Saunders Comprehensive Review for the NCLEX-PN®
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
Question 1 — Pediatric mg/kg divided dosing (oral)
Order: Amoxicillin 50 mg/kg/day PO divided every 8 hours for
an infant. The infant weighs 22 lb. What dose (in mg) should the
nurse give per dose?
A. 125 mg
B. 167 mg
C. 200 mg
D. 250 mg
Answer: B. 167 mg (rounded to nearest mg; common clinical
rounding: 167 mg → document as 167 mg or 0.167 g; provider/
pharmacy may round to 165 or 170 mg)
Solution (dimensional analysis):
1. Convert weight to kg: 22 lb÷2.2=10.0 kg22\ \text{lb} \div
2.2 = 10.0\ \text{kg}22 lb÷2.2=10.0 kg.
, 2. Daily dose = 50 mg/kg/day×10.0 kg=500 mg/day50\
\text{mg/kg/day} \times 10.0\ \text{kg} = 500\
\text{mg/day}50 mg/kg/day×10.0 kg=500 mg/day.
3. Divided q8h → 3 doses/day:
500 mg÷3=166.666… mg/dose500\ \text{mg} \div 3 =
166.666\dots\
\text{mg/dose}500 mg÷3=166.666… mg/dose.
4. Round appropriately → 166.67 mg → clinically report 167
mg.
Rationale:
• B (correct): Follows mg/kg and correct division by 3.
Matches Saunders’ dimensional-analysis steps: convert
weight → calculate total → divide by number of doses.
Elsevier Health
• A (125 mg): Underestimates due to miscalculation (likely
forgot mg/kg or used lb not kg).
• C (200 mg): Overestimates; might be from rounding up
incorrectly to next 50 mg without following mg/kg.
• D (250 mg): Too high — would deliver double the per-dose
amount required.
Question 2 — Neonatal/infant single mg/kg dose (IV)
Order: Gentamicin 2.5 mg/kg IV once. The neonate weighs 4.4
lb. How many mg should be given?
,A. 2 mg
B. 3 mg
C. 4 mg
D. 5 mg
Answer: D. 5 mg
Solution:
1. Convert weight: 4.4 lb÷2.2=2.0 kg4.4\ \text{lb} \div 2.2 =
2.0\ \text{kg}4.4 lb÷2.2=2.0 kg.
2. Dose = 2.5 mg/kg×2.0 kg=5.0 mg2.5\ \text{mg/kg} \times
2.0\ \text{kg} = 5.0\ \text{mg}2.5 mg/kg×2.0 kg=5.0 mg.
Rationale:
• D (correct): Direct mg/kg multiplication after converting to
kg.
• A–C: Result from either converting incorrectly (not
converting lb → kg) or misplacing decimal (e.g., 2.5 × 1 =
2.5 mg → rounded to 2 mg).
Question 3 — IV flow rate (mL/hr)
Order: Normal saline 1,000 mL IV to run over 8 hours. Pump
setting in mL/hr = ?
A. 100 mL/hr
B. 125 mL/hr
C. 150 mL/hr
D. 200 mL/hr
, Answer: B. 125 mL/hr
Solution:
1,000 mL÷8 hr=125 mL/hr1{,}000\ \text{mL} \div 8\ \text{hr} =
125\ \text{mL/hr}1,000 mL÷8 hr=125 mL/hr.
Rationale:
• B (correct): Straight volume/time calculation using
dimensional analysis (mL ÷ hr = mL/hr). Saunders
encourages simple unit cancellation for IV rates. Elsevier
Health
• A/C/D: Common calculation errors (dividing by 10, or
mixing minutes/hours).
Question 4 — IV drops per minute (gtt/min)
Order: Infuse 250 mL D5W over 2 hours via administration set
that delivers 15 gtt/mL. The correct drops/min = ?
A. 19 gtt/min
B. 25 gtt/min
C. 31 gtt/min
D. 41 gtt/min
Answer: C. 31 gtt/min (round to nearest whole drop)
Solution:
1. Total gtt = 250 mL×15 gtt/mL=3,750 gtt250\ \text{mL}
\times 15\ \text{gtt/mL} = 3{,}750\
\text{gtt}250 mL×15 gtt/mL=3,750 gtt.
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
Question 1 — Pediatric mg/kg divided dosing (oral)
Order: Amoxicillin 50 mg/kg/day PO divided every 8 hours for
an infant. The infant weighs 22 lb. What dose (in mg) should the
nurse give per dose?
A. 125 mg
B. 167 mg
C. 200 mg
D. 250 mg
Answer: B. 167 mg (rounded to nearest mg; common clinical
rounding: 167 mg → document as 167 mg or 0.167 g; provider/
pharmacy may round to 165 or 170 mg)
Solution (dimensional analysis):
1. Convert weight to kg: 22 lb÷2.2=10.0 kg22\ \text{lb} \div
2.2 = 10.0\ \text{kg}22 lb÷2.2=10.0 kg.
, 2. Daily dose = 50 mg/kg/day×10.0 kg=500 mg/day50\
\text{mg/kg/day} \times 10.0\ \text{kg} = 500\
\text{mg/day}50 mg/kg/day×10.0 kg=500 mg/day.
3. Divided q8h → 3 doses/day:
500 mg÷3=166.666… mg/dose500\ \text{mg} \div 3 =
166.666\dots\
\text{mg/dose}500 mg÷3=166.666… mg/dose.
4. Round appropriately → 166.67 mg → clinically report 167
mg.
Rationale:
• B (correct): Follows mg/kg and correct division by 3.
Matches Saunders’ dimensional-analysis steps: convert
weight → calculate total → divide by number of doses.
Elsevier Health
• A (125 mg): Underestimates due to miscalculation (likely
forgot mg/kg or used lb not kg).
• C (200 mg): Overestimates; might be from rounding up
incorrectly to next 50 mg without following mg/kg.
• D (250 mg): Too high — would deliver double the per-dose
amount required.
Question 2 — Neonatal/infant single mg/kg dose (IV)
Order: Gentamicin 2.5 mg/kg IV once. The neonate weighs 4.4
lb. How many mg should be given?
,A. 2 mg
B. 3 mg
C. 4 mg
D. 5 mg
Answer: D. 5 mg
Solution:
1. Convert weight: 4.4 lb÷2.2=2.0 kg4.4\ \text{lb} \div 2.2 =
2.0\ \text{kg}4.4 lb÷2.2=2.0 kg.
2. Dose = 2.5 mg/kg×2.0 kg=5.0 mg2.5\ \text{mg/kg} \times
2.0\ \text{kg} = 5.0\ \text{mg}2.5 mg/kg×2.0 kg=5.0 mg.
Rationale:
• D (correct): Direct mg/kg multiplication after converting to
kg.
• A–C: Result from either converting incorrectly (not
converting lb → kg) or misplacing decimal (e.g., 2.5 × 1 =
2.5 mg → rounded to 2 mg).
Question 3 — IV flow rate (mL/hr)
Order: Normal saline 1,000 mL IV to run over 8 hours. Pump
setting in mL/hr = ?
A. 100 mL/hr
B. 125 mL/hr
C. 150 mL/hr
D. 200 mL/hr
, Answer: B. 125 mL/hr
Solution:
1,000 mL÷8 hr=125 mL/hr1{,}000\ \text{mL} \div 8\ \text{hr} =
125\ \text{mL/hr}1,000 mL÷8 hr=125 mL/hr.
Rationale:
• B (correct): Straight volume/time calculation using
dimensional analysis (mL ÷ hr = mL/hr). Saunders
encourages simple unit cancellation for IV rates. Elsevier
Health
• A/C/D: Common calculation errors (dividing by 10, or
mixing minutes/hours).
Question 4 — IV drops per minute (gtt/min)
Order: Infuse 250 mL D5W over 2 hours via administration set
that delivers 15 gtt/mL. The correct drops/min = ?
A. 19 gtt/min
B. 25 gtt/min
C. 31 gtt/min
D. 41 gtt/min
Answer: C. 31 gtt/min (round to nearest whole drop)
Solution:
1. Total gtt = 250 mL×15 gtt/mL=3,750 gtt250\ \text{mL}
\times 15\ \text{gtt/mL} = 3{,}750\
\text{gtt}250 mL×15 gtt/mL=3,750 gtt.
