Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Progesterone relaxes smooth muscle in pregnancy. Which common complaint does this help explain?
A woman with gestational diabetes on insulin asks about her baby after birth. Which statement by the nurse is accurate?
An ampoule of epinephrine (adrenaline) is labelled 1:1000 (1 mg/mL). The prescription is 0.3 mg IM for anaphylaxis. What volume V do you draw up?
A patient is 174 cm tall and weighs 51 kg. The prescription is 100 mg/m². Using the Mosteller formula BSA = √(height (cm) × weight (kg)/3600), find the dose D in mg.
An infusion is ordered at 100 mL/h, but no pump is available. It runs by gravity through a giving set of 15 gtt/mL. Find the drip rate R in drops per minute.
A bag contains 400 mg of a drug in 50 mL and runs at 20 mL/h. How many milligrams per hour D does the patient receive?
Answer: B · Constipation
Progesterone slows gut motility, which causes constipation and contributes to heartburn because the lower oesophageal sphincter relaxes. Gum bleeding and nasal stuffiness are mainly due to oestrogen and increased blood flow.
Answer: B · The baby's glucose will be checked for hypoglycaemia
Babies of mothers with diabetes may have high insulin levels after birth, causing hypoglycaemia. Early, frequent feeding, often skin-to-skin, and glucose monitoring per protocol are standard.
Answer: V = 0.3 mL
Solution strengths: a percentage strength is grams per 100 mL, so 1% = 1 g/100 mL = 10 mg/mL. A ratio strength 1:1000 means 1 g in 1000 mL = 1 mg/mL; 1:10 000 is 0.1 mg/mL. For a dilution the amount of drug stays the same: C₁·V₁ = C₂·V₂.
US labels now state mg/mL (1 mg/mL = 1:1000; 0.1 mg/mL = 1:10 000). Never give 1 mg/mL epinephrine IV push.
Answer: D = 157 mg
Body-surface-area dosing: many cytotoxic and some paediatric doses are prescribed per square metre of body surface area: dose (mg) = dose per m² × BSA (m²). The Mosteller formula estimates BSA = √(height (cm) × weight (kg)/3600).
Answer: R = 25 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: D = 160 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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