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Chapter 11 1. Order: Amikin (amikacin sulfate) 350 mg IVPB in 100 mL DW stat., infuse in 1h. Calculate the flow rate in drops per minute. The drop factor is 10 gtt/mL. 1. 600 gtt/min 2. 17 gtt/min 3. 21 gtt/min 4. 6 gtt/min Answer: 2 Rationale: 100 mL/h = 17 gtt/min. 2. Order: Heparin sodium 25,000 units in 250 mL DW IVPB, infuse at 1500 units /h. Calculate the flow rate in milliliters per hour. 1. 15 mL/h 2. 17 mL/h 3. 25 mL/h 4. 12 mL/h Answer: 1 Rationale: 1500 units/h × 250 mL/25,000 units = 15 mL/h. 3. Order: Vancomycin HCl 1 g in 200 mL DW IVPB, infuse in 60 min. Calculate the flow rate in drops per minute. The drop factor is 20 gtt/mL. 1. 17 gtt/min 2. 167 gtt/min 3. 67 gtt/min 4. 30 gtt/min Answer: 3 Rationale: 200 mL/60 min × 20 gtt/mL = 66.66 gtt/min. 4. Order: Potassium chloride 20 mEq in 1000 mL D/NS (pre-mixed solution) IV, infuse at 2 mEq/h. Calculate the rate in mL/h. 1. 100 mL/h 2. 10 mL/h 3. 250 mL/h 4. 150 mL/h Answer: 1 Rationale: 2 mEq/h × 1000 mL/20 mEq = 100 mL/h. 5. Order: Nitroglycerine 50 mg in 250 mL normal saline, infuse at 10 mcg/minute. Calculate the rate in mL/h. 1. 3 mL/h 2. 2 mL/h 3. 0.5 mL/h 4. 20 mL/h Answer: 1 Rationale: 10 mcg/min × 60 min/h × mg/1000 mcg × 250 mL/50 mg = 3 mL/h. 6. An IVPB is infusing at 100 mL/h. The strength of the solution in the bag is 0.5 mg/mL. What is the dosage rate in mg/h? 1. 300 mg/h 2. 50 mg/h 3. 200 mg/h 4. 120 mg/h Answer: 2 Rationale: 100 mL/h × 0.5 mg/mL = 50 mg/h. 7. An IV is infusing at 125 mL/h. The strength of the solution in the bag is 10 mcg/mL. What is the dosage rate in mg/h? 1. 1250 mg/h 2. 1.25 mg/h 3. 750 mg/h 4. 75 mg/h Answer: 2 Rationale: 125 mL/h × 10 mcg/mL × 1 mg/1000 mcg = 1.25 mg/h. 8. An IV is infusing at 50 mL/h. The strength of the solution in the bag is 150 mg/mL. What is the dosage rate in g/h? 1. 7.5g/h 2. 7500 g/h 3. 3 g/h 4. 300 g/h Answer: 1 Rationale: 50 mL/h × 150 mg/mL × g/1000 mg = 7.5 g/h. 9. An IV is infusing at 80 mL/h. Potassium chloride 20 mEq was added to 1000 mL of IV solution. How much potassium chloride is administered per hour in mEq/h? 1. 4000 mEq/h 2. 4 mEq/h 3. 1.6 mEq/h 4. 0.16 mEq/h Answer: 3 Rationale: 80 mL/h × 20 mEq/1000 mL = 1.6 mEq/h. 10. Order: Pepcid (famotidine) 20 mg IVPB q.12h. The label on the 4 mL vial reads 10 mg/mL. The manufacturer recommends adding the famotidine to 50 mL of D5W and infusing the medication over 60 minutes. At how many microdrops per minute will you set the IVPB solution to infuse? 1. 52 mcgtt/min 2. 20 mcgtt/min 3. 125 mcgtt/min 4. 50 mcgtt/min Answer: 1 Rationale: 52 mL/h = 52 mcgtt/min. 11. Order: Avelox (moxifloxacin HCl) 400 mg IVPB daily for five days. The label on the IV reads moxifloxacin 400 mg/250 mL 0.9 % saline, give over 60 minutes. At how many milliliters per hour will you set the infusion pump? 1. 250 mL/h 2. 400 mL/h 3. 5 mL/h 4. 7 mL/h Answer: 1 Rationale: 250 mL/60 min = 250 mL/h. 12. Order: Mefoxin (cefoxitin sodium) 1 g IVPB q.6h. The manufacturer recommends reconstituting the 1 g vial with 10 mL of sterile water, adding it to 100 mL of D5W, and infusing the medication over 60 minutes. At how many drops per minute will you set the IV to infuse if the drop factor is 15 gtt/mL? 1. 250 gtt/min 2. 28 gtt/min 3. 10 gtt/min 4. 25 gtt/min Answer: 2 Rationale: 110 mL/h × 15 gtt/mL × 1 h/60 min = 27.5 gtt/min. 13. Order: Zofran (ondansetron HCl) 4 mg IVPB, add to 50 mL D1/2 NS and infuse in 20 min. via pump. The label on the vial reads 2 mg/mL. At how many milliliters per hour will you set the infusion pump (mL/h)? 1. 156 mL/h 2. 50 mL/h 3. 104 mL/h 4. 54 mL/h Answer: 1 Rationale: 52 mL/20 min × 60 min/h = 156 mL/h. 14. Order: Add 125 mg of morphine sulfate to DW 250 mL stat. and infuse at 0.005 mg/kg/min. Calculate the flow rate in milliliters per hour for the patient who weighs 95 kilograms. 1. 0.2 mL/h 2. 28.5 mL/h 3. 0.95 mL/h 4. 57 mL/h Answer: 4 Rationale: 95 × 0.005 = 0.475 mg/min. 15. Order: Cipro (ciprofloxacin) 400 mg in 200 mL DW IVPB. The patient weighs 175 pounds, and is to receive 6 mg/kg/h. Calculate the flow rate in drops per minute. The drop factor is 15 gtt/mL. 1. 50 gtt/min 2. 1066 gtt/min 3. 60 gtt/min 4. 262 gtt/min Answer: 3 Rationale: 175 ÷ 2.2 = 79.5 kg × 6 = 477 mg/h. 16. Order: Verapamil HCl 0.075 mg/kg IV push over two min. The label on the vial reads 5 mg/2 mL, and the patient weighs 80 kg. How many mL/min. will you administer? 1. 2.4 mL/min 2. 1.2 mL/min 3. 0.6 mL/min 4. 3 mL/min Answer: 2 Rationale: 0.075 mg/kg × 80 kg = 6 mg to be administered. 2.4 mL/2 min = 1.2 mL/min. 17. Order: Hycamtin (topotecan HCl) 1.5 mg/mIV daily for five days, repeat every 21 days. The label on the vial reads 4 mg, and the manufacturer's directions state: "Reconstitute each 4 mg with 4 mL of sterile water. Withdraw the dose and further dilute in 50 mL D5W and infuse over 30 minutes." Calculate the rate of flow in milliliters per hour for a patient who weighs 92 kg and is 183 cm tall. 1. 106 mL/h 2. 114 mL/h 3. 100 mL/h 4. 87.5 mL/h Answer: 1 Rationale: 2.16 m2 × 1.5 = 3.24 mg = 3.24 mL; 53 ml/0.5 h = 106 mL/h. 18. Order: DTIC-Dome (dacarbazine) 250 mg/m IV for five days. The label on the vial reads 100 mg, and the manufacturer's directions states to reconstitute with 9.9 mL of sterile water for injection, yielding a strength of 10 mg/mL, further dilute in 250 mL of D5W, and infuse over 60 minutes. Calculate the rate of flow in milliliters per hour for a patient who weighs 92 kilograms and is 183 centimeters tall. 1. 250 mL/h 2. 304 mL/h 3. 367 mL/h 4. 540 mL/h Answer: 2 Rationale: 2.16 m2 × 250 = 540 mg; 54 mL + 250 mL = 304 mL. 19. Order: Zofran (ondansetron HCl) 0.15mg/kg IVPB 30 minutes before chemotherapy. The label on the vial reads 2 mg/mL, and the manufacturer's directions states to dilute in 50 mL D5W and infuse in 15 minutes. Calculate the rate of flow in drops per minute for a patient who weighs 55 kilograms. The drop factor is 10 gtt/mL. 1. 216 gtt/min 2. 72 gtt/min 3. 36 gtt/min 4. 14 gtt/min Answer: 3 Rationale: 50 + 4 = 54 mL; 54 mL/0.25 h = 216 mL/h. 20. Order: Heparin 20,000 units in 1000 mL 0.9% NaCl stat., infuse at 25 mL/h. Calculate the units per hour and determine if the dose is within the normal daily range (20,000 – 40,000 units in 24 h). 1. 25,000 units/h, and the dose is within the normal daily range 2. 500,000 units/h, and the dose is higher than the normal daily range 3. 500 units/h, and the dose is lower than the normal daily range 4. 0.8 units/h, and the dose is lower than the normal daily range Answer: 3 Rationale: 25 mL/h × 20,000 units/1000 mL = 500 units/h. 21. A patient who weighs 40 kg is to receive Fortaz (ceftazidime) 50 mg/kg IVPB q.8h. The recommended dose range is from 250 mg to 2 g every 8 – 12 hours. Is this dose within the safe range? ______ Answer: Yes Rationale: 50 mg/kg × 40 kg = 2000 mg, or 2 g. Range is 0.5 – 6 g/day. 22. Order: Heparin 40,000 units in 1000 mL 0.9% NS, infuse at 40 mL/h. Calculate the units per day and determine if the dose is within the normal daily range (20,000 – 40,000 units in 24 h). 1. 1600 units/d, which is lower than the normal daily range 2. 38,400 units/d, which is within the normal daily range 3. 38,400 units/d, which is not within the normal daily range 4. 1600 units/d, which is higher than the normal daily range Answer: 2 Rationale: 40,000 units/1000 mL × 40 mL/h × 24 h/d. 23. Order: Heparin 25,000 units in 1000 mL 0.09% NS, infuse at 100 mL/h. Calculate the units per day if the dose is within the normal daily range (20,000 – 40,000 units in 24 h). 1. 60,000 units, which is within the normal daily range 2. 2500 units, which is not within the normal daily range 3. 25,000 units, which is within the normal daily range 4. 60,000 units, which is not within the normal daily range Answer: 4 Rationale: 2500 units/h × 24 hours = 60,000 units/day. 24. A drug is ordered to be administered IV at the initial rate of 2 mU/min, and may increase by 4 mU/min q 15 min to a maximum of 18 mU/min. The IV strength is 10 mU/mL. The initial flow rate is __________ mL/h. Answer: 12 Rationale: 2mU/min = 12 mL/h. 25. Dopamine is ordered to be administered IV at the initial rate of 5 mcg/kg/min, and may increase by 1 mcg/kg/min to a maximum of 10 mg/kg/min. The solution is mixed 400 mg Dopamine in 250 mL normal saline. The client weighs 50 kilograms. The initial flow rate is ______ mL/h. Answer: 9 Rationale: 50 kg × 5 = 250 mcg/min. 250/mcg/min × 60 min/h × 1 mg/1000 mcg × 250 mL/400 g = 9 mL/h. 26. If 150 mg of a drug is ordered IVP stat over two minutes, and the concentration of the drug is 75 mg/mL, find the total number of milliliters, and indicate how many milliliters you will administer per minute. 1. 10 mL total; 5 mL/min 2. 2mL total; 1 mL/min 3. 1 mL total; 1 mL/min 4. 4 mL total; 2 mL/min Answer: 2 Rationale: 2 mL/2 min = 1 mL/min. 27. Order: Phenytoin (Dilantin) 15 mg/kg loading dose IV push stat. Phenytoin is supplied 50 mg/mL and is to be administered at 25 mg/min. How many mL would you administer over how many minutes if the client weighs 65 kilograms? 1. 19.5 mL over 39 minutes 2. 19.5 mL over 20 minutes 3. 30 mL to be given over 1 hour 4. 30 mL to be given over 30 minutes Answer: 1 Rationale: 15 mg/kg × 65 kg = 975 mg to be administered; 975 mg × min/25 mg = 39 minutes. 28. Order: Furosemide (Lasix) 80 mg IVP now. Furosemide is ototoxic at high doses if given faster than 4 mg/minute. How many minutes would it take to administer this dosage? 1. 2 minutes 2. 360 minutes 3. 80 minutes 4. 20 minutes Answer: 4 Rationale: 80 mg × min/4 mg = 20 minutes. 29. Order: Digoxin (Lanoxin) 0.25 mg IV daily. All dosages of digoxin are to be given over at least five minutes. The drug is supplied 0.25 mg/mL, which is further diluted in 4 mL of fluid. How many mL of medication would you administer per minute? 1. 1 mL per minute 2. 0.2 mL per minute 3. 2 mL per minute 4. 5 mL per minute Answer: 1 Rationale: 0.25 mg in 1 mL + 4 mL = 5 mL total fluid for administration over five minutes or 1 mL per minute. Test Bank for Dosage Calculations: A Multi-Method Approach Anthony Patrick Giangrasso, Dolores M. Shrimpton 9780132158626