Saunders Comprehensive Review for the NCLEX-PN®
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
1 — Dosage by weight (single dose)
A 28-kg child is prescribed amikacin 15 mg/kg IV single dose.
The pharmacy supplies amikacin 250 mg/2 mL. How many mL
should the nurse administer?
A. 1.7 mL
B. 3.4 mL
C. 2.5 mL
D. 4.2 mL
Correct answer: B. 3.4 mL
Solution (step-by-step):
1. Calculate desired dose: 15 mg/kg × 28 kg = 420 mg.
2. Pharmacy concentration: 250 mg / 2 mL → convert to mg
per mL: 250 mg ÷ 2 mL = 125 mg/mL.
3. Use dimensional analysis: Desired (420 mg) ÷ Have (125
mg) × Vehicle (1 mL) = 420 ÷ 125 × 1 = 3.36 mL.
, 4. Rounding: round to one decimal if using syringe for
precise dosing → 3.4 mL.
Nursing safety checks:
• Verify allergy and previous aminoglycoside levels/renal
function.
• Check recommended mg/kg and max single dose for
amikacin.
• Confirm the dose with another nurse if hospital policy
requires.
Rationale:
• B is correct because calculations yield 3.36 mL ≈ 3.4 mL.
• A (1.7 mL) would be half the required dose; C (2.5 mL)
underdoses; D (4.2 mL) overdoses.
2 — Weight-based dose (range checking)
An adult client weight 72 kg is prescribed heparin IV bolus 80
units/kg prior to infusion. Heparin comes as 1,000 units/mL.
How many mL should be given?
A. 4.6 mL
B. 5.8 mL
C. 6.0 mL
D. 8.0 mL
Correct answer: B. 5.8 mL
,Solution:
1. Desired dose: 80 units/kg × 72 kg = 5,760 units.
2. Concentration: 1,000 units / 1 mL.
3. Dimensional analysis: 5,760 units ÷ 1,000 units × 1 mL =
5.76 mL.
4. Rounding: round to one decimal place (syringe
measurable) → 5.8 mL.
Safety checks:
• Verify weight units (kg), allergy, and appropriateness of
bolus.
• Confirm order (units/kg) and that heparin strength is 1,000
units/mL.
Rationale:
• B matches calculated 5.76 mL ≈ 5.8 mL. Others are
incorrect by calculation.
3 — Pediatric dosing with mg/kg/day divided schedule
A 10-kg infant is prescribed ceftazidime 120 mg/kg/day IV
divided q8h. Pharmacy provides 500 mg/5 mL. How many mL
should be given per dose?
A. 4.8 mL
B. 6.0 mL
, C. 8.0 mL
D. 10.0 mL
Correct answer: A. 4.8 mL
Solution:
1. Total daily dose: 120 mg/kg/day × 10 kg = 1,200 mg/day.
2. Divided q8h → 3 doses/day → per dose = 1,200 ÷ 3 = 400
mg per dose.
3. Concentration: 500 mg / 5 mL = 100 mg/mL.
4. Dimensional analysis: Desired 400 mg ÷ Have 100 mg × 1
mL = 4 mL.
Wait—this calculation yields 4.0 mL, not 4.8. Let’s double-
check: maybe misstep—recalculate carefully:
Hold—recompute step 2: 120 mg/kg × 10 kg = 1,200 mg/day.
Divided by 3 = 400 mg/dose. Correct. Have 500 mg/5 mL → 100
mg/mL. 400 ÷ 100 = 4.0 mL. So correct answer should be 4.0
mL, but 4.0 isn't among options. Need to correct the options—
since we must deliver valid answers, revise options: replace A
with 4.0 mL and set correct answer accordingly.
(Correction applied — updated options below)
A. 4.0 mL
B. 6.0 mL
C. 8.0 mL
D. 10.0 mL
Correct answer: A. 4.0 mL
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
1 — Dosage by weight (single dose)
A 28-kg child is prescribed amikacin 15 mg/kg IV single dose.
The pharmacy supplies amikacin 250 mg/2 mL. How many mL
should the nurse administer?
A. 1.7 mL
B. 3.4 mL
C. 2.5 mL
D. 4.2 mL
Correct answer: B. 3.4 mL
Solution (step-by-step):
1. Calculate desired dose: 15 mg/kg × 28 kg = 420 mg.
2. Pharmacy concentration: 250 mg / 2 mL → convert to mg
per mL: 250 mg ÷ 2 mL = 125 mg/mL.
3. Use dimensional analysis: Desired (420 mg) ÷ Have (125
mg) × Vehicle (1 mL) = 420 ÷ 125 × 1 = 3.36 mL.
, 4. Rounding: round to one decimal if using syringe for
precise dosing → 3.4 mL.
Nursing safety checks:
• Verify allergy and previous aminoglycoside levels/renal
function.
• Check recommended mg/kg and max single dose for
amikacin.
• Confirm the dose with another nurse if hospital policy
requires.
Rationale:
• B is correct because calculations yield 3.36 mL ≈ 3.4 mL.
• A (1.7 mL) would be half the required dose; C (2.5 mL)
underdoses; D (4.2 mL) overdoses.
2 — Weight-based dose (range checking)
An adult client weight 72 kg is prescribed heparin IV bolus 80
units/kg prior to infusion. Heparin comes as 1,000 units/mL.
How many mL should be given?
A. 4.6 mL
B. 5.8 mL
C. 6.0 mL
D. 8.0 mL
Correct answer: B. 5.8 mL
,Solution:
1. Desired dose: 80 units/kg × 72 kg = 5,760 units.
2. Concentration: 1,000 units / 1 mL.
3. Dimensional analysis: 5,760 units ÷ 1,000 units × 1 mL =
5.76 mL.
4. Rounding: round to one decimal place (syringe
measurable) → 5.8 mL.
Safety checks:
• Verify weight units (kg), allergy, and appropriateness of
bolus.
• Confirm order (units/kg) and that heparin strength is 1,000
units/mL.
Rationale:
• B matches calculated 5.76 mL ≈ 5.8 mL. Others are
incorrect by calculation.
3 — Pediatric dosing with mg/kg/day divided schedule
A 10-kg infant is prescribed ceftazidime 120 mg/kg/day IV
divided q8h. Pharmacy provides 500 mg/5 mL. How many mL
should be given per dose?
A. 4.8 mL
B. 6.0 mL
, C. 8.0 mL
D. 10.0 mL
Correct answer: A. 4.8 mL
Solution:
1. Total daily dose: 120 mg/kg/day × 10 kg = 1,200 mg/day.
2. Divided q8h → 3 doses/day → per dose = 1,200 ÷ 3 = 400
mg per dose.
3. Concentration: 500 mg / 5 mL = 100 mg/mL.
4. Dimensional analysis: Desired 400 mg ÷ Have 100 mg × 1
mL = 4 mL.
Wait—this calculation yields 4.0 mL, not 4.8. Let’s double-
check: maybe misstep—recalculate carefully:
Hold—recompute step 2: 120 mg/kg × 10 kg = 1,200 mg/day.
Divided by 3 = 400 mg/dose. Correct. Have 500 mg/5 mL → 100
mg/mL. 400 ÷ 100 = 4.0 mL. So correct answer should be 4.0
mL, but 4.0 isn't among options. Need to correct the options—
since we must deliver valid answers, revise options: replace A
with 4.0 mL and set correct answer accordingly.
(Correction applied — updated options below)
A. 4.0 mL
B. 6.0 mL
C. 8.0 mL
D. 10.0 mL
Correct answer: A. 4.0 mL
