Deck 3: Advanced Medication and Intravenous Calculations

Question 1

Ms Jackie Robinson is a young woman who has been admitted to hospital following a motor vehicle accident in which she sustained fractures to her pelvis and left femur. Jackie is a diabetic and has a three-week-old baby as a boarder. She has an intravenous infusion of 1 L of fluid and the drop factor for the giving set is 20 drops/ml. You have been assigned to care for her and the baby, under the guidance of a registered nurse.
-When you visit Jackie, she asks for 'something for a headache'. You check her medication sheet and note she can have 1 gram of paracetamol for mild to moderate pain
4/24 PRN. Stock is 500 mg/tablet, so the number of tablets that she should be given is

A) 1
B) 1 1/2
C) 2
D) 2 1/2

Answer 1

C

Question 2

Ms Jackie Robinson is a young woman who has been admitted to hospital following a motor vehicle accident in which she sustained fractures to her pelvis and left femur. Jackie is a diabetic and has a three-week-old baby as a boarder. She has an intravenous infusion of 1 L of fluid and the drop factor for the giving set is 20 drops/ml. You have been assigned to care for her and the baby, under the guidance of a registered nurse.
-She has an intravenous infusion of 1 L of 0.9% of sodium chloride which is infusing at the rate of 40 drops/minute. The volume/hour that is currently being delivered is

A) 80 ml
B) 100 ml
C) 120 ml
D) 140 ml

Answer 2

C

Question 3

Ms Jackie Robinson is a young woman who has been admitted to hospital following a motor vehicle accident in which she sustained fractures to her pelvis and left femur. Jackie is a diabetic and has a three-week-old baby as a boarder. She has an intravenous infusion of 1 L of fluid and the drop factor for the giving set is 20 drops/ml. You have been assigned to care for her and the baby, under the guidance of a registered nurse.
-Jackie is being prepared for the operating theatre to have her fractured femur stabilised. As part of her premedication she is to have 60 mg of pethidine . Stock is 100 mg/2 ml, so the volume required for this order is

A) 0.8 ml
B) 1 ml
C) 1.2 ml
D) 1.4 ml

Answer 3

C

Question 4

Ms Jackie Robinson is a young woman who has been admitted to hospital following a motor vehicle accident in which she sustained fractures to her pelvis and left femur. Jackie is a diabetic and has a three-week-old baby as a boarder. She has an intravenous infusion of 1 L of fluid and the drop factor for the giving set is 20 drops/ml. You have been assigned to care for her and the baby, under the guidance of a registered nurse.
-Atropine is also due to be given. She is to have 500 mcg. Stock is 0.5 mg/ml. The volume required is

A) 0.4 ml
B) 0.6 ml
C) 0.8 ml
D) 1 ml

Question 5

Ms Jackie Robinson is a young woman who has been admitted to hospital following a motor vehicle accident in which she sustained fractures to her pelvis and left femur. Jackie is a diabetic and has a three-week-old baby as a boarder. She has an intravenous infusion of 1 L of fluid and the drop factor for the giving set is 20 drops/ml. You have been assigned to care for her and the baby, under the guidance of a registered nurse.
-While Jackie is out of the ward you have been asked to bath, weigh, measure and feed the infant. The baby's weight is 3.24 kg and her length is 0.51 m. These measurements
Could also be expressed as

A) 3420 grams, 50 cm
B) 3240 grams, 50 mm
C) 3240 grams, 51 cm
D) 3420 grams, 51 mm

Question 6

Ms Jackie Robinson is a young woman who has been admitted to hospital following a motor vehicle accident in which she sustained fractures to her pelvis and left femur. Jackie is a diabetic and has a three-week-old baby as a boarder. She has an intravenous infusion of 1 L of fluid and the drop factor for the giving set is 20 drops/ml. You have been assigned to care for her and the baby, under the guidance of a registered nurse.
-Baby Robinson should have approximately 460 kilojoules/kg/day. Her daily kilojoule intake should be

A) 1260
B) 1370
C) 1490
D) 1520

Question 7

Ms Jackie Robinson is a young woman who has been admitted to hospital following a motor vehicle accident in which she sustained fractures to her pelvis and left femur. Jackie is a diabetic and has a three-week-old baby as a boarder. She has an intravenous infusion of 1 L of fluid and the drop factor for the giving set is 20 drops/ml. You have been assigned to care for her and the baby, under the guidance of a registered nurse.
-If the baby has seven feeds each day, her approximate kilojoule intake/feed would be

A) 196
B) 213
C) 245
D) 262

Question 8

Ms Jackie Robinson is a young woman who has been admitted to hospital following a motor vehicle accident in which she sustained fractures to her pelvis and left femur. Jackie is a diabetic and has a three-week-old baby as a boarder. She has an intravenous infusion of 1 L of fluid and the drop factor for the giving set is 20 drops/ml. You have been assigned to care for her and the baby, under the guidance of a registered nurse.
-The breast milk in the jug in the fridge contains approximately 280 kilojoules/100 ml of milk. The volume of milk/feed that the infant should have is approximately

A) 76 ml
B) 102 ml
C) 106 ml
D) 110 ml

Question 9

Jackie returns to the ward. She is to have a morphine infusion to deliver pain relief via a syringe driver. You note that the order is for 45 mg of morphine in 60 ml of fluid. You assist the registered nurses to set up this infusion.
-Stock of morphine is 15 mg/ml, so the volume required for this order is

A) 2 ml
B) 2.5 ml
C) 3 ml
D) 4 ml

Question 10

Jackie returns to the ward. She is to have a morphine infusion to deliver pain relief via a syringe driver. You note that the order is for 45 mg of morphine in 60 ml of fluid. You assist the registered nurses to set up this infusion.
-The amount of 0.9% sodium chloride required to complete this task is

A) 58 ml
B) 57.5 ml
C) 57 ml
D) 56 ml

Question 11

Jackie returns to the ward. She is to have a morphine infusion to deliver pain relief via a syringe driver. You note that the order is for 45 mg of morphine in 60 ml of fluid. You assist the registered nurses to set up this infusion.
-The pain relief infusion is to last for 24 hours. The volume/hour that should be delivered from this order is

A) 1.5 ml/hour
B) 1.75 ml/hour
C) 2 ml/hour
D) 2.5 ml/hour

Question 12

Jackie returns to the ward. She is to have a morphine infusion to deliver pain relief via a syringe driver. You note that the order is for 45 mg of morphine in 60 ml of fluid. You assist the registered nurses to set up this infusion.
-The concentration, in mg/ml, of this medicated solution is

A) 0.5 mg/ml
B) 0.75 mg/ml
C) 1 mg/ml
D) 1.25 mg/ml

Question 13

Jackie returns to the ward. She is to have a morphine infusion to deliver pain relief via a syringe driver. You note that the order is for 45 mg of morphine in 60 ml of fluid. You assist the registered nurses to set up this infusion.
-This infusion is to commence with a bolus dose of 4.5 mg of morphine over a 3-minute
Period. The number of mg/minute that she would receive from this order is

A) 1.5
B) 1.75
C) 2
D) 2.25

Question 14

Jackie returns to the ward. She is to have a morphine infusion to deliver pain relief via a syringe driver. You note that the order is for 45 mg of morphine in 60 ml of fluid. You assist the registered nurses to set up this infusion.
-The volume of fluid that contains the mg/minute in this bolus dose is

A) 0.5 ml
B) 0.75 ml
C) 1 ml
D) 2 ml

Question 15

Jackie returns to the ward. She is to have a morphine infusion to deliver pain relief via a syringe driver. You note that the order is for 45 mg of morphine in 60 ml of fluid. You assist the registered nurses to set up this infusion.
-The volume/hour that will deliver this bolus dose over the 3-minute period is

A) 50 ml
B) 75 ml
C) 100 ml
D) 120 ml

Question 16

Jackie returns to the ward. She is to have a morphine infusion to deliver pain relief via a syringe driver. You note that the order is for 45 mg of morphine in 60 ml of fluid. You assist the registered nurses to set up this infusion.
-Jackie's intravenous infusion, 1 L of 5% dextrose (she is not currently taking food or fluids), has 70 ml remaining and is dripping at 60 drops/minute. Remembering that the drop factor for the giving set is 20 drops/ml, this infusion should complete in

A) 20 minutes
B) 23 minutes
C) 25 minutes
D) 27 minutes

Question 17

Jackie returns to the ward. She is to have a morphine infusion to deliver pain relief via a syringe driver. You note that the order is for 45 mg of morphine in 60 ml of fluid. You assist the registered nurses to set up this infusion.
-Jackie has been ordered 10 units of Actrapid insulin. Remembering that insulin is available as 100 units/ml, the volume drawn up in the insulin syringe is equivalent to

A) 0. 1 ml
B) 0.12 ml
C) 0.18 ml
D) 0.2 ml

Question 18

Jackie returns to the ward. She is to have a morphine infusion to deliver pain relief via a syringe driver. You note that the order is for 45 mg of morphine in 60 ml of fluid. You assist the registered nurses to set up this infusion.
-Intravenous metoclopramide (Maxolon) 7.5 mg has been ordered for Jackie's nausea. Stock in the ward is 10 mg/2 ml. The volume required for this order is

A) 0.5 ml
B) 1 ml
C) 1.5 ml
D) 2 ml

Question 19

Jackie returns to the ward. She is to have a morphine infusion to deliver pain relief via a syringe driver. You note that the order is for 45 mg of morphine in 60 ml of fluid. You assist the registered nurses to set up this infusion.
-Subcutaneous Heparin 6000 units is to be given, using an 0.5 ml insulin syringe. Stock is 5000 units/0.2 ml, so the volume required is

A) 0.18 ml
B) 0.24 ml
C) 0.27 ml
D) 0.29 ml

Question 20

Jackie returns to the ward. She is to have a morphine infusion to deliver pain relief via a syringe driver. You note that the order is for 45 mg of morphine in 60 ml of fluid. You assist the registered nurses to set up this infusion.
-Sliding-scale insulin has been ordered for Jackie while she is not eating. She is to have no insulin if her reading is below 8 mmol/L, but if her reading is 8 mmol/L, she is to have 2 units of insulin. For every 4 mmol/L above 8 mmol/L (e.g. 12 or 16 mmol/L), she is to have an additional 2 units. The reading you have just taken is 22 mmol/L. The number of units of insulin she should receive is

A) 6 units
B) 8 units
C) 10 units
D) 12 units

Question 21

Mr James Chifley has been admitted to hospital with a compound, comminuted fracture of his right arm. He is scheduled for surgery to stabilise his fractures in 30 minutes. His premedication is due and he is to have 12 mg of morphine and 400 mcg of Atropine.
-If morphine is available as 15 mg/ml, what volume is required for this dose?

Question 22

Mr James Chifley has been admitted to hospital with a compound, comminuted fracture of his right arm. He is scheduled for surgery to stabilise his fractures in 30 minutes. His premedication is due and he is to have 12 mg of morphine and 400 mcg of Atropine.
-Atropine stock is 0.5 mg/ml, what volume should be drawn up?

Question 23

Mr James Chifley has been admitted to hospital with a compound, comminuted fracture of his right arm. He is scheduled for surgery to stabilise his fractures in 30 minutes. His premedication is due and he is to have 12 mg of morphine and 400 mcg of Atropine.
-An intravenous line has been established in his left arm and 1 L of 0.9% sodium chloride is to infuse over 6 hours. Calculate the volume to be run into the burette every hour.

Question 24

Mr James Chifley has been admitted to hospital with a compound, comminuted fracture of his right arm. He is scheduled for surgery to stabilise his fractures in 30 minutes. His premedication is due and he is to have 12 mg of morphine and 400 mcg of Atropine.
-If the drop factor for the giving set is 20 drops/ml, how many drops/minute will deliver the above order?

Question 25

Mr Chifley returns to the ward three hours later and two registered nurses are setting up an infusion to control his pain. His pain relief medication is to be delivered via a secondary line in a volumetric pump. He is to have 300 mg of pethidine in 100 ml of 0.9% sodium chloride, and this solution is to infuse over a 20-hour period. You have been asked to assist by working out the nursing calculations required for this task.
-What volume of pethidine is required for this task if stock available is 100 mg/2 ml?

Question 26

Mr Chifley returns to the ward three hours later and two registered nurses are setting up an infusion to control his pain. His pain relief medication is to be delivered via a secondary line in a volumetric pump. He is to have 300 mg of pethidine in 100 ml of 0.9% sodium chloride, and this solution is to infuse over a 20-hour period. You have been asked to assist by working out the nursing calculations required for this task.
-What volume of fluid needs to be removed from the 100 ml bag to maintain a total volume of 100 ml?

Question 27

Mr Chifley returns to the ward three hours later and two registered nurses are setting up an infusion to control his pain. His pain relief medication is to be delivered via a secondary line in a volumetric pump. He is to have 300 mg of pethidine in 100 ml of 0.9% sodium chloride, and this solution is to infuse over a 20-hour period. You have been asked to assist by working out the nursing calculations required for this task.
-What is the concentration, in mg/ml, of this medicated solution?

Question 28

Mr Chifley returns to the ward three hours later and two registered nurses are setting up an infusion to control his pain. His pain relief medication is to be delivered via a secondary line in a volumetric pump. He is to have 300 mg of pethidine in 100 ml of 0.9% sodium chloride, and this solution is to infuse over a 20-hour period. You have been asked to assist by working out the nursing calculations required for this task.
-What volume of fluid/hour will deliver the prescribed dose in the given time?

Question 29

After an hour, Mr Chifley calls you and says his pain is unbearable. His medication chart indicates he may have a bolus dose of 12 mg of pethidine over a 4-minute period. The registered nurse is supervising your calculations as you work out the change in the rate of flow to deliver this order.
-How many mg/minute does this order entail?

Question 30

After an hour, Mr Chifley calls you and says his pain is unbearable. His medication chart indicates he may have a bolus dose of 12 mg of pethidine over a 4-minute period. The registered nurse is supervising your calculations as you work out the change in the rate of flow to deliver this order.
-What volume of fluid/minute contains the dose/minute he is to have?

Question 31

After an hour, Mr Chifley calls you and says his pain is unbearable. His medication chart indicates he may have a bolus dose of 12 mg of pethidine over a 4-minute period. The registered nurse is supervising your calculations as you work out the change in the rate of flow to deliver this order.
-To what rate of flow will the volume/hour need to be adjusted, to deliver the ordered dose in the prescribed time?