Saunders Comprehensive Review for the NCLEX-PN®
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
1) Pediatric IM dose (mg/kg)
Stem: A child weighing 22 lb is ordered cefazolin 25 mg/kg IM.
The vial on the cart is 250 mg / 5 mL suspension. What volume
should the nurse administer? (Round to nearest 0.1 mL.)
A. 2.5 mL
B. 5.0 mL ← Correct
C. 1.0 mL
D. 10.0 mL
Step-by-step (dimensional analysis):
1. Convert pounds to kilograms:
o 22 lb × 0.45359237 kg / 1 lb = 9.97903214 kg
(showing digits)
2. Calculate dose in mg:
o 25 mg/kg × 9.97903214 kg = 249.4758035 mg
, 3. Find concentration (mg/mL):
o 250 mg / 5 mL = 50 mg / 1 mL
4. Solve volume:
o (249.4758035 mg) × (1 mL / 50 mg) = 4.98951607 mL
5. Round to nearest 0.1 mL → 4.9 ≈ 5.0 mL
Answer rationale:
• Correct (B, 5.0 mL): Correct kg conversion and dimensional
analysis produced ~4.99 mL → rounds to 5.0 mL (nearest
0.1 mL as instructed).
• A (2.5 mL): Likely error: halved the result (maybe using 125
mg/5 mL instead of 250 mg/5 mL or forgetting kg
conversion).
• C (1.0 mL): Underestimation — likely forgot to convert lb
→ kg (22 lb treated as 22 kg).
• D (10.0 mL): Doubled value — may have reversed ratio
(used 5 mL = 250 mg incorrectly as 5 mL = 125 mg).
Safety checks: Verify weight in kg from chart, confirm drug &
concentration, check allergy history, document lot/vial if multi-
dose.
2) Continuous IV infusion (mL/hr)
,Stem: Order: D5W 1000 mL to run over 8 hours. What infusion
rate in mL/hr should the nurse set? (Round to nearest whole
mL/hr.)
A. 80 mL/hr
B. 125 mL/hr ← Correct
C. 200 mL/hr
D. 1000 mL/hr
Calculation:
• mL/hr = total volume ÷ total hours = 1000 mL ÷ 8 hr =
125.0 mL/hr
Rationale:
• B correct: Direct division.
• A & C: Misdivisions (1000 ÷ 12.5 or 1000 ÷ 5).
• D: Incorrect: volume, not rate.
Safety checks: Confirm infusion orders and fluid type; use
pump; label tubing.
3) Macrodrip gtt/min
Stem: The physician orders 1,200 mL IV fluid to infuse over 10
hours. The macrodrip tubing in use is 15 gtt/mL. What is the
flow in gtt/min? (Round to nearest whole drop/min.)
A. 30 gtt/min ← Correct
B. 15 gtt/min
, C. 45 gtt/min
D. 60 gtt/min
Calculation (dimensional):
1. Convert time to minutes: 10 hr × 60 = 600 min
2. Total drops = volume × drop factor = 1,200 mL × 15 gtt/mL
= 18,000 gtt
3. Drops per minute = 18,000 gtt ÷ 600 min = 30 gtt/min
Rationale:
• A correct: Proper sequence: mL → drops → ÷ minutes.
• B or C: Mistaken drop factor or wrong division.
• D: Possibly used 30 gtt/mL instead of 15.
Safe practice: Round to whole drop; use pump if available;
verify tubing calibration.
4) Reconstitution — single vial
Stem: A vial contains 500 mg of antibiotic in powder form. The
nurse reconstitutes the vial with 10 mL sterile water, yielding a
concentration of ? mg/mL. The patient is ordered 125 mg IM.
What volume should be given? (Round to nearest 0.1 mL.)
A. 5.0 mL
B. 2.5 mL ← Correct
C. 1.0 mL
D. 10.0 mL
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
1) Pediatric IM dose (mg/kg)
Stem: A child weighing 22 lb is ordered cefazolin 25 mg/kg IM.
The vial on the cart is 250 mg / 5 mL suspension. What volume
should the nurse administer? (Round to nearest 0.1 mL.)
A. 2.5 mL
B. 5.0 mL ← Correct
C. 1.0 mL
D. 10.0 mL
Step-by-step (dimensional analysis):
1. Convert pounds to kilograms:
o 22 lb × 0.45359237 kg / 1 lb = 9.97903214 kg
(showing digits)
2. Calculate dose in mg:
o 25 mg/kg × 9.97903214 kg = 249.4758035 mg
, 3. Find concentration (mg/mL):
o 250 mg / 5 mL = 50 mg / 1 mL
4. Solve volume:
o (249.4758035 mg) × (1 mL / 50 mg) = 4.98951607 mL
5. Round to nearest 0.1 mL → 4.9 ≈ 5.0 mL
Answer rationale:
• Correct (B, 5.0 mL): Correct kg conversion and dimensional
analysis produced ~4.99 mL → rounds to 5.0 mL (nearest
0.1 mL as instructed).
• A (2.5 mL): Likely error: halved the result (maybe using 125
mg/5 mL instead of 250 mg/5 mL or forgetting kg
conversion).
• C (1.0 mL): Underestimation — likely forgot to convert lb
→ kg (22 lb treated as 22 kg).
• D (10.0 mL): Doubled value — may have reversed ratio
(used 5 mL = 250 mg incorrectly as 5 mL = 125 mg).
Safety checks: Verify weight in kg from chart, confirm drug &
concentration, check allergy history, document lot/vial if multi-
dose.
2) Continuous IV infusion (mL/hr)
,Stem: Order: D5W 1000 mL to run over 8 hours. What infusion
rate in mL/hr should the nurse set? (Round to nearest whole
mL/hr.)
A. 80 mL/hr
B. 125 mL/hr ← Correct
C. 200 mL/hr
D. 1000 mL/hr
Calculation:
• mL/hr = total volume ÷ total hours = 1000 mL ÷ 8 hr =
125.0 mL/hr
Rationale:
• B correct: Direct division.
• A & C: Misdivisions (1000 ÷ 12.5 or 1000 ÷ 5).
• D: Incorrect: volume, not rate.
Safety checks: Confirm infusion orders and fluid type; use
pump; label tubing.
3) Macrodrip gtt/min
Stem: The physician orders 1,200 mL IV fluid to infuse over 10
hours. The macrodrip tubing in use is 15 gtt/mL. What is the
flow in gtt/min? (Round to nearest whole drop/min.)
A. 30 gtt/min ← Correct
B. 15 gtt/min
, C. 45 gtt/min
D. 60 gtt/min
Calculation (dimensional):
1. Convert time to minutes: 10 hr × 60 = 600 min
2. Total drops = volume × drop factor = 1,200 mL × 15 gtt/mL
= 18,000 gtt
3. Drops per minute = 18,000 gtt ÷ 600 min = 30 gtt/min
Rationale:
• A correct: Proper sequence: mL → drops → ÷ minutes.
• B or C: Mistaken drop factor or wrong division.
• D: Possibly used 30 gtt/mL instead of 15.
Safe practice: Round to whole drop; use pump if available;
verify tubing calibration.
4) Reconstitution — single vial
Stem: A vial contains 500 mg of antibiotic in powder form. The
nurse reconstitutes the vial with 10 mL sterile water, yielding a
concentration of ? mg/mL. The patient is ordered 125 mg IM.
What volume should be given? (Round to nearest 0.1 mL.)
A. 5.0 mL
B. 2.5 mL ← Correct
C. 1.0 mL
D. 10.0 mL
