND MARYANNE WERNER-MCCULLOUGH

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TEST BANK CALCULATING DRUG DOSAGES A PATIENT-SAFE APPROACH TO NURSING AND MATH ANDRA LUZ MARTINEZ DE CASTILLO AND MARYANNE WERNER-MCCULLOUGH Table of Contents: I. Safety in Medication Administration Chapter 1. Safety in Medication Administration Chapter 2.The Drug Label II. Systems of Measurement Chapter 3. The Metric System Chapter 4. The Household System III. Methods of Calculation Chapter 5. Linear Ratio and Proportion Chapter 6. Fractional Ratio and Proportion Chapter 7. Dimensional Analysis Chapter 8. Formula Method IV. Administration of Medications Chapter 9. Calculating Oral Medication Doses Chapter 10. Syringes and Needles Chapter 11. Calculating Parenteral Medication Dosages Chapter 12. Preparing Powdered Parenteral Medications Chapter 13. Administration of Insulin V. IV Therapy and Administration of Intravenous Medications Chapter 14. Intravenous Infusion and Infusion Rates Chapter 15. Calculating Infusion and Completion Time Chapter 16. Administering IV Push Medications VI. Verifying Safe Dose and Critical Care Calculations Chapter 17. Verifying Safe Dose Chapter 18. Titration of Intravenous Medications VII. Intake and Output Chapter 19. Calculating Intake and Output Chapter 20. Calculating Parenteral Intake VIII. Dosages for Pediatric and Older Adult Populations Chapter 21. Considerations for the Pediatric Patient Chapter 22. Considerations for the Older Adult

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Institution
CALCULATING DRUG DOSAGES A PATIENT-SAFE APPROACH
Course
CALCULATING DRUG DOSAGES A PATIENT-SAFE APPROACH

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TEST BANK
CALCULATING DRUG DOSAGES A PATIENT-SAFE APPROACH TO NURSING AND MATH

ANDRA LUZ MARTINEZ DE CASTILLO AND MARYANNE WERNER-MCCULLOUGH

2nd Edition




TEST BANK

,Castillo/Werner-McCullough: Calculating Drug Dosages: A Patient-Safe Approach to Nursing and Math,,2e
Test Bank

Table of Contents:
I. Safety in Medication Administration
Chapter 1. Safety in Medication Administration
Chapter 2. The Drug Label
II. Systems of Measurement
Chapter 3. The Metric System
Chapter 4. The Household System
III. Methods of Calculation
Chapter 5. Linear Ratio and Proportion
Chapter 6. Fractional Ratio and Proportion
Chapter 7. Dimensional Analysis
Chapter 8. Formula Method
IV. Administration of Medications
Chapter 9. Calculating Oral Medication Doses
Chapter 10. Syringes and Needles
Chapter 11. Calculating Parenteral Medication Dosages
Chapter 12. Preparing Powdered Parenteral Medications
Chapter 13. Administration of Insulin
V. IV Therapy and Administration of Intravenous Medications
Chapter 14. Intravenous Infusion and Infusion Rates
Chapter 15. Calculating Infusion and Completion Time
Chapter 16. Administering IV Push Medications
VI. Verifying Safe Dose and Critical Care Calculations
Chapter 17. Verifying Safe Dose
Chapter 18. Titration of Intravenous Medications
VII. Intake and Output
Chapter 19. Calculating Intake and Output
Chapter 20. Calculating Parenteral Intake
VIII. Dosages for Pediatric and Older Adult Populations
Chapter 21. Considerations for the Pediatric Patient
Chapter 22. Considerations for the Older Adult

,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e



Chapter 1: Safety in Medication Administration
Castillo: Calculating Drug Dosages: A Patient-Safe Approach to Nursing and Math 2nd Edition


MULTIPLE CHOICE

1. The following medication order is in the patient’s medication administration record (MAR):

methylPREDnisolone 40 mg PO daily at 0900.

After reading the order, the nurse correctly determines:
A “PO” is an inappropriate abbreviation.
B the medication order is written correctly.
C 40 mg should be written as 40mg.
D tall man lettering indicates that the drug is a narcotic.

ANS: B
Feedback
The medication order has all the required components (drug name, dose, route, and
frequency of administration) for a drug order. “PO” is an appropriate abbreviation;
40 mg is written correctly with a space between the dose and the unit of
measurement. Tall man lettering is used to distinguish the drug from another drug
with a similar name.



2. Which of the following accurately describes the “Boxed Warning” found on a drug label?
A It is primarily is used to identify the safe dose for the patient.
B It is commonly found on all drug labels.
C It identifies serious potential risks and side effects related to drug use.
D It protects the patient by providing information to decrease side effects.

ANS: C
Feedback
A drug label with a boxed warning provides information to healthcare professionals
and patients regarding the serious risks and side effects related to the drug. The
Boxed Warning is not the primary source for identifying the patient’s drug dosage.
The warning is found on specific prescription medications and does not provide
information to reduce or decrease side effects.



3. When practicing safety in the administration of medication, for which of the following
medication orders should a nurse seek clarification before the administration of the
medication?


1

,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e


A Regular insulin 5 u subcut now.
B Enoxaparin 80 mg subcut every 12 hours.
C Benadryl 50 mg PO PRN every 6 hr for itching.
D Ondansetron 4 mg IVP stat.

ANS: A
Feedback
The “u” should never be used in a medication order; rather, for safety, the word
“units” should be spelled out. The other answer options contain the required
components needed to safely carry out the medication order.



4. A nurse is reviewing a drug label with a drug name written with tall man lettering. Which
statements shows the nurse has a correct understanding of tall man lettering on a drug label?
A “The tall man lettering means this is a high alert drug.”
B “The tall man lettering helps me distinguish this drug with other drugs that
have similar names.”
C “The tall man lettering means that this drug must have a Boxed Warning.”
D “The tall man lettering helps me quickly identify that this drug is an injectable
drug.”

ANS: B
Feedback
Tall man lettering highlights a portion of the drug name to help distinguish from
similar drug names. It is not used to identify high alert drugs, highlight a boxed
warning, or identify injectable drugs.



5. The following medication orders are found in the patient’s MAR:

Metformin HCl 500 mg PO daily at 0900.
Hydrochlorothiazide 25 mg PO every 12 hr at 0900 and 2100.
Digoxin .25 mg PO daily at 0900.

In reading the medication orders for the 0700–1500 shift, the nurse determines that which of
the following is the priority nursing intervention?
A Clarify the metformin HCl order.
B Clarify the hydrochlorothiazide order.
C Clarify the digoxin order.
D Prepare to administer the 0900 medications.

ANS: C


2

,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e



Feedback
The digoxin medication order is lacking a zero before the decimal fraction (.25).
Safe practice recommends using a zero before a decimal point when the dose is less
than one. The metformin HCl and the hydrochlorothiazide orders are written
correctly. The order should be clarified before preparing the 0900 medications.



6. In the administration of medications, when should the nurse document the administration of
medications?
A 30 minutes before administering to the patient.
B Immediately before administering to the patient.
C At the end of the shift.
D Immediately after administering to the patient.

ANS: D
Feedback
The last “Right of Medication Administration” is the documentation of medications.
The documentation is done immediately after administering the medications to the
patient.



7. The following medication is ordered for the patient:

Calcitriol Oral Solution 2 µg PO Daily

After reading the order, what is the initial action needed by the nurse?
A Clarify the written medication dose of 2 µg.
B Look up the dose in a drug reference book.
C Transcribe the medication order onto the MAR.
D Ask the patient the daily dose taken at home.

ANS: A
Feedback
The initial action is for the nurse to clarify the drug dose because it is written with
the error-prone letter/symbol “µ.” To avoid medication errors, it is recommended
that the “µ” not be used in medication orders. Instead the abbreviation “mcg” is to
be used for microgram.



8. Recommendations by the Institute of Medicine for reducing medication errors help enhance
safe nursing practice by:


3

,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e


A shifting fprimary fresponsibility ffor fdrug ftherapy fonto fpatients fand
f families.
B referring fpatients fand ffamilies fto fthe fpharmacist ffor fdrug ftherapy
fquestions.
C answering fdrug ftherapy fquestions fwhen fa fnew fprescription fis fordered.
D promoting fongoing fcommunication fbetween fpatients fand fhealthcare
providers.

ANS: fD
Feedback
The fInstitute fof fMedicine frecommendations finclude fthe festablishment fof
fcollaborative fpartnership fbetween fpatients fand fhealthcare fproviders fto fassist fin
educating, fconsulting, fand flistening fto fpatient’s fconcerns. fOngoing
fcommunication f between fpatients fand f healthcare fproviders fkeeps fthe f focus fon
fthe fneeds fof fthe
individual fpatient fand fpromotes fsafety.



9. In fconsulting fa fdrug freference fbook, fthe fnurse freads fthat fcertain fmedications fare
fclassified fas f “high-alert” fmedications. fIn fthe fadministration fof fhigh-alert fmedications,
fwhat fis fthe fpriority faction fof fthe f nurse?
A Inform fthe fpatient fof fthe fharmful fside feffects.
B Double-check fthe fdose fwith fanother fnurse fprior fto fadministering fthe
fdrug.
C Provide fdrug fliterature fto fthe ffamily fto fassist fwith fmonitoring ffor
fharmful
effects.
D Seek fassistance ffrom fthe fpharmacist fto fexplain fthe feffects fof fthe
fdrug.


ANS: fB
Feedback
High-alert fmedications fhave fan fincreased frisk fof fpatient fharm. fSafe fpractice fin
fthe fadministration fof f high-alert fmedications frequires fthe f nurse fto fdouble fcheck
fthe fdose fwith fanother fnurse fprior fto fthe fadministration fof fthe fdrug. fInforming
fthe fpatient fand f family fof fthe fdrug’s f harmful feffects f may f be f indicated ffor
fsome fpatients, fbut fthe fprevention fof f a f medication ferror fis fcritical. fDrug
f literature fmay f be f helpful f for fsome f families, fbut fnot fall. fThe fnurse fshould fseek
fassistance ffrom fthe fpharmacist fwhenever
there fis fa fquestion, fbut fthis fis fnot fspecific ffor fhigh-alert fmedications.



10. All fof fthe ffollowing fmedication forders fare ffound fin fa fpatient’s fMAR. fSelect fthe
fmedication forder fthat frequires fclarification fbefore fadministration.
A Captopril f12.5 fmg fPO fat f0700 fand f1700
4

, Castillo/Werner-McCullough: Calculating Drug Dosages, 2e
B Regular finsulin f7 funits fsubcut f30 fminutes fbefore
fbreakfast.
C Ketorolac f15 fmg fIM fstat
D Morphine fsulfate f45.0 fmg fPO fevery f5 fhr ffor fpain.




5

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CALCULATING DRUG DOSAGES A PATIENT-SAFE APPROACH
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CALCULATING DRUG DOSAGES A PATIENT-SAFE APPROACH

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