Saunders Comprehensive Review for the NCLEX-
PN® Examination
9th Edition
Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
1) Medication-administration principle (multiple choice)
A nurse is preparing to administer an oral antihypertensive.
Which nursing action best follows the six rights and reduces
medication error risk before administration?
A. Ask the patient whether they recognize the medication by its
trade name.
B. Scan the barcode on the medication and compare it to the
electronic medication administration record (eMAR).
C. Rely on the unit clerk's verification that the medication was
prepared correctly.
D. Give the medication within a 2-hour window of the
scheduled time because it is noncritical.
Answer: B. Scan the barcode on the medication and compare
it to the eMAR.
Rationale (correct): Barcode scanning verifies right patient,
right medication, right dose, right route, right time by
electronically matching the med to the eMAR and the patient’s
,ID band, which reduces human transcription/identification error
(Saunders: medication administration and safety principles).
Evolve
Rationale (incorrect):
A — Patient recognition is helpful but not sufficient; many
patients may not know medication names.
C — Relying on others bypasses independent verification and
increases risk.
D — Timing windows depend on medication criticality; giving a
med outside recommended timeframe may be unsafe.
2) Tablet dosage calculation (calculation — show work)
Order: Cefuroxime 250 mg PO. Available: 125 mg tablets. How
many tablets should the nurse give? Show calculation and
round to nearest whole tablet if required.
Answer: 2 tablets.
Calculation (digit-by-digit):
Needed = 250 mg. Available per tablet = 125 mg.
250 ÷ 125 = 2.
Therefore give 2 tablets.
Rationale: Straight division of ordered dose by tablet strength
gives correct number. Always verify order and tablet strength
prior to administration (Saunders: medication calculations and
safe administration). Evolve+1
,3) IV infusion rate (calculation)
An IV bag of 1000 mL normal saline is to infuse over 8 hours.
The infusion pump displays mL/hr. What rate should the nurse
set?
Answer: 125 mL/hr.
Calculation: 1000 mL ÷ 8 hr = 125 mL/hr.
Rationale: Simple volume/time calculation. Confirm pump
settings and recheck infusion totals frequently. (Saunders: IV
administration and infusion rate calculations). Evolve
4) Pediatric weight-based dose (calculation + rounding)
Order: Amoxicillin 40 mg/kg/day PO divided every 8 hours for a
child who weighs 22 lb. Available suspension: 125 mg/5 mL.
Calculate the dose volume in mL per administration. Show
work, include unit conversion and digit-by-digit math.
Answer: ~5.3 mL per dose (round according to facility policy;
commonly 5.3 mL).
Calculation (stepwise):
1. Convert pounds to kilograms: 22 lb ÷ 2.20462 = 9.9795 kg
→ round to 10.0 kg (keep noted precision).
2. Total daily dose = 40 mg/kg/day × 10.0 kg = 400 mg/day.
, 3. Dosing interval q8h → 3 doses/day → dose per
administration = 400 mg ÷ 3 = 133.333... mg ≈ 133.33 mg.
4. Suspension concentration: 125 mg per 5 mL → 125 mg / 5
mL = 25 mg/mL.
5. Volume needed = 133.33 mg ÷ (25 mg/mL) = 5.3332 mL ≈
5.3 mL.
Rationale: Convert pounds to kg first, calculate daily mg, divide
by number of doses, then convert mg to mL using
concentration. Round per facility practice; in pediatrics retain
safe precision and document rounding rationale. (Saunders:
pediatric dose calculations and safety). Evolve
5) ACE inhibitor (cardiovascular) — single best answer
A patient with new onset hypertension is prescribed lisinopril.
Which statement to the patient reflects correct teaching about
the medication's mechanism, a common adverse effect, and
when to seek immediate care?
A. “Lisinopril blocks beta receptors in the heart; expect an
increased heartrate and call if you have a cough.”
B. “Lisinopril inhibits angiotensin-converting enzyme, can cause
a dry cough and dizziness; seek immediate care for facial
swelling or difficulty breathing.”
C. “Lisinopril is a calcium channel blocker; it commonly causes
constipation and should be stopped if you get a skin rash.”
PN® Examination
9th Edition
Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
1) Medication-administration principle (multiple choice)
A nurse is preparing to administer an oral antihypertensive.
Which nursing action best follows the six rights and reduces
medication error risk before administration?
A. Ask the patient whether they recognize the medication by its
trade name.
B. Scan the barcode on the medication and compare it to the
electronic medication administration record (eMAR).
C. Rely on the unit clerk's verification that the medication was
prepared correctly.
D. Give the medication within a 2-hour window of the
scheduled time because it is noncritical.
Answer: B. Scan the barcode on the medication and compare
it to the eMAR.
Rationale (correct): Barcode scanning verifies right patient,
right medication, right dose, right route, right time by
electronically matching the med to the eMAR and the patient’s
,ID band, which reduces human transcription/identification error
(Saunders: medication administration and safety principles).
Evolve
Rationale (incorrect):
A — Patient recognition is helpful but not sufficient; many
patients may not know medication names.
C — Relying on others bypasses independent verification and
increases risk.
D — Timing windows depend on medication criticality; giving a
med outside recommended timeframe may be unsafe.
2) Tablet dosage calculation (calculation — show work)
Order: Cefuroxime 250 mg PO. Available: 125 mg tablets. How
many tablets should the nurse give? Show calculation and
round to nearest whole tablet if required.
Answer: 2 tablets.
Calculation (digit-by-digit):
Needed = 250 mg. Available per tablet = 125 mg.
250 ÷ 125 = 2.
Therefore give 2 tablets.
Rationale: Straight division of ordered dose by tablet strength
gives correct number. Always verify order and tablet strength
prior to administration (Saunders: medication calculations and
safe administration). Evolve+1
,3) IV infusion rate (calculation)
An IV bag of 1000 mL normal saline is to infuse over 8 hours.
The infusion pump displays mL/hr. What rate should the nurse
set?
Answer: 125 mL/hr.
Calculation: 1000 mL ÷ 8 hr = 125 mL/hr.
Rationale: Simple volume/time calculation. Confirm pump
settings and recheck infusion totals frequently. (Saunders: IV
administration and infusion rate calculations). Evolve
4) Pediatric weight-based dose (calculation + rounding)
Order: Amoxicillin 40 mg/kg/day PO divided every 8 hours for a
child who weighs 22 lb. Available suspension: 125 mg/5 mL.
Calculate the dose volume in mL per administration. Show
work, include unit conversion and digit-by-digit math.
Answer: ~5.3 mL per dose (round according to facility policy;
commonly 5.3 mL).
Calculation (stepwise):
1. Convert pounds to kilograms: 22 lb ÷ 2.20462 = 9.9795 kg
→ round to 10.0 kg (keep noted precision).
2. Total daily dose = 40 mg/kg/day × 10.0 kg = 400 mg/day.
, 3. Dosing interval q8h → 3 doses/day → dose per
administration = 400 mg ÷ 3 = 133.333... mg ≈ 133.33 mg.
4. Suspension concentration: 125 mg per 5 mL → 125 mg / 5
mL = 25 mg/mL.
5. Volume needed = 133.33 mg ÷ (25 mg/mL) = 5.3332 mL ≈
5.3 mL.
Rationale: Convert pounds to kg first, calculate daily mg, divide
by number of doses, then convert mg to mL using
concentration. Round per facility practice; in pediatrics retain
safe precision and document rounding rationale. (Saunders:
pediatric dose calculations and safety). Evolve
5) ACE inhibitor (cardiovascular) — single best answer
A patient with new onset hypertension is prescribed lisinopril.
Which statement to the patient reflects correct teaching about
the medication's mechanism, a common adverse effect, and
when to seek immediate care?
A. “Lisinopril blocks beta receptors in the heart; expect an
increased heartrate and call if you have a cough.”
B. “Lisinopril inhibits angiotensin-converting enzyme, can cause
a dry cough and dizziness; seek immediate care for facial
swelling or difficulty breathing.”
C. “Lisinopril is a calcium channel blocker; it commonly causes
constipation and should be stopped if you get a skin rash.”
