Deck 16: Preparation of Noninjectable Solutions

Question 1

Which of the following patients, based on age, would require extra consideration when calculating medication dosages?

A) 18-year-old male
B) 25-year-old female
C) 40-year-old female
D) 70-year-old male

Answer 1

70-year-old male

Question 2

_____ is the process that moves a drug from the site at which it was administered into the bloodstream.

A) Pharmacokinetics
B) Absorption
C) Biotransformation
D) Distribution

Answer 2

Absorption

Question 3

The movement of drugs from the bloodstream into other body tissues and fluids is called _____.

A) pharmacokinetics
B) absorption
C) elimination
D) distribution

Answer 3

distribution

Question 4

The process of the chemically changing a drug is called metabolism or biotransformation. Alteration in which organ would greatly affect this process?

A) liver
B) kidney
C) stomach
D) large intestines

Question 5

Patients with poor circulation are likely to experience alterations in

A) metabolism and absorption.
B) distribution and metabolism.
C) absorption and distribution.
D) absorption and elimination.

Question 6

Physicians may be inclined to order larger than normal intramuscular drug doses for patients experiencing which of the following?

A) circulation impairment
B) kidney impairment
C) liver impairment
D) mental impairment

Question 7

The elderly tend to have lower muscle mass; this often causes a(n)

A) increased creatinine clearance.
B) decreased creatinine clearance.
C) increased creatinine absorption.
D) decreased creatinine absorption.

Question 8

When administered to patients having less than the ideal body weight, water-soluble medication doses should be calculated based on

A) a standard weight.
B) the ideal weight.
C) actual body weight.
D) creatinine clearance.

Question 9

Polypharmacy refers to

A) patients using more than one pharmacy to get prescriptions filled.
B) patients taking many medications at the same time.
C) state and local pharmacy chains that specialize in geriatric prescriptions.
D) state and local pharmacy chains that specialize in pediatric prescriptions.

Question 10

Elderly patients with clotting disorders should avoid which of the following medications?

A) narcotics
B) antipsychotics
C) aspirin
D) steroids

Question 11

The study of what happens to drugs in the body is

A) medicokinetics.
B) pharmacology.
C) pharmacy.
D) pharmacokinetics.

Question 12

Drugs can be _____ through sweat, feces, or any other body secretion.

A) absorbed
B) eliminated
C) distributed
D) changed

Question 13

If a patient has liver disease, the medication dose may have to be _____ because of alterations in metabolism.

A) decreased
B) increased by half
C) left unchanged
D) increased twofold

Question 14

Which of the following is not a recommendation for working with geriatric patients?

A) Encourage them to participate in planning their schedule.
B) Ask if they need bottle caps that are not childproof.
C) Instruct them to take their medication using color of tablets.
D) Make a chart with the names of the medicines, times, and descriptions.

Question 15

Although the physician prescribes medication dosages, if you are going to measure and administer the medication, you must

A) give the medication without questioning the order.
B) hold the medication if it is a safe dose.
C) give the medication even if it is outside the standard recommended dose.
D) check that the dose is the standard recommended dose.

Question 16

Based on the adult nomogram, the BSA for a patient that is 6 ft tall and 200 lb is

A) 2.14 m^2.
B) 1.80 m^2.
C) 2.30 m^2.
D) 1.50 m^2.

Question 17

Based on the adult nomogram, the BSA for a patient who is 68 in. tall and 145 lb is

A) 1.70 m^2.
B) 1.80 m^2.
C) 1.77 m^2.
D) 1.73 m^2.

Question 18

Using the child nomogram, a child who is 3 ft tall and 36 lb has a BSA of

A) 0.50 m².
B) 0.64 m².
C) 0.58 m².
D) 0.69 m².

Question 19

Using the child nomogram, a child who is 62 cm and 14 kg has a BSA of

A) 0.44 m^2.
B) 0.50 m^2.
C) 0.40 m^2.
D) 0.39 m^2.

Question 20

Creatinine clearance _____ with age because of a decrease in muscle mass.

A) increases by half
B) does not change
C) doubles
D) decreases

Question 21

Which of the following is a factor in causing an adverse drug reaction?

A) young age
B) polypharmacy
C) taking only one medicine
D) living with family

Question 22

The child weighs 6 lb 11 oz. Convert this weight to kg: _______________. (Round to the nearest hundredth)

Question 23

The child weighs 1 lb 4 oz. Convert this weight to kg: _______________. (Round to the nearest hundredth)

Question 24

The child weighs 3 lb 12 oz. Convert this weight to kg: _______________ (Round to the nearest tenth)

Question 25

The patient is a 5-day-old newborn who weighs 7 lb 3 oz. Ordered: Nebcin 4 mg IM q12h. Refer to information from package insert. If this is a safe dose, calculate the amount to administer: _______________ If it is not a safe dose, write: not safe.
0.4 mL

Question 26

The patient is a 3-day-old newborn who weighs 4 lb. Ordered: Nebcin 4 mg IM q12h. Refer to information from the package insert. If this is a safe dose for this newborn calculate the amount to administer: _________. If it is not a safe dose, write: not safe.

Question 27

The patient is a 23-hour-old newborn who weighs 3 lb 5 oz. Ordered: Nebcin 2 mg IM q12h. Refer to information from the package insert. If this is a safe dose, determine the amount to administer: _______________. If it is not a safe dose, write: not safe.

Question 28

The patient weighs 88 lb and is receiving myelosuppressive chemotherapy. Ordered: Neupogen 200 mcg IVPB over 30 minutes. Refer to information from the package insert for the dose on hand. If this is a safe dose for this patient, determine the amount to administer: _______________. If it is not a safe dose, write: not safe.

Question 29

The patient is a 55 lb child receiving myelosuppressive chemotherapy. Ordered: Neupogen 100 mcg subcut daily. Refer to the information from the package insert for the dose on hand. If this is a safe dose for this patient, determine amount to administer: _______________. If it is not a safe dose, write: not safe.

Question 30

The child weighs 33 lb. Ordered: Depakene syrup 120 mg po q12h. Refer to the information from the package insert for the dose on hand. If this is a safe dose for this patient, calculate the amount to administer: _______________ If it is not a safe dose, write: not safe.
not safe

Question 31

The child weighs 43 lb. Ordered: Depakene syrup 125 mg po q12h. Refer to the information from the package insert for the dose on hand. If this is a safe dose for this patient, determine the amount to administer: _______________. If it is not a safe dose, write: not safe.

Question 32

Height = 90 cm; weight = 25 kg. Calculate the BSA: _______________. (Round to the nearest hundredth)

Question 33

Height = 56 cm; weight = 18 kg. Calculate the BSA: _______________. (Round to the nearest hundredth)

Question 34

Height = 167 cm; weight = 63.6 kg. Calculate the BSA: _______________. (Round to the nearest hundredth)

Question 35

Height = 60 in.; weight = 240 lb. Calculate the BSA: _______________. (Round to the nearest hundredth)

Question 36

Height = 48 in.; weight = 80 lb. Calculate the BSA: _______________. (Round to the nearest hundredth)

Question 37

Height = 21.5 in.; weight = 10 lb. Calculate the BSA: _______________. (Round to the nearest hundredth)

Question 38

Calculate the recommended dosage for 200 mg/m² for a patient whose BSA is 0.26 m²: _______________.

Question 39

Calculate the recommended dosage for 125 mg/m² for a patient whose BSA is 1.12 m²: _______________.

Question 40

Ordered: Cerubidine 22 mg/m² IV q week
On hand: Cerubidine for injection. When reconstituted, each milliliter contains 5 mg of drug.
The maximum recommended pediatric dosage is 25 mg/m² IV the first day every week. Patient is 65 cm tall and weighs 20 kg. If this is a safe dose for this patient, determine amount to administer: _______________. If it is not a safe dose, write: not safe.

Question 41

When a patient receives an IM injection, the medication moves from the injection site into the bloodstream by a process called _______________.

Question 42

Chemical changes to drugs, which occur primarily in the liver, are the result of the process of _______________.

Question 43

Both absorption and distribution of medications are affected in patients who have poor _______________.

Question 44

When administering medications, it is your responsibility to check that the ordered dose is at or below the ______________ recommended dose.

Question 45

A nomogram is a special chart that can be used to determine a patient's _______________.

Question 46

A by-product of muscle metabolism found in the blood is _______________.

Question 47

One indicator of the rate at which kidneys filter blood is the patient's _______________.

Question 48

For obese patients, doses of water-soluble medications should be based on their ___________ body weight.

Question 49

For a patient who is underweight, dosages should be based on the patient's _______________ weight.

Question 50

Mr. Paul takes eight different prescription medications plus several OTC medications. Taking multiple medications is called _______________.

Question 51

Since Mr. Paul takes multiple medications, he is at higher risk for a drug _______________.

Question 52

The patient is a 3-year-old child who weighs 26 lb and has a severe infection.
Ordered: Amoxicillin 120 mg po q8h
On hand: See label. The package insert says the dosing regimen for children is 20 to 40 mg/kg/day q8h. Determine if the order is safe. If it is, calculate the amount to administer: _______________. If the dose is not safe, write: not safe.

Question 53

The patient is a 5-year-old child who weighs 42.6 lb.
Ordered: Levsin 5 mcg/kg 30 min prior to anesthesia
On hand: Levsin 0.5 mg/mL single-use vials Calculate the amount to administer: _______________.

Question 54

Cindy is an 11-year-old, 79 lb child who sliced her forearm open on a sharp piece of metal while helping her father clean out the garage. At the emergency room, the wound was cleaned up and the physician determined that she would need several sutures. Cindy is very upset, and the physician orders Midazolam for injection to sedate her and help decrease her anxiety. However, when Cindy sees the needle, she becomes very agitated, so the physician changes the order to Midazolam HCl syrup 18 mg PO. On hand, the emergency room has a 118 mL bottle of Midazolam HCl syrup . According to the package insert, the usual oral dose is 0.25 to 1 mg/kg. Determine if the ordered dose is safe. If it is safe, determine the amount to administer: _______________. If the dose is not safe, write: not safe.

Question 55

The patient weighs 16 kg.
Ordered: Cipro 250 mg PO BID
On hand: Cipro 250 mg tablets. According to the package insert, the medication can be given 10 to 20 mg/kg every 12 hours.
Determine whether the dose is safe. If it is safe, calculate the amount to administer: _______________. If the dose is not safe, write: not safe.

Question 56

Timmy is a 7-year-old child who weighs 52 lb. His mother brought him to the walk-in clinic because he has a persistent earache that was not relieved by over-the-counter medications. The physician diagnoses a moderate ear infection and prescribes Erythromycin suspension 275 mg po q12h for 7 days. On hand is erythromycin oral suspension . The package insert indicates that the usual dosage for children over 3 months of age is either 25 mg/kg/day in divided doses every 12 h, or 20 mg/kg/day in divided doses every 8 h. Determine if the dose is safe. If it is safe, calculate the amount to administer: _______________. If the dose is not safe, write: not safe. (Round to nearest whole number)

Question 57

The patient is a 13-year-old with a severe throat infection. The patient weighs 45 kg.
Ordered: Erythromycin 650 mg PO q8h for 7 days
On hand: See label
Determine if the dose is safe. If it is safe, calculate the amount to administer: _______________. If the dose is not safe, write: not safe.

Question 58

The patient is a 4-year-old child who weighs 33 lb 6 oz.
Ordered: Erythromycin suspension 180 mg po qid for 7 days
On hand: See label
Determine if the dose is safe. If it is safe, calculate the amount to administer: _______________. If the dose is not safe, write: not safe.

Question 59

The patient is 5 years old and weighs 41 lb. She will receive erythromycin for an upper respiratory infection. According to the label, the maximum safe daily dose for this patient is _______________.

Question 60

Mr. Quitman is 70 years old, weighs 132 lb, and is 5 ft 9 in. tall. At his follow-up appointment after several tests, his physician told him that he has bladder cancer and referred him to an oncologist. The oncologist explained that the treatment regimen will include an IV injection of doxorubicin for 3 consecutive days every 3 to 4 weeks. The oncologist ordered doxorubicin 45 mg by IV injection for the first three daily doses. On hand are 10 mL single-use vials of doxorubicin . According to the package insert, the usual dose is 60-90 mg/m² IV injection every 21 days, 20-30 mg/m²/day IV for 3 consecutive days every 3 to 4 weeks, or 20 mg/m² IV weekly, for a total cumulative dose of 550 mg/m². Determine whether this is a safe dose for this patient. If the dose is safe, calculate the amount to administer: _______________. If the dose is not safe, write: not safe.

Question 61

Find the BSA for a patient who is 4 ft 2 in. tall and weighs 57 lb: _______________. (Round to the nearest hundredth)

Question 62

Find the BSA for a patient who is 6 ft 1 in. tall and weighs 245 lb: _______________. (Round to the nearest hundredth)

Question 63

The BSA for a patient who is 1.3 m tall and weighs 28.2 kg is _______________. (Round to the nearest hundredth)

Question 64

The BSA for a patient who is 76 cm and weighs 9.5 kg is _______________. (Round to the nearest hundredth)

Question 65

The child's BSA is 0.56 m². The recommended dosage is 25 mcg/m². The recommended dosage for this child is _______________.

Question 66

A burn patient's BSA is 1.72 m². The recommended dosage range is 37-52 mg/m². The maximum safe dose for this patient is _______________. (Round to the nearest milligram)

Question 67

A 42-year-old patient has been diagnosed with mesothelioma. The physician has prescribed pemetrexed 850 mg IV over 10 minutes every 21 days. According to the package insert, the usual dose is 500 mg/m2. The patient is 5 ft 6 in. and weighs 154 lb. The maximum safe dose for this patient is _______________.

Question 68

The study of what happens to a drug after it is administered to a patient is _______________.

Question 69

The process that moves a drug from the bloodstream to other body tissues and fluids is known as _______________.

Question 70

Another term for the process of biotransformation is _______________.

Question 71

The process through which a drug leaves the body through urine, sweat, feces, or other body secretions is called _______________.

Question 72

Pharmacokinetic processes in children are different from those in adults partly because children have a higher percentage of _______________ per kilogram of body weight.

Question 73

A child's BSA is 0.68 m2. The recommended dosage is 80 mg/m². The recommended dosage for this child is _______________.

Question 74

The patient is a 6-year-old child who weighs 44 lb.
Ordered: Proventil 2 mg po tid

On hand: Proventil Syrup . According to the package insert, for children 2 to 6 years of age, dosing should be initiated at 0.1 mg/kg of body weight 3 times a day. Determine if this order is safe. If it is safe, calculate the amount to administer: _______________. If the dose is not safe, write: not safe.