Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Where universal screening for group B streptococcus is used, when is the vaginal–rectal swab usually taken?
A labouring woman refuses a recommended caesarean for fetal distress after a full explanation. She has decision-making capacity. What should the nurse do?
A patient weighs 25 kg and is prescribed 10 mg/kg as a single dose. Find the dose D in mg.
An infusion contains 50000 units of a drug in 500 mL. The prescription is 2000 units per hour. At what rate R do you set the pump, in mL/h?
Infuse 1500 mL over 5 hours with a giving set of 15 gtt/mL. Find the drip rate R in drops per minute.
A drip runs at 28 gtt/min through a set of 20 gtt/mL. There are 200 mL left in the bag. How many hours t until it is empty? Round to one decimal place.
Answer: D · At about 36 to 37 weeks
Colonisation can come and go, so the swab is taken late in pregnancy, close to birth. A positive result leads to intrapartum antibiotics to protect the newborn. Some countries use a risk-based approach instead.
Answer: B · Respect her decision, document it and inform the team
A woman with capacity has the right to refuse treatment, even if this may harm the fetus. The nurse ensures she has understood, documents the discussion, continues care and informs the team.
Answer: D = 250 mg
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 = 20 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 = 75 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.
Answer: t = 2.4 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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