Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which newborn is at greatest risk of hypoglycaemia in the first hours after birth?
A woman in her first antenatal visit discloses that her partner hits her. What is the most appropriate nursing action?
A child weighing 11 kg is prescribed 20 mg/kg of a drug. The stock solution contains 50 mg/mL. Draw up the dose: what volume V do you give?
A patient weighs 33 lb. The prescription is 1 mg/kg as a single dose, and the stock contains 50 mg in 1 mL. Using 1 kg = 2.2 lb, what volume V do you give?
Infuse 1000 mL over 8 hours with a giving set of 10 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.
1000 mL was ordered over 6 hours. After 3 hours you find that 600 mL is still in the bag, and the order must still finish on time. By what percentage Δ must the original pump rate be increased?
Answer: D · A large baby of a mother with diabetes
High maternal glucose crosses the placenta and the fetus makes extra insulin. After the cord is cut, the glucose supply stops but the insulin stays high. Preterm, small and cold babies are also at risk.
Answer: B · Talk with her alone, assess her safety and offer support
Intimate partner violence often begins or worsens in pregnancy. The nurse should talk to her alone, assess safety, document carefully and offer support and local resources, without confronting the partner.
Answer: V = 4.4 mL
Drawing up a dose: volume = (prescribed dose/stock strength) × stock volume. Convert to the same units first, then check that the volume fits the syringe and lands on one of its graduations.
On this 10 mL syringe every small line is 0.2 mL.
Answer: V = 0.3 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: Δ = 20 %
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.
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