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A nursing instructor is describing how to perform dosage calculations using dimensional analysis. Which of the following would the instructor emphasize to ensure accuracy?
- A. A formula that is specific to the drug being administered is needed.
- B. Decimals rather than fractions are used to determine amounts.
- C. Proportions are needed but labels related to units are not important.
- D. The focus is on the unit of measure set up in a specific order.
Correct Answer: D
Rationale: Dimensional analysis is a method used to perform calculations where the focus is on the units of measure, thereby eliminating the need to memorize equations. Because the units are set up in a specific order, it eliminates the need to be concerned about setting up proportions correctly. When using DA to calculate dosage problems, dosages are written as common fractions.
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A client has been taking warfarin (Coumadin) 5 \mathrm{mg} daily. After a check of the client's INR, the physician wants to increase the client's dose to 7.5 \mathrm{mg} on Wednesdays and continue 5 \mathrm{mg} all the other days of the week. The client has warfarin 5 -mg tablets on hand. The nurse would instruct the client to take tablets on Wednesdays.
- A. 1 tablet
- B. 1.5 tablets
- C. 2 tablets
- D. 2.5 tablets
Correct Answer: B
Rationale: 7.5 mg / 5 mg = 1.5
The physician writes an order for a client to receive 1 mg of vitamin B12 once every month. Vitamin B12 comes in a 1000 mcg/mL vial. The nurse would administer ?... to the client each month.
- A. 0.5 mL
- B. 1.0 mL
- C. 1.5 mL
- D. 2.0 mL
Correct Answer: B
Rationale: First, the nurse needs to convert the milligrams to micrograms. Therefore, 1 mg = 1000 mcg. Since there is 1000 mcg/mL, the nurse would give 1 mL.
Which of the following drug doses is written correctly? Select all that apply.
- A. Synthroid 0.175 \mathrm{mg}
- B. Synthroid 175 \mathrm{mg}
- C. Synthroid 175 \mathrm{mcg}
- D. Synthroid 175.0 \mathrm{mcg}
- E. Synthroid 1750 \mathrm{mg}
Correct Answer: A,C
Rationale: When there is no number to the left of the decimal, a zero is written; therefore, Synthroid 0.175 mg and 175 mcg are correct.
A nursing instructor is describing the importance of preventing errors in medication administration and doses. Which of the following would the instructor emphasize as the best method for detecting errors?
- A. Checking calculations three times
- B. Having each person involved in the process check the dosage
- C. Reading drug labels very carefully
- D. Checking the dosage in a reputable drug reference
Correct Answer: B
Rationale: The best method of error detection is the manual redundancy system. This is a system in which each person in the process of medication prescription and delivery checks the drug dosage for accuracy. Nurses use this system when they perform the 5 rights and 3 checks to catch a potential error in drug administration. Double checking calculations and reading labels carefully are important, but they are not the best method for detecting errors. Checking the dosage in a reputable drug reference would help to ensure that the dosage is within the safe dosage range, but this would do nothing to ensure that the dosage is accurate.
A client is prescribed 500 mg of ampicillin IM. The drug is supplied in a multidose vial that requires reconstitution with 2 mL sterile water for injection. The resulting concentration contains 250 mg/mL. How much of the drug would the nurse administer?
- A. 0.5 mL
- B. 1.0 mL
- C. 1.5 mL
- D. 2.0 mL
Correct Answer: D
Rationale: The drug is supplied as 250 mg/mL after reconstitution. To calculate the amount needed, set up the equation: 500 mg / 250 mg ? 1 mL = 2.0 mL.