Math for Healthcare Professionals: Dosage Calculations and Fundamentals of Medication Administration
Student Resources

NCLEX Review

Please read each question and select your answer from the choices provided. You must complete all of the questions in order to view your results. At the end of each exam, you have the option to e-mail your results to your instructor.

1:  Allowing an IV solution to run dry may result in loss of IV access due to catheter occlusion. Therefore, you need to determine when an intravenous infusion should be totally complete. Based on the information below, what time should the infusion be completed?

Prescription: Infuse D5 ½ NS 1,000 mL IV at 125 mL until taking PO fluids.
You have a 1,000-mL bag of D5 ½ NS and you hang the bag at 0800 hours (8 A.M.).
A: 2400 hours (12:00 midnight).
B: 1600 hours (4:00 P.M.).
C: 1400 hours (2:00 P.M.).
D: 1200 hours (12:00 noon).

2:  Prior to her hospital discharge, your patient brings you the prescription the nurse practitioner has written out, which reads, “Tolterodine tartrate (Detrol) extended release 4 mg PO QD in A.M.” The patient asks you how many pills per day she should take and how often should she take them. You call the pharmacy, and the pharmacists states that the Detrol will be dispensed in 4-mg tablets. What is your response to the patient?
A: Take 1 tablet every morning.
B: Take 2 tablets every morning.
C: Take 1 tablet in the morning and 1 tablet in the evening every day.
D: Take 1 tablet every other day.

3:  Your patient, Mr. Lawrence, has been prescribed Mucinex (guaifenesin) 300 mg orally daily as part of his treatment for bronchitis. The pharmacy sends up Mucinex 600-mg extended-release tablets. How many tablets do you give Mr. Lawrence?
A: None.
B: 0.5 tablet.
C: 1 tablet.
D: 2 tablets.

4:  Based on safety as a rationale, 1 unit of packed red blood cells should run in completely between 2 and 4 hours according to your hospital policy. The nurse from whom you are receiving report states that she set the 1 unit of packed cells (250 mL) to run at 80 mL/h and hung it at 1400 hours (2:00 P.M.). Based on your calculations, how long should it take the complete unit to be administered and is this time frame according to hospital policy time frame?
A: Complete infusion time should be 3.1 hours, which is within the 2- to 4-hour time range.
B: Complete infusion time should be 6 hours, which is not within the 2- to 4-hour time range.
C: Complete infusion time should be 2.4 hours, which is within the 2- to 4-hour time range.
D: Complete infusion time should be 4.1 hours, which is within the 2- to 4-hour time range.

5:  A prescription of 11 units regular and 20 units NPH insulin SC every A.M. can be mixed so that both insulins are contained in one insulin syringe.

6:  For Mrs. Kolanowski to keep her serum potassium within normal limits, she needs to take KCl (potassium chloride) 40 mEq orally daily. Her pharmacist has dispensed KCl tablets, each of which contains 10 mEq of KCl medication. How many tablets per day should Mrs. Kolanowski take?
A: 2 tablets.
B: 3 tablets.
C: 4 tablets.
D: 5 tablets.

7:  Mr. Whitney takes Captopril 12.5 mg orally daily to maintain his blood pressure around 120/80 mm Hg. He tells you that he has a new pharmacist and the pills “look different.” The pill bottle states that it contains “Captopril 25 mg tablets.” How many tablets should Mr. Whitney take per day?
A: 0.5 tablet.
B: 1 tablet.
C: 2 tablets.
D: 4 tablets.

8:  Your patient, Mrs. Sullivan, needs a bolus of heparin at 80 units/kg intravenously. You ask your colleague to determine the dose based on the patient's weight of 94 kg, as you want to compare your calculation result to that made by your colleague. How many units of heparin should you administer?
A: 752 units.
B: 7,520 units.
C: 7,220 units.
D: 3,442 units.

9:  Five-year-old Johnny has an order for Tylenol (acetaminophen) liquid 128 mg for fever of more than 100°F. His temperature is currently 100.4°F. The pharmacy sends up Tylenol oral solution at a dose strength of 160 mg/5 mL. How much Tylenol do you give Johnny?
A: 6.25 mL.
B: 4096 mL.
C: 4 mL.
D: 31.25 mL.

10:  Mrs. Flanceski is prescribed digoxin 0.25 mg orally daily. The pharmacy dispenses her prescription using digoxin 0.125-mg tablets. How many tablets should Mrs. Flanceski take per day?
A: 0.5 tablet.
B: 1 tablet.
C: 2 tablets.
D: 4 tablets.

11:  Karen is a 9-year-old patient with a diagnosis of fever who has been prescribed Cleocin (clindamycin palmitrate hydrochloride) 150 mg orally daily. The pharmacy sends up Cleocin oral solution at a dose strength of 75 mg/5 mL. How much medication do you give Karen?
A: 2 mL.
B: 150 mL.
C: 2.5 mL.
D: 10 mL.

12:  Mrs. Hopi keeps her type 2 diabetes under control by taking metformin (Glucophage) 1 g orally daily. Her pharmacist dispenses metformin in 250-mg tablets because they are easier to swallow. How many tablets should Mrs. Hopi take per day?
A: 1 tablet.
B: 2 tablets.
C: 3 tablets.
D: 4 tablets.

13:  Ms. Oglethorpe is post-cholecystectomy and has gas and bloating. You contact the nurse practitioner on call and receive a prescription for simethicone 100 mg now. The pharmacy sends up a simethicone suspension that is labeled 40 mg/2 mL. How much suspension do you pour to administer to Ms. Oglethorpe?
A: 1.25 mL.
B: 5 mL.
C: 2,000 mL.
D: 0.2 mL.

14:  Your patient has a discharge prescription for methotrexate 2.5 mg orally twice a day × 20 tablets. Your patient asks you how many days in total she should take her medication. What do you tell her?
A: 10 days.
B: 20 days.
C: 8 days.
D: 50 days.

15:  Medication labels often indicate that two medications are mixed into one tablet. If the medication label reads “amoxicillin and clavulanate potassium tablets 500 mg/125 mg,” how many milligrams of amoxicillin would be in 2 tablets?
A: 4 mg.
B: 8 mg.
C: 1,000 mg.
D: 250 mg.

16:  Mr. Smith's blood sugar has not stabilized, so the physician decides to add glyburide to his medication regimen to control the blood sugar. The new medication comes as a combination of glyburide and metformin (2.5 mg/500 mg). The physician states that you should give Mr. Smith the amount of glyburide that matches his 1 g of metformin per day. How many milligrams per day of glyburide will he receive in this new combination medication?
A: 2.5 mg.
B: 5 mg.
C: 7.5 mg.
D: 1,000 mg.

17:  Mrs. Raphael is scheduled to begin her maintenance dose of an antidepressant, specifically, a selective serotonin reuptake inhibitor. She prefers a liquid to a pill. Paroxetine 30 mg orally every morning is prescribed. The paroxetine suspension is packaged as 10 mg/5 mL. How many milliliters will you administer every morning?
A: 3 mL.
B: 5 mL.
C: 60 mL.
D: 15 mL.

18:  The nurse practitioner prescribes 10 mg ondansetron hydrochloride dehydrate every 12 hours orally. The pharmacy sends up Zofran (ondansetron hydrochloride) 8 mg. The package insert from the pharmaceutical company states that each tablet contains 10 mg of ondansetron hydrochloride dehydrate, which is equivalent to 8 mg of Zofran. It is time to give your patient the first dose of the prescribed medication. How many Zofran tablets do you give?
A: None.
B: 1 tablet.
C: 1.25 tablets.
D: 2 tablets.

19:  Twelve-year-old Jonathon has an infection. He is prescribed 75 mg of Vibramycin (doxycycline monohydrate) orally daily. The bottle from the local pharmacy reads “raspberry-flavored Vibramycin 25 mg/5 mL.” Jonathon's mother, who is a nurse, left to go to work early and forgot to give Jonathon his medication. When she called home, her husband said, “Don't worry. I gave Jonathon 10 mL of his medicine.” What should the mother instruct the husband to do?
A: Thank him for giving Jonathon his medicine.
B: Tell him to give Jonathon another 10 mL of the medicine.
C: Tell him to give Jonathon another 5 mL of the medicine.
D: Tell him to call 9-1-1 as he has overdosed Jonathon.

20:  Ms. Thompson has Graves' disease and is prescribed methimazole 7.5 mg orally every morning. Her pharmacist fills the prescription with methimazole 5-mg tablets. How many tablets do you tell Ms. Thompson to take every morning?
A: 1.5 tablets.
B: 3 tablets.
C: 0.75 tablet.
D: 0.66 tablet.

21:  Mr. Rollins is a known alcoholic who is brought to the Emergency Department by the police. He has severe ascites from his chronic alcoholism, and the physician prescribes spironolactone 50 mg orally now. The pharmacy dispenses spironolactone 25-mg tablets. How many tablets do you give Mr. Rollins?
A: 0.5 tablet.
B: 1 tablet.
C: 2 tablets.
D: 4 tablets.

22:  Six-year-old Helen comes into the pediatric nurse clinic complaining of ear pain. According to her mother, she keeps pulling on her ear. The nurse practitioner diagnoses otitis media and prescribes an antibiotic for Helen's ear infection. Which of the following words would you find written on this prescription?
A: Optic.
B: Topical.
C: Otic.
D: Intradermal.

23:  Prior to administering a vaginal suppository to a female patient, you should have the patient
A: Void.
B: Defecate.
C: Do 3 sit-ups.
D: Lie on her stomach.

24:  To relieve Mrs. Bailey's bilateral leg edema due to heart failure, the physician prescribes furosemide (Lasix) 80 mg intravenously now. The pharmacy sends up multiple vials of furosemide 40 mg/mL for intravenous use. How many milliliters of furosemide do you draw up now?
A: 1 mL.
B: 2 mL.
C: 0.5 mL.
D: 20 mL.

25:  To maintain adequate kidney function, your renal failure patient, Mr. Borick, is on fluid restriction. Specifically, his oral fluid intake is restricted to 1,200 mL/day. You note that Mr. Borick has ingested 300 mL over the 11:00 to 7:00 shift. How much oral intake can he have over the next 16 hours?
A: 600 mL.
B: 1,500 mL.
C: 900 mL.
D: 400 mL.

26:  Mr. Rolliou needs to have his heparin adjusted daily based on the results of his PTT lab test to maintain proper coagulation. The physician writes the following prescription: Adjust IV heparin daily based on PTT results and use the sliding scale below:

PTT < 35: Give 80 units/kg bolus.
PTT 35–45: Give 40 units/kg bolus.
PTT 46–70: No change.
PTT > 70: Call the physician immediately.

Mr. Rolliou's PTT result came back as 44. What is your intervention?
A: Do nothing; give him no heparin.
B: Call the physician immediately.
C: Give an 80 units/kg bolus now.
D: Give a 40 units/kg bolus now.

27:  Mr. Boyle is postoperative day 2 from repair of a compound leg fracture. On nurse-to-nurse report, you are told he is 56 years old, has a low pain tolerance, is demanding, and is allergic to Tylenol (acetaminophen). His patient-controlled analgesia (PCA) medication has just been discontinued, and he has been prescribed oxycodone with acetaminophen (Percocet 5/325) 1–2 tablets orally every 4 to 6 hours as needed for pain. Mr. Boyle calls the nurses' desk and asks, “Can my new nurse give me whatever I can have the most of for pain? I am really hurting.” What is your next action?
A: Give Mr. Boyle 2 oxycodone tablets.
B: Give Mr. Boyle 1 oxycodone tablet and reevaluate his pain in 30 minutes.
C: Call the physician for a new prescription for pain control.
D: Share with Mr. Boyle that he should try watching television as distraction and to call back in 15 minutes if he is still having pain.

28:  To maintain adequate hydration initially in your patient who is burned, you need to use a formula like the following:

Parkland formula = 4 mL/kg × %BSA burn for milliliters of fluid over 24 hours

Your patient weighs 77 kg and the % BSA (percent body surface area) burned is 35. How many milliliters of fluid should you give the patient over the next 24 hours?
A: 1.8 mL.
B: 108 mL.
C: 10,780 mL.
D: 23,716 mL.

29:  Smoking cigarettes often increases the metabolism of some psychiatric medications. If this is true, then how should the medication dose be adjusted?
A: Decrease the dose.
B: Increase the dose.
C: Administer the entire dose of medication in the morning.
D: Administer the entire dose of medication at bedtime.

30:  Mr. Yeh is manic depressive and is being treated with lithium carbonate (Eskalith) for this condition. He is also anxious and has been prescribed diazepam (Valium). These two medications can interact and cause hypothermia as a side effect. To assess for this potential side effect, what would you ask the patient?
A: “Have you been feeling dizzy?”
B: “Do you have a skin rash anywhere on your body?”
C: “Have you been going to the bathroom a lot?”
D: “Have you been feeling cold?”

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