Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
In early pregnancy, how does the serum hCG level normally change?
A newborn's heart rate is 80/min after 30 seconds of positive-pressure ventilation and the chest is not moving. What should the nurse do next?
A patient weighs 25 kg. The prescribed dose is 5 mg/kg per day, given in 2 equal doses. How many milligrams D are given per dose?
A patient weighs 101.2 lb. The prescription is 2 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? Round to one decimal place.
Infuse 1500 mL over 12 hours with a giving set of 10 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.
An infusion of 400 mg in 500 mL runs at 5 mL/h. How many micrograms per minute D does the patient receive?
Answer: A · It roughly doubles every 2 to 3 days in the first weeks
In a normal early intrauterine pregnancy hCG roughly doubles every 48 to 72 hours, then peaks at around 8 to 10 weeks. A slow rise can suggest an ectopic pregnancy or a failing pregnancy.
Answer: D · Correct the ventilation, starting with mask and airway
If the chest does not rise, ventilation is ineffective. Corrective steps include adjusting the mask seal, repositioning the head, suctioning, opening the mouth and increasing pressure. Compressions start only if the heart rate stays under 60/min with effective ventilation.
Answer: D = 62.5 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 = 3.7 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 = 21 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: 21 gtt/min.
Answer: D = 66.67 mcg/min
Dose-based infusions: concentration = amount of drug in the bag/bag volume. Pump rate (mL/h) = dose per hour/concentration, and dose per hour = mL/h × concentration. Convert per-minute doses to per-hour (× 60) and keep the mass units the same (1 g = 1000 mg, 1 mg = 1000 mcg).
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