Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
In a large ventricular septal defect, in which direction does blood mainly flow through the defect?
The nurse has taught the family of a 7-year-old with coeliac disease. Which statement shows a need for further teaching?
Practice exercise (made-up values, not clinical guidance). A bag contains 25 000 units of heparin in 500 mL. The order is 20 units/kg/h for a patient who weighs 53 kg. At what rate R do you set the pump, in mL/h? Round to one decimal place.
Practice exercise (made-up values, not clinical guidance). A dopamine infusion of 400 mg in 250 mL runs at 5 mL/h. The patient weighs 108 kg. What dose D in mcg/kg/min is the patient receiving? Round to one decimal place.
Practice exercise (made-up values, not clinical guidance). The record shows a patient's intake and output for one 12-hour shift. The patient weighs 61 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 500 mL bag was started at 06:30 and runs by pump at 125 mL/h. How many mL V are left in the bag at 09:30?
Answer: B · From left to right, increasing blood flow to the lungs
Left ventricular pressure is higher, so blood flows from left to right, overloading the lungs and right heart. This causes increased pulmonary blood flow and can lead to heart failure in infancy.
Answer: C · "He can eat normal bread at weekends if he's strict in the week."
Even small amounts of gluten damage the gut lining in coeliac disease, so the diet must be strict and lifelong. Avoiding cross-contamination, reading labels and using naturally gluten-free foods are correct.
Answer: R = 21.2 mL/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: D = 1.2 mcg/kg/min
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.
Answer: U = 2.6 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: V = 125 mL
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.
ExamProblems · examproblems.com/courses/pediatric-nursing