Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A child is in skin traction for a leg fracture. Which nursing action is correct?
A 7-year-old has a fever, joint pain moving from joint to joint and a new heart murmur, three weeks after a sore throat. What should the nurse suspect?
Practice exercise (made-up values, not clinical guidance). An infusion of 100 units of regular insulin in 100 mL runs at 8 mL/h. How many units per hour D does the patient receive?
Practice exercise (made-up values, not clinical guidance). A patient who weighs 71 kg has an order for nitroglycerin at 10 mcg/min. The bag contains 25 mg in 250 mL. Find the pump rate R in mL/h. Round to one decimal place.
Practice exercise (made-up values, not clinical guidance). The record shows a patient's intake and output for one 8-hour shift. The patient weighs 95 kg. Find the average urine output U in mL/kg/h. Round to two decimal places.
Practice exercise (made-up values, not clinical guidance). A 1000 mL infusion starts at 13:00 at 150 mL/h. After 4 hours the rate is changed to 80 mL/h and is not changed again. How many hours t after the start will the bag be empty? Round to one decimal place.
Answer: C · Keep the weights hanging freely, clear of the bed and floor
The weights must hang freely to keep a steady pull, and the ropes must run smoothly over the pulleys. The nurse checks the skin, circulation and sensation regularly without removing the traction unless allowed.
Answer: B · Acute rheumatic fever
Acute rheumatic fever follows group A streptococcal pharyngitis and causes migratory polyarthritis, carditis, rashes and chorea. Carditis can lead to rheumatic heart disease. Treating streptococcal sore throats prevents it.
Answer: D = 8 units/h
Heparin and insulin infusions: concentration = units in the bag/bag volume (units/mL). Pump rate (mL/h) = units per hour/concentration, and units per hour = mL/h × concentration. For a weight-based order, units/h = units/kg/h × weight first. A bolus volume = units needed/vial strength. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
Answer: R = 6 mL/h
Titrated drips: first find the concentration in mcg/mL (mg × 1000/mL). For a weight-based order, mcg/min = mcg/kg/min × weight. Then mL/h = mcg/min × 60/concentration. Working backwards, mcg/kg/min = mL/h × concentration/(60 × weight). The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
The order is per minute for the whole patient, so the weight is not needed.
Answer: U = 2.04 mL/kg/h
Intake and output: intake counts everything that goes in (oral fluids, IV infusions, IV medications and flushes, tube feeds); ice chips count as half their volume. Output counts urine, drains, vomit and other losses. Balance = total intake − total output; a negative balance is a net loss. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
Answer: t = 9 h
Infusion time: time (h) = volume to infuse (mL)/rate (mL/h); use the volume still left in the bag, not the bag size. Volume infused = rate × time. Convert decimal hours to hours and minutes with the fraction × 60 (0.5 h = 30 min, not 50 min). The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
That is about 9 h 00 min, so the bag runs out at about 22:00.
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