Medication Dosage Calculations

Help Questions

NCLEX-RN › Medication Dosage Calculations

Questions 1 - 10
1

A 7-year-old child (weight 25 kg) has bronchitis and is prescribed prednisolone 1 mg/kg/day by mouth divided twice daily. The oral solution available is 15 mg/5 mL. How many mL should the nurse administer per dose?

2.1 mL per dose

1 mL per dose

4.2 mL per dose

8.3 mL per dose

Explanation

This question tests medication dosage calculation and clinical judgment in pediatric corticosteroid use. Accurate dosage calculation is essential for client safety to reduce inflammation while minimizing side effects like growth suppression. The correct answer, 4.2 mL per dose, is accurate because the daily dose is 25 mg (1 mg/kg/day × 25 kg), divided into 12.5 mg per dose, and with 15 mg/5 mL (3 mg/mL), it requires 12.5 / 3 ≈ 4.17 mL (rounded to 4.2 mL). The distractors represent common errors: 2.1 mL halves the dose, 8.3 mL doubles it, and 1 mL underestimates severely. Nurses must taper doses appropriately. Clinical judgment involves monitoring for infection risks. A transferable strategy for medication calculations is to double-check unit conversions and weight-based dosing by calculating per-dose amounts.

2

A 2-year-old child (weight 12 kg) has sinusitis and is prescribed amoxicillin-clavulanate 45 mg/kg/day (amoxicillin component) divided every 12 hours. The suspension available is 400 mg/5 mL (amoxicillin component). How many mL should the nurse administer per dose?

3.4 mL per dose

5 mL per dose

1.7 mL per dose

6.8 mL per dose

Explanation

This question tests medication dosage calculation and clinical judgment in pediatric antibiotic therapy. Accurate dosage calculation is crucial for client safety to treat infection effectively in toddlers. The correct answer, 3.4 mL per dose, is accurate because the daily dose is 540 mg (45 mg/kg/day × 12 kg), divided into 270 mg per dose, and with 400 mg/5 mL (80 mg/mL), it requires 270 / 80 ≈ 3.375 mL (rounded to 3.4 mL). The distractors represent common errors: 1.7 mL halves the dose, 6.8 mL doubles it, and 5 mL ignores weight calculation. Nurses must use calibrated devices for suspensions. Clinical judgment involves monitoring for diarrhea and completion of course. A transferable strategy for medication calculations is to double-check unit conversions and weight-based dosing by deriving mg/mL first.

3

A 79-year-old client (weight 55 kg) with renal impairment has a creatinine clearance of 20 mL/min. The provider prescribes cefepime 1 g IV every 24 hours (renal-adjusted). The vial label reads 1 g per 10 mL after reconstitution. How many mL should the nurse prepare for one dose?

1 mL

10 mL

5 mL

20 mL

Explanation

This question tests medication dosage calculation and clinical judgment in renal-adjusted antibiotic dosing. Accurate dosage calculation is crucial for client safety to treat infection effectively while preventing accumulation in impaired kidneys. The correct answer, 10 mL, is accurate because the 1 g dose matches the vial's 1 g per 10 mL after reconstitution. The distractors represent common errors: 1 mL underdoses by a factor of 10, 5 mL halves the volume, and 20 mL doubles it unnecessarily. Nurses must verify reconstitution instructions and infusion times. Clinical judgment involves monitoring renal function and signs of infection resolution. A transferable strategy for medication calculations is to double-check unit conversions and weight-based dosing by confirming vial labels precisely.

4

A 52-year-old client (weight 68 kg) in the ICU with diabetic ketoacidosis is prescribed regular insulin at 6 units/hr by IV infusion. The bag is prepared with 100 units of regular insulin in 100 mL of 0.9% sodium chloride. What is the appropriate IV rate in mL/hr?

12 mL/hr

3 mL/hr

6 mL/hr

0.6 mL/hr

Explanation

This question tests medication dosage calculation and clinical judgment in insulin infusion for metabolic emergencies. Accurate dosage calculation is crucial for client safety to correct hyperglycemia without causing hypoglycemia. The correct answer, 6 mL/hr, is accurate because the 6 units/hr dose with 1 unit/mL (100 units/100 mL) requires 6 mL/hr. The distractors represent common errors: 3 mL/hr halves the rate, 12 mL/hr doubles it, and 0.6 mL/hr divides by 10 mistakenly. Nurses must monitor blood glucose frequently during infusion. Clinical judgment includes adjusting rates based on protocols and assessing for complications. A transferable strategy for medication calculations is to double-check unit conversions and weight-based dosing by verifying bag concentrations.

5

A 6-year-old child (weight 20 kg) is diagnosed with acute otitis media and is prescribed amoxicillin oral suspension 40 mg/kg/day divided every 12 hours. The available concentration is 400 mg/5 mL. How many mL should the nurse administer for each dose?

10 mL per dose

5 mL per dose

20 mL per dose

2.5 mL per dose

Explanation

This question tests medication dosage calculation and clinical judgment in pediatric antibiotic administration. Accurate dosage calculation is crucial for client safety to ensure therapeutic efficacy while minimizing the risk of toxicity or underdosing in children. The correct answer, 5 mL per dose, is accurate because the child's daily dose is 800 mg (40 mg/kg/day × 20 kg), divided into two doses of 400 mg each, and with a concentration of 400 mg/5 mL, each dose requires 5 mL. The distractors represent common errors: 2.5 mL assumes a once-daily dose without division, 10 mL doubles the concentration incorrectly, and 20 mL miscalculates the daily dose as per dose. Nurses must always verify the prescribed frequency and perform weight-based calculations step-by-step. Clinical judgment involves confirming the medication's indication and monitoring for adverse effects like allergic reactions. A transferable strategy for medication calculations is to double-check unit conversions and weight-based dosing by using the formula: dose required divided by concentration available.

6

A 3-year-old child (weight 15 kg) has community-acquired pneumonia and is prescribed azithromycin 10 mg/kg by mouth on day 1 (single dose). The oral suspension available is 200 mg/5 mL. How many mL should the nurse administer for the day 1 dose?

15 mL

7.5 mL

1.9 mL

3.75 mL

Explanation

This question tests medication dosage calculation and clinical judgment in pediatric antibiotic therapy. Accurate dosage calculation is essential for client safety to ensure infection resolution while avoiding toxicity in young children. The correct answer, 3.75 mL, is accurate because the day 1 dose is 150 mg (10 mg/kg × 15 kg), and with 200 mg/5 mL, it requires (150/200) × 5 = 3.75 mL. The distractors represent common errors: 1.9 mL miscalculates half the dose, 7.5 mL assumes a full daily divided dose, and 15 mL doubles the required amount. Nurses must confirm the dosing regimen for azithromycin's loading phase. Clinical judgment involves assessing for gastrointestinal side effects and treatment adherence. A transferable strategy for medication calculations is to double-check unit conversions and weight-based dosing by verifying the concentration per mL.

7

A 77-year-old client (weight 62 kg) with chronic kidney disease has a creatinine clearance of 18 mL/min. The provider prescribes levofloxacin 250 mg by mouth every 24 hours (renal-adjusted). Available tablets are 500 mg each and are scored. What dose should the nurse administer per dose?

Half of a 500 mg tablet

One quarter of a 500 mg tablet

One and a half 500 mg tablets

One 500 mg tablet

Explanation

This question tests medication dosage calculation and clinical judgment in renal-adjusted antibiotic dosing. Accurate dosage calculation is vital for client safety to combat infection without exacerbating kidney issues. The correct answer, half of a 500 mg tablet, is accurate because the 250 mg dose requires half of the scored 500 mg tablet. The distractors represent common errors: one tablet provides 500 mg, one and a half gives 750 mg, and one quarter underdoses at 125 mg. Nurses must educate on tablet splitting accuracy. Clinical judgment involves checking for drug interactions and monitoring efficacy. A transferable strategy for medication calculations is to double-check unit conversions and weight-based dosing by verifying tablet strengths.

8

A 59-year-old client (weight 88 kg) in the ICU with severe hypertension is prescribed nicardipine at 7.5 mg/hr by IV infusion. The IV bag contains nicardipine 25 mg in 250 mL of normal saline. What is the appropriate IV rate in mL/hr?

50 mL/hr

7.5 mL/hr

75 mL/hr

25 mL/hr

Explanation

This question tests medication dosage calculation and clinical judgment in antihypertensive infusion. Accurate dosage calculation is crucial for client safety to lower blood pressure without hypotension. The correct answer, 75 mL/hr, is accurate because the 7.5 mg/hr dose divided by 0.1 mg/mL (25 mg/250 mL) equals 75 mL/hr. The distractors represent common errors: 25 mL/hr thirds the rate, 50 mL/hr halves it, and 7.5 mL/hr ignores concentration. Nurses must titrate based on BP readings. Clinical judgment includes checking for infusion site reactions. A transferable strategy for medication calculations is to double-check unit conversions and weight-based dosing by calculating mg/mL first.

9

A 3-year-old child (weight 15 kg) with a respiratory infection is prescribed azithromycin 10 mg/kg by mouth once daily. The available oral suspension is 200 mg per 5 mL. How many mL should the nurse administer for each dose?

1.9 mL

3.75 mL

2.5 mL

7.5 mL

Explanation

This question tests medication dosage calculation and clinical judgment for pediatric oral suspensions. Accurate dosage calculation is vital for client safety in pediatric populations where weight-based dosing ensures therapeutic effectiveness while minimizing adverse effects. The correct answer is C (3.75 mL) because the calculation follows: 15 kg × 10 mg/kg = 150 mg needed, and since the concentration is 200 mg/5 mL (40 mg/mL), the volume is 150 mg ÷ 40 mg/mL = 3.75 mL. Option A (1.9 mL) represents approximately half the correct dose, option B (2.5 mL) represents a calculation error, and option D (7.5 mL) doubles the correct amount. When calculating pediatric liquid medications, always verify the concentration per mL and ensure the final volume is appropriate for the child's age. A transferable strategy is to use proportion equations: if 200 mg is in 5 mL, then 150 mg is in X mL, solving for X = 3.75 mL.

10

A 6-year-old child (weight 20 kg) is diagnosed with a respiratory infection and is prescribed amoxicillin oral suspension 40 mg/kg/day by mouth divided every 12 hours. The available concentration is 400 mg per 5 mL. How many mL should the nurse administer for each dose?

10 mL

2.5 mL

5 mL

20 mL

Explanation

This question tests medication dosage calculation and clinical judgment for pediatric weight-based dosing. Accurate dosage calculation is critical for client safety, especially in pediatric populations where medication errors can have severe consequences. The correct answer is B (5 mL) because the calculation follows: 20 kg × 40 mg/kg/day = 800 mg/day ÷ 2 doses = 400 mg per dose, and since the concentration is 400 mg/5 mL, each dose requires 5 mL. Option A (2.5 mL) represents calculating for only one dose per day instead of dividing by two, option C (10 mL) doubles the correct amount, and option D (20 mL) represents the total daily volume rather than per dose. When calculating pediatric doses, always verify the total daily dose first, then divide by the number of doses, and finally convert to the appropriate volume. A transferable strategy is to write out each step of the calculation and double-check that units cancel appropriately, ensuring the final answer matches the required administration unit (mL).

Page 1 of 3