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Dosage Calculation and Medication Administration: Exercises and Questions, Exams of Pharmacology

King's CollegePharmacology

A series of exercises and questions related to dosage calculation and medication administration. It covers various aspects of medication administration, including drug interactions, injection techniques, dosage conversions, and medication reconciliation. Rationales for each question, explaining the correct answers and highlighting important concepts in medication safety.

Typology: Exams

2024/2025

Available from 03/11/2025

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Chapter 17: Dosage Calculation and Medication Administration
Study online at https://quizlet.com/_e1wwnd
1. What is the term for when
one drug increases the
action or the effect of an-
other drug?
1. Interaction
2. Antagonist
3. Synergism
4. Incompatibility
Synergism
Rationale: When one drug increases the action
or effects of another drug, it is called potentiation
or synergism. Drug interaction is when the com-
bined actions of two or more drugs given together
produce a totally different than expected effect. A
drug that will block the action of another drug is
an antagonist. Drug incompatibility is when a drug
does not combine chemically with another drug
2. When preparing a med-
ication for a subcuta-
neous injection, what
size needle length is
needed?
1.) 1½ to 2 in
2.) 1 to 1½ in
3.) ½ to ] in
4.) \ to ] in
½ to ] in
Rationale: Needle length for subcutaneous injec-
tions is usually ½ to ] in. Intramuscular injections
may require a 1- to 1½-in needle. A \- to ]-in needle
is used for intradermal injections.
3. The health care provider
orders Dilantin (pheny-
toin) 0.2 g PO twice
daily. The label on the
medication reads Dilan-
tin 100 mg per capsule.
How many capsule(s) will
you prepare to adminis-
ter one dose?
1.) 1 capsule
2.) 2 capsules
3.) 3 capsules
4.) 4 capsules
2 capsules
Rationale: You would need to convert the 0.2 g to
mg = 200 mg. To figure the amount, you would
take the desired amount (200 mg), divide it by
the amount you have (100 mg), and multiply by
the capsule (1 capsule). Thus 1 dose equals 2
capsules.
4. The health care provider
orders that a patient 0.2 mL
1 / 21
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Partial preview of the text

Download Dosage Calculation and Medication Administration: Exercises and Questions and more Exams Pharmacology in PDF only on Docsity!

Study online at https://quizlet.com/_e1wwnd

  1. What is the term for when one drug increases the action or the effect of an- other drug?

  2. Interaction

  3. Antagonist

  4. Synergism

  5. Incompatibility Synergism Rationale: When one drug increases the action or effects of another drug, it is called potentiation or synergism. Drug interaction is when the com- bined actions of two or more drugs given together produce a totally different than expected effect. A drug that will block the action of another drug is an antagonist. Drug incompatibility is when a drug does not combine chemically with another drug

  6. When preparing a med- ication for a subcuta- neous injection, what size needle length is needed? 1.) 1½ to 2 in 2.) 1 to 1½ in 3.) ½ to ] in 4.) \ to ] in ½ to ] in Rationale: Needle length for subcutaneous injec- tions is usually ½ to ] in. Intramuscular injections may require a 1- to 1½-in needle. A - to ]-in needle is used for intradermal injections.

  7. The health care provider orders Dilantin (pheny- toin) 0.2 g PO twice daily. The label on the medication reads Dilan- tin 100 mg per capsule. How many capsule(s) will you prepare to adminis- ter one dose? 1.) 1 capsule 2.) 2 capsules 3.) 3 capsules 4.) 4 capsules 2 capsules Rationale: You would need to convert the 0.2 g to mg = 200 mg. To figure the amount, you would take the desired amount (200 mg), divide it by the amount you have (100 mg), and multiply by the capsule (1 capsule). Thus 1 dose equals 2 capsules.

  8. The health care provider orders that a patient 0.2 mL

Study online at https://quizlet.com/_e1wwnd receive cyanocobalamin (vitamin B12) 100 mcg IM every month. The vial reads: cyanocobalamin (vitamin B12) 0.5 mg/ mL. How many milliliters will you administer to the patient? 1.) 0.2 mL 2.) 0.5 mL 3.) 1 mL 4.) 2 mL Rationale: 1. Convert 100 mcg to mg = 0.1 mg. Formula is: desired amount (0.1 mg) divided by amount on hand (0.5 mg) then multiplied by mL (1 mL). The amount to be given is 0.2 mL.

  1. The health care provider orders 3000 mL of 5% dextrose to be adminis- tered over 24 hours. How many milliliters per hour will be administered? 1.) 50 mL 2.) 75 mL 3.) 100 mL 4.) 125 mL 125 mL Rationale: To determine how many milliliters per hour are to be administered, divide the total amount prescribed by the total time period. For- mula: 3000 mL divided by 24 hours = 125 mL/h.

  2. The nurse is preparing to administer 8 a.m. med- ications to assigned pa- tients. The nurse reads and reviews all medica- tion orders. What would prevent the nurse from administering a medica- tion? (Select all that ap- ply.)

  3. The nurse did not write the order.

    1. Do not know the patient s drug history.
    2. Have questions about any part of the order. Rationale: You should assess the patient's drug history before giving the drug. If the patient has any known allergies to drugs, the drug should be withheld and this information reported to the charge nurse. If there is any question about an order, the medication should not be administered until it has been clarified by the health care provider. Medication errors can be very serious. A health care provider writes the medication order, not the LPN/LVN. The drug received on the nurs-

Study online at https://quizlet.com/_e1wwnd formed? Select all that apply.

  1. When removing the drug from where it has been stored.
  2. When the pharmacy de- livers a new batch of medications.
  3. Before removing the medication from the con- tainer.
  4. Before administering the drug to the patient.
  5. At the end of every shift. tainer.
    1. Before administering the drug to the patient. Rationale: The label is checked three times: when taking the medication from where it has been stored, before removing the medication from its container and before giving the medication to the patient. Controlled substances are usually count- ed at the end of the shift. Pharmacy delivery varies by facility, but ultimately the nurse is re- sponsible to check the medication before admin- istering it to the patient, regardless of how it is delivered or stored on the unit.
  6. A patient needs a PRN dose of pain medication. The HCP's prescription reads: 2 mg oral MS PRN for severe pain. The phar- macy sends magnesium sulfate. What would the nurse do first?
  7. Ask the patient if he has ever taken magne- sium sulfate for relief of pain.
  8. Call the HCP and ask for clarification of the prescription.
  9. Use a drug reference and see if magnesium sulfate is a pain medica- tion.
  10. Call the pharmacy and Call the HCP and ask for clarification of the pre- scription. Rationale: The HCP has used an inappropriate abbreviation. It is likely that the intended prescrip- tion is for morphine, but this must be clarified.

Study online at https://quizlet.com/_e1wwnd ask for clarification of what was sent.

  1. A new nurse is working in a small rural long-term care facility. An older HCP routinely directs the care of the residents and he prefers to handwrite his notes and orders, rather than use a comput- er. What would the new nurse do first if the HCP's handwriting is illegible?

  2. Consult the director of nursing services about the HCP's behavior.

  3. Call the HCP for clarifi- cation whenever it is nec- essary.

  4. Ask the charge nurse for assistance in inter- preting the handwriting.

  5. Gently offer to help Ask the charge nurse for assistance in interpret- ing the handwriting. Rationale: First, the new nurse should consult the charge nurse, because it is likely that the expe- rienced nursing staff can read the HCP's hand- writing. The nurse must call for clarification as needed. The director of nursing should be made aware of the situation and the nurse might offer to teach the HCP once rapport is established.

  6. Based on Joint Commis- sion requirements, un- der what circumstances must the nurse per- form medication recon- ciliation? Select all that apply.

  7. The patient has just been admitted to the medical-surgical unit.

  8. The HCP has just made morning rounds and sev-

  9. The patient has just been admitted to the med- ical-surgical unit. medications are prescribed.

  10. The patient's daughter is taking her father home after a prolonged hospitalization.

  11. The patient is being transferred to a rehabilita- tion unit after having hip surgery. Rationale: The purpose of medication reconcilia- tion is continuity of care and information flow as the patient transitions from one care setting to an- other. Medications that are added or discontinued in a given care setting would become part of the

Study online at https://quizlet.com/_e1wwnd HCP wrote for several pa- tients. Which one will the nurse attend to first?

  1. A prescription for a PRN stool softerner
  2. A dose of antipyretic medication now
  3. A stat dose of IV epi- nephrine
  4. A one-time only dose of an anxiolytic Rationale: "Stat" has the highest priority. This type of prescription indicates an urgent or emergency situation. "Now" has a relative urgency; for exam- ple, the HCP may want the nurse to give pain medication prior to starting a procedure, but the patient is not in critical danger. "One time only" is used for medications that are only given once; for example, medication that is given just before going to the operating room. The frequency of a "PRN" medication is based on the assessment of the patient's condition.
  5. A prescription for codeine gr 1/2 is writ- ten for the patient. The medication is supplied in mg. How much would the nurse administer? 1.) 3 g 2.) 30 g 3.) 3 mg 4.) 30 mg 30 mg Rationale: One grain is equal to 60 mg; therefore, half of a grain is 30 mg.
  6. An IV of 500 ml D5W is to infuse over 4 hours. The administration set is 15 gtt/mL. What is the cor- rect number of gtt/min? 1.) 19 gtt/min 2.) 24 gtt/min 3.) 31 gtt/min 4.) 42 gtt/min 31 gtt/min Rationale: Amount × Drip factor/Time (in minutes)= gtt/min 4x60 = 240 minutes 500 ml x 15 gtt / 240 mins = 31 gtt/min
  7. The nurse determine the location for an injection by identifying the greater Ventrogluteal Rationale: Greater trochanter of the femur, the an-

Study online at https://quizlet.com/_e1wwnd trochanter of the femur, the anterosuperior iliac spine, and the iliac crest. Which injection site has the nurse located?

  1. Rectus femoris
  2. Ventrogluteal
  3. Dorsogluteal
  4. Vastus lateralis terosuperior iliac spine, and the iliac crest are the landmarks for the ventrogluteal site. See Figure 17.14 for additional information.
  5. Upon getting the assign- ment for the evening, the nurse notices that two patients on the unit have the same last name. What is the best way to pre- vent medication errors for these two patients?
  6. Ask the patients their names.
  7. Check the patients' identification bands.
  8. Ask another nurse about their identities.
  9. Verify their names with the family members. Check the patients' identification bands. Rationale: Identification bands (ID) should show the patient's full name and generally will have an additional identifier, such as a patient number or birthdate. Asking patient to state his/her name is also recommended. Occasionally, mental status, language, or cognitive status will prevent use of this method. Asking another nurse about identity is a method that could be used in some cases, such as with long-term care residents who do not wear ID bands, but it is not a preferred method. Asking family members to verify names is also occasionally done, but again is not the preferred method.
  10. The nurse is working in the newborn nursery and will be giving vitamin K injections to the babies. What is the preferred site for these injections?
  11. Deltoid
  12. Dorsogluteal Vastus lateralis Rationale: For infants younger than 12 months, vastus lateralis is the preferred site.

Study online at https://quizlet.com/_e1wwnd

  1. Upper outer aspect of the arm.
  2. Anterior aspect of the forearm.
  3. Middle third of the an- terior thigh.
  4. A 2-inch diameter around the umbilicus cutaneous injections. Middle third of the anterior thigh is an intramuscular injection site.
  5. How does the nurse de- termine what the drop factor is for an IV set?
  6. Ask the charge nurse.
  7. Calculate the IV rate.
  8. Look in a reference book.
  9. Check the IV tubing box. Check the IV tubing box. Rationale: Drip factors will vary by manufacturer, so looking at the package label and instructions is the best way to find the drip factor.
  10. The nurse is observing the patient self-adminis- ter medication with a me- tered-dose inhaler (MDI). Which action by the pa- tient requires correction and further instruction?
  11. Shakes canister to de- termine how much is left.
  12. Inhales one puff with one inspiration.
  13. Inhales medication slowly and deeply.
  14. Waits 2-5 minutes be- tween puffs Shakes canister to determine how much is left. Rationale: Evidence-based practice indicates if the canister does not have a counter, patients should be taught to calculate the number of puffs used per day to calculate the number of days that the inhaler should last. The other actions are correct.
  15. What types of medica- tions cannot be crushed
  16. Extended-release capsules
  17. Sublingual tablets

Study online at https://quizlet.com/_e1wwnd for ease of administra- tion? Select all that apply.

  1. Extended-release cap- sules
  2. Tablets
  3. Sublingual tablets
  4. Enteric-coated tablets
  5. Sustained-released capsules
    1. Enteric-coated tablets
    2. Sustained-released capsules Rationale: The extended-release and sus- tained-release beads are designed to dissolve and release the medication at different times; thus, crushing the beads destroys the mecha- nism. Sublingual tablets are meant to be placed under the tongue and the medication is absorbed directly into the bloodstream. Enteric-coated tablets are intentionally coated to delay absorp- tion.
  6. The nurse identifies that a patient is having an idiosyncratic reaction to a medication. which pa- tient's report is consis- tent with the nurse's analysis?
  7. Sedative medication causes him to be awake most of the night.
  8. Antianxiety medication seems to make the pain medication more effec- tive.
  9. Previous dosage of pain medication does not seem to be working like it used to.
  10. Antibiotic medication seems to cause an un- comfortable, itchy rash. Sedative medication causes him to be awake most of the night. Rationale: An idiosyncratic reaction is an unex- pected reaction that seems to be unique to that individual, sometimes the opposite effect of what the medication is supposed to do. Medications that augment action are synergistic. Need for higher dosage is evidence of tolerance to a drug. Development of a rash is likely to be an allergic reaction.
  11. Which route of drug ad- ministration will achieve the fastest onset of ac- Intravenous

Study online at https://quizlet.com/_e1wwnd if the nurse correctly set the flow rate? 1.) 1000 mL 2.) 750 mL 3.) 625 mL 4.) 500 mL patient should have been receiving IV fluid for 6 hours: 125 mL/hour × 6 hours = 750 mL.

  1. The nurse hears in re- port that 1000 mL of nor- mal saline was started at 3:00 AM to infuse at 125 mL per hour. At 7: AM, the nurse evaluates the patient and the IV in- fusion, which is running by gravity; the IV fluid bag shows that approxi- mately 200 mL has been infused. what would the nurse do first?

  2. Calculate the amount of fluid that should have infused and then give it.

  3. Report the error to the charge nurse and write an incident report.

  4. Document the amount of fluid infused and the appe Recalculate the drops/minute and reset the rate of flow to 125 mL/hour. Rationale: First, the nurse would recalculate the gravity rate (gtt/min) and then reset the flow rate so that 125 mL/hr is being delivered. The charge nurse should be consulted if the nurse is unsure about how to proceed. In some facilities, this type of error requires an incident report. The charge nurse may also decide that someone should talk to the night-shift nurse, because it appears the IV was not checked after the fluid was started. In oth- er situations, the HCP would have to be notified, because the patient could suffer ill effects. The IV flow is behind schedule, but generally infusing the fluid to "catch up" is not recommended.

  5. The HCP prescribes two medications and sug- gests to the nurse that they could be mixed to- gether in the same sy- ringe to prevent the pa- tient from having to get Discard the syringe and call the pharmacy for information about compatibilities. Rationale: A precipitate indicates that the med- ications are incompatible, so the drug should be discarded. The nurse should have called the phar- macy prior to mixing the drugs. Administering

Study online at https://quizlet.com/_e1wwnd two separate injections. The nurse mixes the drugs, but a precipitate forms in the syringe. What would the nurse do?

  1. Ask the HCP to veri- fy the request to mix the drugs.
  2. Gently rotate the sy- ringe between the palms of the hand to mix the so- lution.
  3. Discard the syringe and call the pharmacy for information about com- patibilities.
  4. Adm the drug or verifying the prescription is incorrect, because incompatible drugs should not be given together. Rotating the syringe does apply in some cases, but not for incompatible drugs.
  5. The nurse is giving a pa- tient the morning medica- tions. The patient says, "I don't recognize this pill." What would the nurse say?
  6. "The medications that you will get in the hospi- tal may be different than the ones you take at home."
  7. "Medications are made by different manufactur- ers. They can be chemi- cally identical but have a different appearance."
  8. "Let me review the list of your home med- "Let me review the list of your home medications and I'll find out if anything new was prescribed for you." Rationale: Patients are usually familiar with the medications they have to take at home, so if there is a comment that suggests a difference, it is best for the nurse to stop and find out why the med- ication looks different. After checking, the nurse might consider using some of the other options. If there is a new medication, the nurse should take the opportunity to do patient teaching.

Study online at https://quizlet.com/_e1wwnd nurses to recheck the cal- culations and the answer is always 15. What would the nurse do first?

  1. Give the 15 tablets because the calculations have been checked and rechecked.
  2. Call the pharmacy and ask if the medica- tion comes in a different strength.
  3. Call the HCP and ask for verification of the pre- scrip tomatically question the prescription. A reliable drug source will cite the typical dose range. Based on information of the typical drug dose, the nurse can contact the HCP or the pharmacy as needed.
  4. Two nurses are standing in the medication area. Nurse A is preparing medication, but hears an alarm indicating that an unstable patient needs help right away. She hands the prepared med- ication to Nurse B and asks her to give it to the correct patient. What would Nurse B do first?
  5. Go ahead and give it because she witnessed all of the preparations that Nurse A made.
  6. Inform the charge nurse that Nurse A needs assistance because of a critical patient. Inform the charge nurse that Nurse A needs as- sistance because of a critical patient. Rationale: Inform the charge nurse, so that he/ she is aware of the critical patient and events that are affecting a group of patients. The charge nurse may elect to give the medication her- or himself or may opt to delegate the duty to Nurse B. Giving medications to someone else's patients is never ideal; however, delaying medication is also not good for the patients. If Nurse B is asked to give the medications, she would have to use the six rights and quickly familiarize herself with the patient's health conditions.

Study online at https://quizlet.com/_e1wwnd

  1. Give the medication, but later indicat
  2. The nurse is supervising a nursing student who must give several med- ications. The nurse would intervene if the student performed which action?
  3. Puts a suppository in a uniform pocket
  4. Used aseptic tech- nique to handle pills
  5. Looked at the menis- cus when pouring a liq- uid
  6. Read the label of the bottle as she took it off the shelf Puts a suppository in a uniform pocket Rationale: Suppositories will melt at body temper- ature and a soft suppository is more difficult to insert. The other actions are appropriate.
  7. The patient has an or- der for a medication that is to be delivered via an MDI. Which chronic health condition is the patient most likely to have?
  8. Hypertension
  9. Chronic bronchitis
  10. Diabetes mellitus
  11. Arteriosclerotic heart disease Chronic bronchitis Rationale: Inhalers usually deliver medication to the lungs; therefore, patients with asthma, em- physema, or chronic bronchitis are more likely to have this type of medication prescription. Patients with acute respiratory problems are also treated with inhalers until symptoms improve. (MDI = me- tered dosed inhaler)
  12. Which factor would be the most important in the nurse's decision to choose an 18-gauge nee- Viscosity of solution Rationale: If the solution is viscous, the nurse

Study online at https://quizlet.com/_e1wwnd bruising and the patient will receive many allergy test.

  1. There are no major veins or arteries in the in- tradermal tissues.
  2. The needle is so fine and short that it is unlike- ly to cause tissue dam- age. has not selected an appropriate site, or improper technique is used, the needle could puncture a blood vessel.
  3. The nurse is assessing a patient who is receiving IV fluid and medication. Which finding is the most serious?
  4. The patient complains of pain at the insertion site.
  5. The patient is dyspne- ic and has weak thready pulse.
  6. The patient's arm is swollen and the skin is cool to the touch.
  7. The patients is very scared and upset be- cause the IV bag is emp- ty. The patient is dyspneic and has weak thready pulse. Rationale: Dyspnea and a weak, thready pulse are possible signs of pulmonary embolus or ana- phylactic reaction. This is a medical emergency. The other findings are less urgent, but still require the nurse's attention.
  8. An older patient is re- ceiving a medication that is potentially nephrotox- ic. Which assessment is the most relevant to po- tential nephrotoxicity?
  9. Change of mental sta- Reduced urinary output Rationale: Older patients have reduced kidney function and an increased risk for nephrotoxicity. If urinary output is reduced, this further damages the kidneys. Nephrotoxic effects will eventually affect mental status, but this would be a late sign. Vomiting could contribute to nephrotoxicity if fluid

Study online at https://quizlet.com/_e1wwnd tus

  1. Reduced urinary out- put
  2. Nausea and vomiting
  3. Increased blood pres- sure loss is not corrected. High blood pressure is asso- ciated with kidney problems; however, this is more associated with pathophysiology that develops over time.
  4. Upon assessment of the IV insertion site, the nurse suspects that the patient has phlebitis. Which assessment find- ing supports the nurse's analysis?
  5. Edema at the site
  6. Erythema along the vein
  7. Cool skin around site
  8. Sluggish flow of IV fluid Erythema along the vein Rationale: Phlebitis is an inflammation of the vein, and as it progresses, the redness will travel up the vein. Edema can accompany phlebitis but will also be seen in infiltration. Cool skin and sluggish flow are more typical of infiltration.
  9. The nurse is at home and her husband accidentally gets a caustic chemical splash in his eyes. What would the nurse do first?
  10. Drive him to the hospi- tal and flush his eyes with sterile normal saline.
  11. Call Poison Control and ask for advice about the specific chemical.
  12. Gently flush his eyes with tap water for at least 15 minutes.
  13. Assess him for burn- ing, changes in visual acuity, or pain. Gently flush his eyes with tap water for at least 15 minutes. Rationale: If a caustic substance enters the eye, the correct action is to immediately flush the eye with the cleanest fluid available. At home this would be tap water. The nurse is also likely to perform the other actions at the appropriate time.