All questions
Question 1
1 L NS started at 0800 at 100 mL/hr. At 1200, 600 mL remains. New mL/hr to finish by 1600?
- 150 mL/hr (correct answer)
- 100 mL/hr
- 125 mL/hr
- 75 mL/hr
Explanation: From 0800 to 1200 is 4 hours, so 100 mL/hr infuses 400 mL, leaving 600 mL. From 1200 to 1600 is also 4 hours, so 600 divided by 4 = 150 mL/hr. The tempting 125 mL/hr would average the whole liter over 8 hours, but you only need a rate for the 600 mL remaining over 4 hours.
Question 2
180 mL remains; 15 gtt/mL set; 20 gtt/min. How long until empty?
- 3 hours
- 1.5 hours
- 2.25 hours (correct answer)
- 4.5 hours
Explanation: At 15 gtt/mL, 20 gtt/min delivers 20/15 = 1.33 mL/min. For 180 mL: 180 / 1.33 = 135 minutes, which is 2.25 hours. The tempting error is 3 hours, which happens if you treat 20 gtt/min as 1 mL/min and ignore the drop factor; but 20 drops at 15 drops/mL is more than 1 mL per minute.
Question 3
A patient is to receive 5 mcg/kg/min drug from 500 mg/250 mL. Weight 70 kg. Infusion rate (mL/hr)?
- 21 mL/hr
- 10.5 mL/hr (correct answer)
- 5.25 mL/hr
- 42 mL/hr
Explanation: Multiply 5 mcg/kg/min by 70 kg to get 350 mcg/min, then by 60 min/hr to get 21,000 mcg/hr, which is 21 mg/hr. The concentration is 500 mg/250 mL = 2 mg/mL. So divide 21 mg/hr by 2 mg/mL to get 10.5 mL/hr. The tempting error is 21 mL/hr, which uses the mg/hr dose without dividing by the 2 mg/mL concentration.
Question 4
250 mL antibiotic over 2 h with a 15 gtt/mL set. After 30 min, 75 mL remains. New gtt/min?
- 37.5 gtt/min
- 31.25 gtt/min
- 9.375 gtt/min
- 12.5 gtt/min (correct answer)
Explanation: After 30 minutes, 175 mL has infused, leaving 75 mL. The remaining time is 90 minutes (120 - 30). Run 75 mL over 90 min: 75 / 90 = 0.833 mL/min. Multiply by the drop factor: 0.833 x 15 = 12.5 gtt/min. The tempting error is using the original 31.25 gtt/min rate, which ignores the remaining volume and time adjustment.
Question 5
Heparin 25,000 units in 500 mL D5W infusing at 18 mL/hr. Dose (units/min)?
- 900 units/hr
- 50 units/mL
- 15 units/min (correct answer)
- 1.5 units/min
Explanation: First find the concentration: 25,000 units in 500 mL gives 50 units/mL. At 18 mL/hr, you deliver 900 units/hr. Divide by 60 minutes to get 15 units/min. The tempting wrong answer is 900 units/hr because it is the hourly dose, not the per-minute rate.
Question 6
A 180-lb patient requires a continuous intravenous infusion of a medication at a rate of 5 mcg/kg/min. The pharmacy supplies a solution of 50 mg of the medication in 250 mL of D5W. At what rate, in mL/hr, should the nurse set the infusion pump? (Round to the nearest whole number).
- 55 mL/hr
- 123 mL/hr (correct answer)
- 5 mL/hr
- 270 mL/hr
Explanation: This is a multi-step calculation. First, convert the patient's weight from pounds to kilograms: 180 lbs ÷ 2.2 lbs/kg = 81.82 kg. Second, calculate the required dose in mg/hr: (5 mcg/kg/min × 81.82 kg × 60 min/hr) ÷ 1000 mcg/mg = 24.55 mg/hr. Third, calculate the concentration of the solution: 50 mg ÷ 250 mL = 0.2 mg/mL. Finally, calculate the flow rate: 24.55 mg/hr ÷ 0.2 mg/mL = 122.75 mL/hr, which rounds to 123 mL/hr.
Question 7
A patient is receiving a nitroglycerin infusion at 12 mL/hr. The solution concentration is 50 mg of nitroglycerin in 250 mL of D5W. A new order is given to titrate the infusion upwards by 3 mcg/min due to persistent chest pain. What is the new flow rate in mL/hr?
- 12.9 mL/hr (correct answer)
- 15.0 mL/hr
- 13.5 mL/hr
- 12.3 mL/hr
Explanation: First, calculate the concentration of the solution: 50 mg / 250 mL = 0.2 mg/mL, which is 200 mcg/mL. Second, calculate the rate of increase in mL/hr: (3 mcg/min × 60 min/hr) ÷ 200 mcg/mL = 0.9 mL/hr. Finally, add this increase to the current rate: 12 mL/hr + 0.9 mL/hr = 12.9 mL/hr.
Question 8
A physician orders 1,000,000 units of Penicillin G in 100 mL of D5W to be infused over 45 minutes. The administration set has a drop factor of 15 gtts/mL. The nurse should set the manual IV drip rate to what value?
- 25 gtts/min
- 33 gtts/min (correct answer)
- 7 gtts/min
- 45 gtts/min
Explanation: The formula for drip rate is (Volume in mL ÷ Time in minutes) × Drop factor in gtts/mL. The dose in units is extraneous information. Calculation: (100 mL ÷ 45 min) × 15 gtts/mL = 33.33 gtts/min. This is rounded to 33 gtts/min.
Question 9
A patient with a pulmonary embolism is ordered to receive a continuous heparin infusion. The pharmacy prepares a solution of 25,000 units of heparin in 250 mL of D5W. The order is to infuse the heparin at 1,200 units/hr. The patient's weight is 80 kg. At what rate, in mL/hr, should the infusion pump be set?
- 10 mL/hr
- 12 mL/hr (correct answer)
- 15 mL/hr
- 25 mL/hr
Explanation: First, calculate the concentration of the heparin solution: 25,000 units ÷ 250 mL = 100 units/mL. The patient's weight is not needed for this calculation as the dose is not weight-based. Second, calculate the flow rate: (1,200 units/hr) ÷ (100 units/mL) = 12 mL/hr.
Question 10
A patient is prescribed a fluid bolus of 500 mL of 0.9% NaCl to be infused over 90 minutes. The nurse is using an infusion pump. What is the correct rate setting in mL/hr? (Round to the nearest whole number).
- 6 mL/hr
- 250 mL/hr
- 333 mL/hr (correct answer)
- 500 mL/hr
Explanation: To calculate the flow rate in mL/hr, the time must be in hours. Convert 90 minutes to hours: 90 min ÷ 60 min/hr = 1.5 hours. Then, divide the total volume by the time in hours: 500 mL ÷ 1.5 hr = 333.33 mL/hr. This rounds to 333 mL/hr.
Question 11
An IV pump is infusing a solution at 75 mL/hr. The IV bag contains 800 mg of a drug in 500 mL of fluid. The pump was incorrectly programmed and should have been set to 100 mL/hr. How much additional medication, in mg, will the patient have received after 4 hours at the correct rate compared to the incorrect rate?
- 50 mg
- 160 mg (correct answer)
- 240 mg
- 320 mg
Explanation: First, calculate the drug concentration: 800 mg / 500 mL = 1.6 mg/mL. Second, calculate the volume difference over 4 hours: (100 mL/hr - 75 mL/hr) × 4 hr = 25 mL/hr × 4 hr = 100 mL. This is the additional volume the patient would receive. Finally, calculate the amount of drug in that additional volume: 100 mL × 1.6 mg/mL = 160 mg.
Question 12
An IV is ordered to run at 30 gtts/min using a macrodrip tubing with a drop factor of 10 gtts/mL. The infusion pump is not available, and the nurse must use a dial-flow controller that is calibrated in mL/hr. What mL/hr setting is equivalent to the ordered drip rate?
- 3 mL/hr
- 30 mL/hr
- 180 mL/hr (correct answer)
- 300 mL/hr
Explanation: This requires converting gtts/min to mL/hr. First, find the rate in mL/min by dividing the drip rate by the drop factor: 30 gtts/min ÷ 10 gtts/mL = 3 mL/min. Second, convert the rate from mL/min to mL/hr by multiplying by 60: 3 mL/min × 60 min/hr = 180 mL/hr.
Question 13
A patient's infusion of 1 liter of D5W started at 22:00 and is running at 100 mL/hr. At 02:00, the patient shows signs of fluid overload, and the provider orders the rate decreased by 50%. When will the remaining fluid finish infusing?
- 08:00
- 10:00
- 12:00
- 14:00 (correct answer)
Explanation: First, calculate volume infused before the rate change. From 22:00 to 02:00 is 4 hours. Volume infused = 100 mL/hr × 4 hr = 400 mL. Second, calculate remaining volume: 1000 mL - 400 mL = 600 mL. Third, calculate the new rate: 100 mL/hr × 0.50 = 50 mL/hr. Fourth, calculate time to infuse the remaining volume: 600 mL ÷ 50 mL/hr = 12 hours. Finally, add this time to the time of the rate change: 02:00 + 12 hours = 14:00.
Question 14
A pediatric patient weighing 33 lbs is prescribed Cefazolin 30 mg/kg IV. The dose is to be infused over 30 minutes. The pharmacy provides the exact dose in a 50 mL syringe. At what rate, in mL/hr, should the nurse program the syringe pump?
- 25 mL/hr
- 50 mL/hr
- 75 mL/hr
- 100 mL/hr (correct answer)
Explanation: The calculation does not require the patient's weight or drug dosage, as the problem states the pharmacy has provided the exact dose in a 50 mL syringe. The task is to infuse this 50 mL volume over 30 minutes. To find the rate in mL/hr, use the formula: Rate = Volume ÷ Time. Time must be in hours: 30 minutes = 0.5 hours. Rate = 50 mL ÷ 0.5 hr = 100 mL/hr.
Question 15
A patient is to receive a loading dose of a medication 15 mg/kg over 1 hour, followed by a maintenance infusion of 2 mg/kg/hr. The patient weighs 165 lbs. The medication is supplied as 5000 mg in 250 mL. What is the rate in mL/hr for the maintenance infusion?
- 3 mL/hr
- 7.5 mL/hr (correct answer)
- 16.5 mL/hr
- 56.3 mL/hr
Explanation: The question asks for the maintenance infusion rate. First, convert weight: 165 lbs ÷ 2.2 lbs/kg = 75 kg. Second, calculate the maintenance dose in mg/hr: 2 mg/kg/hr × 75 kg = 150 mg/hr. Third, calculate the drug concentration: 5000 mg ÷ 250 mL = 20 mg/mL. Finally, calculate the infusion rate: 150 mg/hr ÷ 20 mg/mL = 7.5 mL/hr. The loading dose information is a distractor.
Question 16
An order is given to infuse 75 mL of an antibiotic solution over 1 hour using a microdrip (60 gtts/mL) administration set. What is the correct manual drip rate in gtts/min?
- 13 gtts/min
- 60 gtts/min
- 75 gtts/min (correct answer)
- 1 gtt/min
Explanation: The formula for drip rate is (Volume in mL ÷ Time in minutes) × Drop factor. The infusion is 75 mL over 60 minutes. The drop factor is 60 gtts/mL. The calculation is (75 mL / 60 min) × 60 gtts/mL. The '60' in the numerator and denominator cancel out, leaving a drip rate of 75 gtts/min. A useful shortcut is that for a microdrip set, the rate in mL/hr is always equal to the rate in gtts/min.
Question 17
A 1-liter bag of 0.9% NaCl is started at 08:00 at a rate of 125 mL/hr. At 12:00, the provider orders the rate to be decreased to 75 mL/hr. At what military time will the infusion be complete?
- 16:00
- 18:40 (correct answer)
- 19:20
- 21:20
Explanation: First, calculate the volume infused from 08:00 to 12:00 (4 hours): 125 mL/hr × 4 hr = 500 mL. Second, calculate the remaining volume: 1000 mL - 500 mL = 500 mL. Third, calculate the time required to infuse the remaining volume at the new rate: 500 mL ÷ 75 mL/hr = 6.67 hours. Convert the decimal to minutes: 0.67 hr × 60 min/hr ≈ 40 minutes. The infusion will take 6 hours and 40 minutes from 12:00. Finally, calculate the completion time: 12:00 + 6 hours and 40 minutes = 18:40.
Question 18
A 70-kg patient is receiving norepinephrine at 10 mL/hr. The concentration is 8 mg in 250 mL D5W. After 48 hours of diuresis, the patient's new weight is 67 kg. The order is to continue the same dose in mcg/kg/min based on the new weight. What is the new pump rate in mL/hr? (Round to one decimal place).
- 9.6 mL/hr (correct answer)
- 10.0 mL/hr
- 9.1 mL/hr
- 10.4 mL/hr
Explanation: This requires calculating the current dose and applying it to the new weight. First, find concentration: 8 mg / 250 mL = 0.032 mg/mL = 32 mcg/mL. Second, find the dose in mcg/kg/min: (10 mL/hr × 32 mcg/mL) ÷ 70 kg ÷ 60 min/hr = 0.076 mcg/kg/min. Third, calculate the new total dose rate in mcg/hr using the new weight: 0.076 mcg/kg/min × 67 kg × 60 min/hr = 305.5 mcg/hr. Finally, calculate the new pump rate: 305.5 mcg/hr ÷ 32 mcg/mL = 9.55 mL/hr, which rounds to 9.6 mL/hr. A shortcut is to multiply the old rate by the ratio of the weights: 10 mL/hr × (67 kg / 70 kg) = 9.57 mL/hr.
Question 19
An order is written for 1.5 g of an antibiotic IVPB over 90 minutes. The pharmacy reconstitutes a 2 g vial, resulting in a concentration of 200 mg/mL. The pharmacy then adds the required dose to a 50 mL minibag of 0.9% NaCl. At what rate, in mL/hr, should the nurse set the infusion pump? (Round to the nearest whole number).
- 33 mL/hr
- 40 mL/hr
- 38 mL/hr (correct answer)
- 58 mL/hr
Explanation: First, calculate the volume of the drug to be added: 1.5 g = 1500 mg. Volume = 1500 mg ÷ 200 mg/mL = 7.5 mL. Second, determine the total volume to be infused by adding the drug volume to the minibag volume: 50 mL + 7.5 mL = 57.5 mL. Finally, calculate the rate in mL/hr: Time = 90 minutes = 1.5 hours. Rate = 57.5 mL ÷ 1.5 hr = 38.33 mL/hr, which rounds to 38 mL/hr.
Question 20
A physician orders 1,000,000 units of Penicillin G in 100 mL of D5W to be infused over 45 minutes. The administration set has a drop factor of 15 gtts/mL. The nurse should set the manual IV drip rate to what value?
- 25 gtts/min
- 33 gtts/min (correct answer)
- 7 gtts/min
- 45 gtts/min
Explanation: The formula for drip rate is (Volume in mL ÷ Time in minutes) × Drop factor in gtts/mL. The dose in units is extraneous information. Calculation: (100 mL ÷ 45 min) × 15 gtts/mL = 33.33 gtts/min. This is rounded to 33 gtts/min.