Saunders Comprehensive Review for the NCLEX-
PN® Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
NURSING PHARMACOLOGY (ADVANCED — DRUG
ADMINISTRATION, DOSAGE & CATEGORIES). TEST BANK
Items 1–13 — Standalone NCLEX-style questions
1) Safe administration — patient identifiers (multiple choice)
A nurse is preparing to give one dose of lisinopril 20 mg PO to
Mr. K. The patient’s armband is smudged and the name is
partially unreadable. Which action should the nurse take first?
A. Give the medication — the patient is in the bed with the
same room number on the chart.
B. Ask the patient to state full name and date of birth and
compare to the MAR. (Correct)
C. Check the medication order and give the medication because
the order is verified in the electronic record.
D. Wait for the next nurse’s shift and ask them to identify the
patient.
,Rationales
A. Incorrect. Room number alone is not an acceptable identifier
— two patient identifiers (e.g., name and DOB or medical
record number) are required to prevent wrong-patient errors.
Administering by room number risks a serious medication error.
B. Correct. Use two acceptable identifiers — asking the patient
to state full name and DOB and comparing to the MAR (or
scanning an armband) is the best immediate safety action. This
follows the “rights of medication” (right patient) and error-
prevention principles.
C. Incorrect. Verifying the order is necessary but does not
confirm the patient’s identity at the bedside. Med-admin
requires bedside verification of identity.
D. Incorrect. Waiting is unnecessary and could delay needed
therapy; the nurse should immediately use acceptable
identifiers or obtain a new armband from unit
clerk/registration.
2) Dosage calculation — IV gravity drops (calculation)
Order: D5W 1000 mL IV to infuse over 8 hours using tubing that
delivers 20 gtt/mL. What is the infusion rate in gtt/min? Show
work.
A. 34 gtt/min
B. 42 gtt/min (Correct)
C. 58 gtt/min
D. 20 gtt/min
,Calculation & Answer
• mL/hr = 1000 mL ÷ 8 hr = 125 mL/hr.
• gtt/min = (125 mL/hr × 20 gtt/mL) ÷ 60 min/hr = 2500 ÷ 60
= 41.666… ≈ 42 gtt/min.
Correct answer: B.
Rationales
A. Incorrect. 34 gtt/min is too low — reflects calculation error.
B. Correct. Shows correct stepwise conversion and proper
rounding to whole drops/min (always report whole drops).
C. Incorrect. 58 gtt/min is too high — likely miscalculated mL/hr
or used wrong denominator.
D. Incorrect. 20 gtt/min corresponds to ~60 mL/hr with this
tubing — not the correct rate for 1000 mL/8 hr.
3) Dosage calculation — IV infusion mL/hr (calculation)
Order: Heparin infusion 5,000 units/hour. Pharmacy delivered
heparin 25,000 units in 250 mL. What should the infusion pump
be set to (mL/hr)?
A. 10 mL/hr
B. 25 mL/hr
C. 50 mL/hr (Correct)
D. 100 mL/hr
Calculation & Answer
• Units per mL = 25,000 units ÷ 250 mL = 100 units/mL.
, • Desired mL/hr = 5,000 units/hr ÷ 100 units/mL = 50 mL/hr.
Correct answer: C.
Rationales
A. Incorrect. 10 mL/hr would deliver 1,000 units/hr (not
enough).
B. Incorrect. 25 mL/hr would deliver 2,500 units/hr (still too
low).
C. Correct. 50 mL/hr delivers the prescribed 5,000 units/hr. Use
pump programming and double-check with a second nurse per
facility policy for high-alert IV anticoagulants.
D. Incorrect. 100 mL/hr would deliver 10,000 units/hr (double
the ordered dose) — dangerous.
4) Pediatric dosing — mg/kg and volume calculation
(calculation)
A child weighs 18 kg. The provider orders amoxicillin 50
mg/kg/day PO divided q12h. The pharmacy supplies
amoxicillin suspension 250 mg / 5 mL. How many mL per dose
should the nurse administer?
A. 4.5 mL
B. 9 mL (Correct)
C. 18 mL
D. 2.5 mL
Calculation & Answer
• Total daily dose = 50 mg/kg × 18 kg = 900 mg/day.
PN® Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
NURSING PHARMACOLOGY (ADVANCED — DRUG
ADMINISTRATION, DOSAGE & CATEGORIES). TEST BANK
Items 1–13 — Standalone NCLEX-style questions
1) Safe administration — patient identifiers (multiple choice)
A nurse is preparing to give one dose of lisinopril 20 mg PO to
Mr. K. The patient’s armband is smudged and the name is
partially unreadable. Which action should the nurse take first?
A. Give the medication — the patient is in the bed with the
same room number on the chart.
B. Ask the patient to state full name and date of birth and
compare to the MAR. (Correct)
C. Check the medication order and give the medication because
the order is verified in the electronic record.
D. Wait for the next nurse’s shift and ask them to identify the
patient.
,Rationales
A. Incorrect. Room number alone is not an acceptable identifier
— two patient identifiers (e.g., name and DOB or medical
record number) are required to prevent wrong-patient errors.
Administering by room number risks a serious medication error.
B. Correct. Use two acceptable identifiers — asking the patient
to state full name and DOB and comparing to the MAR (or
scanning an armband) is the best immediate safety action. This
follows the “rights of medication” (right patient) and error-
prevention principles.
C. Incorrect. Verifying the order is necessary but does not
confirm the patient’s identity at the bedside. Med-admin
requires bedside verification of identity.
D. Incorrect. Waiting is unnecessary and could delay needed
therapy; the nurse should immediately use acceptable
identifiers or obtain a new armband from unit
clerk/registration.
2) Dosage calculation — IV gravity drops (calculation)
Order: D5W 1000 mL IV to infuse over 8 hours using tubing that
delivers 20 gtt/mL. What is the infusion rate in gtt/min? Show
work.
A. 34 gtt/min
B. 42 gtt/min (Correct)
C. 58 gtt/min
D. 20 gtt/min
,Calculation & Answer
• mL/hr = 1000 mL ÷ 8 hr = 125 mL/hr.
• gtt/min = (125 mL/hr × 20 gtt/mL) ÷ 60 min/hr = 2500 ÷ 60
= 41.666… ≈ 42 gtt/min.
Correct answer: B.
Rationales
A. Incorrect. 34 gtt/min is too low — reflects calculation error.
B. Correct. Shows correct stepwise conversion and proper
rounding to whole drops/min (always report whole drops).
C. Incorrect. 58 gtt/min is too high — likely miscalculated mL/hr
or used wrong denominator.
D. Incorrect. 20 gtt/min corresponds to ~60 mL/hr with this
tubing — not the correct rate for 1000 mL/8 hr.
3) Dosage calculation — IV infusion mL/hr (calculation)
Order: Heparin infusion 5,000 units/hour. Pharmacy delivered
heparin 25,000 units in 250 mL. What should the infusion pump
be set to (mL/hr)?
A. 10 mL/hr
B. 25 mL/hr
C. 50 mL/hr (Correct)
D. 100 mL/hr
Calculation & Answer
• Units per mL = 25,000 units ÷ 250 mL = 100 units/mL.
, • Desired mL/hr = 5,000 units/hr ÷ 100 units/mL = 50 mL/hr.
Correct answer: C.
Rationales
A. Incorrect. 10 mL/hr would deliver 1,000 units/hr (not
enough).
B. Incorrect. 25 mL/hr would deliver 2,500 units/hr (still too
low).
C. Correct. 50 mL/hr delivers the prescribed 5,000 units/hr. Use
pump programming and double-check with a second nurse per
facility policy for high-alert IV anticoagulants.
D. Incorrect. 100 mL/hr would deliver 10,000 units/hr (double
the ordered dose) — dangerous.
4) Pediatric dosing — mg/kg and volume calculation
(calculation)
A child weighs 18 kg. The provider orders amoxicillin 50
mg/kg/day PO divided q12h. The pharmacy supplies
amoxicillin suspension 250 mg / 5 mL. How many mL per dose
should the nurse administer?
A. 4.5 mL
B. 9 mL (Correct)
C. 18 mL
D. 2.5 mL
Calculation & Answer
• Total daily dose = 50 mg/kg × 18 kg = 900 mg/day.
