Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which reflex causes the newborn's toes to fan out when the sole is stroked from heel to toe?
A woman at 34 weeks was in a car crash. She has abdominal pain, a rigid tender uterus and only slight vaginal bleeding. Late decelerations appear. Which statement is most accurate?
A vial contains 500 mg of powder. The label says: add 9.6 mL of water for injection to give a total volume of 10 mL. The prescription is 50 mg. What volume V of the reconstituted solution do you give?
An infusion contains 20000 units of a drug in 500 mL. The prescription is 1250 units per hour. At what rate R do you set the pump, in mL/h?
Infuse 250 mL over 6 hours with a giving set of 60 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.
A bag contains 500 mg of a drug in 50 mL and runs at 25 mL/h. How many milligrams per hour D does the patient receive?
Answer: A · Babinski reflex
The Babinski reflex, fanning of the toes with dorsiflexion of the big toe, is normal in infants until about 1 year. Pressing the sole near the toes gives the plantar grasp instead.
Answer: D · She may have a concealed abruption with major blood loss despite little visible bleeding
Placental abruption can bleed into the space behind the placenta. Pain, rigidity and fetal compromise with little visible blood suggest a concealed abruption, which is an emergency for mother and fetus.
Answer: V = 1 mL
Dose calculation: the amount to give equals what is prescribed divided by what you have, times the quantity it comes in: amount = (desired dose/stock strength) × stock volume. Always keep the units the same (convert g to mg, mg to mcg first) and check that the answer is sensible.
Answer: R = 31.25 mL/h
Dose calculation: the amount to give equals what is prescribed divided by what you have, times the quantity it comes in: amount = (desired dose/stock strength) × stock volume. Always keep the units the same (convert g to mg, mg to mcg first) and check that the answer is sensible.
Answer: R = 42 gtt/min
Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.
At the bedside you round to the nearest whole drop: 42 gtt/min.
Answer: D = 250 mg/h
Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.
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