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TEST BANK
CALCULATING DRUG DOSAGES:
A Patient-Safe Approach to Nursing and Math
2nd Edition
Castillo | Werner-McCullough




TEST BANK

,Castillo/Werner-McCullough: Calculating Drug Dosages: A Patient-Safe Approach to Nursing and Math,,2e
Test Bank

Table of Contents:
I. Safety in Medication Administration
Chapter 1. Safety in Medication Administration
Chapter 2. The Drug Label
II. Systems of Measurement
Chapter 3. The Metric System
Chapter 4. The Household System
III. Methods of Calculation
Chapter 5. Linear Ratio and Proportion
Chapter 6. Fractional Ratio and Proportion
Chapter 7. Dimensional Analysis
Chapter 8. Formula Method
IV. Administration of Medications
Chapter 9. Calculating Oral Medication Doses
Chapter 10. Syringes and Needles
Chapter 11. Calculating Parenteral Medication Dosages
Chapter 12. Preparing Powdered Parenteral Medications
Chapter 13. Administration of Insulin
V. IV Therapy and Administration of Intravenous Medications
Chapter 14. Intravenous Infusion and Infusion Rates
Chapter 15. Calculating Infusion and Completion Time
Chapter 16. Administering IV Push Medications
VI. Verifying Safe Dose and Critical Care Calculations
Chapter 17. Verifying Safe Dose
Chapter 18. Titration of Intravenous Medications
VII. Intake and Output
Chapter 19. Calculating Intake and Output
Chapter 20. Calculating Parenteral Intake
VIII. Dosages for Pediatric and Older Adult Populations
Chapter 21. Considerations for the Pediatric Patient
Chapter 22. Considerations for the Older Adult
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,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e



Chapter 1: Safety in Medication Administration
Castillo: Calculating Drug Dosages: A Patient-Safe Approach to Nursing and Math 2nd Edition


MULTIPLE CHOICE

1. The following medication order is in the patient’s medication administration record (MAR):

methylPREDnisolone 40 mg PO daily at 0900.

After reading the order, the nurse correctly determines:
A “PO” is an inappropriate abbreviation.
B the medication order is written correctly.
C 40 mg should be written as 40mg.
D tall man lettering indicates that the drug is a narcotic.

ANS: B
Feedback
The medication order has all the required components (drug name, dose, route, and
frequency of administration) for a drug order. “PO” is an appropriate abbreviation;
40 mg is written correctly with a space between the dose and the unit of
measurement. Tall man lettering is used to distinguish the drug from another drug
with a similar name.



2. Which of the following accurately describes the “Boxed Warning” found on a drug label?
A It is primarily is used to identify the safe dose for the patient.
B It is commonly found on all drug labels.
C It identifies serious potential risks and side effects related to drug use.
D It protects the patient by providing information to decrease side effects.

ANS: C
Feedback
A drug label with a boxed warning provides information to healthcare professionals
and patients regarding the serious risks and side effects related to the drug. The
Boxed Warning is not the primary source for identifying the patient’s drug dosage.
The warning is found on specific prescription medications and does not provide
information to reduce or decrease side effects.



3. When practicing safety in the administration of medication, for which of the following
medication orders should a nurse seek clarification before the administration of the
medication?


1

,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e



A Regular insulin 5 u subcut now.
B Enoxaparin 80 mg subcut every 12 hours.
C Benadryl 50 mg PO PRN every 6 hr for itching.
D Ondansetron 4 mg IVP stat.

ANS: A
Feedback
The “u” should never be used in a medication order; rather, for safety, the word
“units” should be spelled out. The other answer options contain the required
components needed to safely carry out the medication order.



4. A nurse is reviewing a drug label with a drug name written with tall man lettering. Which
statements shows the nurse has a correct understanding of tall man lettering on a drug label?
A “The tall man lettering means this is a high alert drug.”
B “The tall man lettering helps me distinguish this drug with other drugs that
have similar names.”
C “The tall man lettering means that this drug must have a Boxed Warning.”
D “The tall man lettering helps me quickly identify that this drug is an injectable
drug.”

ANS: B
Feedback
Tall man lettering highlights a portion of the drug name to help distinguish from
similar drug names. It is not used to identify high alert drugs, highlight a boxed
warning, or identify injectable drugs.



5. The following medication orders are found in the patient’s MAR:

Metformin HCl 500 mg PO daily at 0900.
Hydrochlorothiazide 25 mg PO every 12 hr at 0900 and 2100.
Digoxin .25 mg PO daily at 0900.

In reading the medication orders for the 0700–1500 shift, the nurse determines that which of
the following is the priority nursing intervention?
A Clarify the metformin HCl order.
B Clarify the hydrochlorothiazide order.
C Clarify the digoxin order.
D Prepare to administer the 0900 medications.

ANS: C


2

,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e



Feedback
The digoxin medication order is lacking a zero before the decimal fraction (.25).
Safe practice recommends using a zero before a decimal point when the dose is less
than one. The metformin HCl and the hydrochlorothiazide orders are written
correctly. The order should be clarified before preparing the 0900 medications.



6. In the administration of medications, when should the nurse document the administration of
medications?
A 30 minutes before administering to the patient.
B Immediately before administering to the patient.
C At the end of the shift.
D Immediately after administering to the patient.

ANS: D
Feedback
The last “Right of Medication Administration” is the documentation of medications.
The documentation is done immediately after administering the medications to the
patient.



7. The following medication is ordered for the patient:

Calcitriol Oral Solution 2 µg PO Daily

After reading the order, what is the initial action needed by the nurse?
A Clarify the written medication dose of 2 µg.
B Look up the dose in a drug reference book.
C Transcribe the medication order onto the MAR.
D Ask the patient the daily dose taken at home.

ANS: A
Feedback
The initial action is for the nurse to clarify the drug dose because it is written with
the error-prone letter/symbol “µ.” To avoid medication errors, it is recommended
that the “µ” not be used in medication orders. Instead the abbreviation “mcg” is to
be used for microgram.



8. Recommendations by the Institute of Medicine for reducing medication errors help enhance
safe nursing practice by:


3

,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e



A shifting primary responsibility for drug therapy onto patients and families.
B referring patients and families to the pharmacist for drug therapy questions.
C answering drug therapy questions when a new prescription is ordered.
D promoting ongoing communication between patients and healthcare
providers.

ANS: D
Feedback
The Institute of Medicine recommendations include the establishment of
collaborative partnership between patients and healthcare providers to assist in
educating, consulting, and listening to patient’s concerns. Ongoing communication
between patients and healthcare providers keeps the focus on the needs of the
individual patient and promotes safety.



9. In consulting a drug reference book, the nurse reads that certain medications are classified as
“high-alert” medications. In the administration of high-alert medications, what is the priority
action of the nurse?
A Inform the patient of the harmful side effects.
B Double-check the dose with another nurse prior to administering the drug.
C Provide drug literature to the family to assist with monitoring for harmful
effects.
D Seek assistance from the pharmacist to explain the effects of the drug.

ANS: B
Feedback
High-alert medications have an increased risk of patient harm. Safe practice in the
administration of high-alert medications requires the nurse to double check the dose
with another nurse prior to the administration of the drug. Informing the patient and
family of the drug’s harmful effects may be indicated for some patients, but the
prevention of a medication error is critical. Drug literature may be helpful for some
families, but not all. The nurse should seek assistance from the pharmacist whenever
there is a question, but this is not specific for high-alert medications.



10. All of the following medication orders are found in a patient’s MAR. Select the medication
order that requires clarification before administration.
A Captopril 12.5 mg PO at 0700 and 1700
B Regular insulin 7 units subcut 30 minutes before breakfast.
C Ketorolac 15 mg IM stat
D Morphine sulfate 45.0 mg PO every 5 hr for pain.




4

,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e



ANS: D
Feedback
The ordered dose of morphine sulfate, 45.0 mg, has a trailing zero, which may lead
to an error in the administration of the ordered dose. The medication orders for
captopril, Regular insulin, and ketorolac contain the required components of a
medication order.




5

,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e



Chapter 2: The Drug Label
Castillo: Calculating Drug Dosages: A Patient-Safe Approach to Nursing and Math 2nd Edition

MULTIPLE CHOICE

1. On a home health visit, the nurse finds a drug bottle with the following information on the
label:

Flagyl ®
metronidazole tablets USP
250 mg tablets

In reading the drug label, the nurse is correct to interpret that:
A Metronidazole is the generic name of the drug.
B Flagyl is the generic name of the drug.
C “USP” indicates a boxed warning.
D The symbol ® identifies the drug as a high-alert drug.

ANS: A
Feedback
The generic name is listed under the brand name. Flagyl is the brand name. USP
stands for United States Pharmacopeia and does not indicate a boxed warning. The
symbol ® is found next to the brand name and indicates that the drug name is
registered and trademark protected.



2. The following information is on the drug label:

Diazepam CIV
Oral Solution
5 mg per 5 mL

In reading the drug label, the nurse is correct to interpret that:
A diazepam is the brand name.
B diazepam is a controlled substance.
C the CIV is used to identify oral solutions on the label.
D the drug is on the list of Confused Drug names.

ANS: B
Feedback




1

,Castillo/Werner-McCullough: Calculating Drug Dosages, 2e



The CIV indicates that the drug is a controlled substance found under the Schedule
IV category. Diazepam is the generic name. The letter “C” indicates that the drug is
a controlled substance and the roman numeral (IV) signify under which schedule the
drug is categorized. The CIV is not used to highlight confused drug names.



3. The following information is on the drug label:

Minipress ®
(prazosin hydrochloride)
1 mg
Capsules

The nurse can safely administer this drug via which route?
A IM
B Subcut
C IV
D PO

ANS: D
Feedback
Although not specifically stated on the label, it is understood that capsules and
tablets are administered via the oral (PO) route. All the other routes indicate
parenteral routes of administration.



4. The nurse is preparing the following medication:

Glucotrol XL ®
(glipizide)
Extended release tabs
2.5 mg

What does the nurse need to do when administering this drug?
A Crush and dissolve the tablet in 15 mL of water.
B Give half the tablet now and the other a half hour later.
C Instruct the patient swallow the entire tablet.
D Instruct the patient to chew the tablet slowly.

ANS: C
Feedback



2

, Castillo/Werner-McCullough: Calculating Drug Dosages, 2e



Extended release tablets must be swallowed whole to safely allow for constant
release of the medication over a specific time. Extended release tablets must not be
crushed, divided, or chewed.



5. The medication order is to administer 0.1 mL of a drug intradermally. The nurse
demonstrates proper administration of the drug when the drug is:
A given into the muscle.
B placed between the gum and lining of the cheek.
C injected into the top layers of the skin.
D inhaled through the mouth or nose.

ANS: C
Feedback
Intradermal (ID) administration of a drug is given into the top layers of the skin.
Drugs given into the muscle use the intramuscular (IM) route. Drugs placed between
the gum and lining of the cheek use the buccal route. Drugs administered through
the mouth or nose use the inhalant route.



6. The medication order is to give 0.5 mg of a drug sublingually. The nurse demonstrates proper
administration of the drug when the drug is:
A placed between the gum and lining of the cheek.
B placed under the tongue.
C injected into the subcutaneous tissue.
D inhaled through the nasal mucosa.

ANS: B
Feedback
The sublingual (SL) administration of a drug is correct when the drug is placed
under the tongue. Drugs placed between the gum and lining of the cheek use the
buccal route. Drugs injected into the top layers of the skin use the subcutaneous
(subcut) route. Drugs inhaled through the nasal mucosa use the intranasal route.



7. The nurse finds the following medication in the patient’s medication drawer:

Aldactazide ®
spironolactone and
hydrochlorothiazide
tablets


3

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