Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
On abdominal palpation at 39 weeks, only 2/5 of the fetal head can be felt above the pelvic brim. How is this interpreted?
A woman with pre-eclampsia has a tonic–clonic seizure. What should the nurse do first?
A patient weighs 45 kg. The prescribed dose is 2 mg/kg per day, given in 2 equal doses. How many milligrams D are given per dose?
A patient weighs 17.6 lb. The prescription is 1 mg/kg as a single dose, and the stock contains 125 mg in 5 mL. Using 1 kg = 2.2 lb, what volume V do you give?
500 mL was ordered over 6 hours. After 2 hours you find that 350 mL is still in the bag, and the order must still finish on time. To what rate R in mL/h must the pump be reset?
A drip runs at 20 gtt/min through a set of 15 gtt/mL. There are 400 mL left in the bag. How many hours t until it is empty?
Answer: B · The head is engaged in the pelvis
Descent can be described in fifths of the head palpable above the brim. When 2/5 or less can be felt, the widest part of the head has passed the inlet, so it is engaged; 5/5 palpable means the head is free. Many US units describe descent mainly by station on vaginal examination instead.
Answer: B · Call for help, stay with her, protect her from injury and turn her onto her side once possible
During an eclamptic seizure, call for help, protect from injury, and after the jerking stops turn her on her side to keep the airway clear and give oxygen. Magnesium sulfate is given as ordered, and the fetus is assessed when the mother is stable.
Answer: D = 45 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: V = 0.32 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 = 87.5 mL/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.
Many hospitals allow such an adjustment up to 25% without a new order; check local policy.
Answer: t = 5 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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