Nightingale Dosage Calc

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Sample questions from Nightingale Dosage Calc

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.During a home visit, a community nurse reviews a new prescription for a 6-month-old infant weighing 7.2 kg. The provider prescribes amoxicillin 40 mg/kg/day PO divided every 12 hours. The suspension contains 400 mg/5 mL. How many milliliters should the caregiver administer per dose?

   • A.3.6 mL
   • B.4.5 mL
   • C.1.8 mL
   • D.2.25 mL

   Rationale: The daily dose is 40 mg x 7.2 kg = 288 mg, so each of two daily doses is 144 mg. At 400 mg/5 mL, the concentration is 80 mg/mL, and 144 mg requires 1.8 mL; therefore, the correct option is 1.8 mL.

2. 2.At change of shift on a medical unit, an 82-year-old client with atrial fibrillation is due for digoxin. The client reports new nausea and blurred vision; the apical pulse is 54/min, potassium is 3.2 mEq/L (reference range 3.5-5.0 mEq/L), and a digoxin level drawn 8 hours after the last dose is 2.3 ng/mL (reference range 0.5-2.0 ng/mL). The prescription is digoxin 0.125 mg PO now. What is the nurse's best action?

   • A.Ask an assistive personnel to obtain another pulse before administration.
   • B.Hold the dose and promptly notify the provider of the findings.
   • C.Administer the prescribed dose and recheck the pulse in 1 hour.
   • D.Give the dose with food to reduce nausea and improve tolerance.

   Rationale: The bradycardia, visual and gastrointestinal symptoms, elevated digoxin level, and hypokalemia together suggest possible digoxin toxicity, so the nurse should hold the dose and promptly notify the provider. Giving the dose, even with food, could worsen toxicity. An assistive personnel may collect data but cannot assess this high-risk medication situation or replace the nurse's required clinical judgment.

3. 3.Refer to the client's chart. The 8-year-old client has a new gentamicin prescription. Which actions should the nurse take before administering the next dose? Select all that apply.

   • A.Verify that the gentamicin dose is based on the client's current weight and prescribed interval.
   • B.Administer the dose because the gentamicin trough is within the stated reference range.
   • C.Ask the caregiver to give the medication at home without laboratory follow-up.
   • D.Review the client's hearing and balance symptoms and report any new changes.
   • E.Hold the dose and contact the provider about the increased creatinine and reduced urine output.

   Rationale: The chart shows creatinine rising from 0.4 to 0.9 mg/dL and urine output decreasing from 1.2 to 0.5 mL/kg/hr, so the nurse should hold the dose and contact the provider about possible renal impairment. Gentamicin dosing requires verification against current weight and interval, and hearing or balance changes require prompt attention because of ototoxicity risk. The trough of 1.8 mcg/mL is within the stated 0.5-2.0 mcg/mL range, but that result alone does not make administration safe despite deteriorating renal cues; unsupervised home dosing without follow-up is inappropriate.

4. 4.In the emergency department, a 68-year-old client with a suspected ischemic stroke weighs 80 kg. The provider prescribes alteplase 0.9 mg/kg IV, with 10% of the total dose given as an initial bolus and the remainder infused over 60 minutes. The calculated total dose is 72 mg. Which bolus dose should the nurse administer?

   • A.7.2 mg
   • B.72 mg
   • C.6.48 mg
   • D.64.8 mg

   Answer and rationale are in the full material.

5. 5.A provider prescribes heparin 18 units/kg/hr for a 64-kg pregnant client at 32 weeks who is being treated for venous thromboembolism. The infusion bag contains 25,000 units in 500 mL. The client is hemodynamically stable, and the aPTT is within the protocol's therapeutic range. At what rate should the nurse set the pump?

   • A.20.5 mL/hr
   • B.36.0 mL/hr
   • C.23.0 mL/hr
   • D.18.0 mL/hr

   Answer and rationale are in the full material.