Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which finding suggests developmental dysplasia of the hip in an infant?
A parent asks whether giving paracetamol (acetaminophen) at the first sign of fever will prevent another febrile seizure. What is the best answer?
Practice exercise (made-up values, not clinical guidance). An infusion contains 100 units of regular insulin in 100 mL. The order is 0.05 units/kg/h for a patient who weighs 82 kg. Find the pump rate R in mL/h. Round to one decimal place.
Practice exercise (made-up values, not clinical guidance). A patient who weighs 97 kg has an order for norepinephrine at 16 mcg/min. The bag contains 8 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 12-hour shift. The IV infusion ran at the rate shown for the whole shift. Find the fluid balance B = intake − output in mL (a negative answer means a net loss).
Practice exercise (made-up values, not clinical guidance). A 1000 mL bag was started at 08:00 and runs by pump at 50 mL/h. How many mL V are left in the bag at 12:30?
Answer: C · Asymmetric skin folds of the thighs or buttocks and limited hip abduction
Signs include asymmetric skin folds, limited abduction, an apparently shorter leg and positive Ortolani or Barlow tests. Treatment in infancy often uses a Pavlik harness.
Answer: D · No; it may ease discomfort but does not prevent febrile seizures
Antipyretics relieve discomfort but have not been shown to prevent febrile seizure recurrence. Parents are taught seizure first aid, when to call for help and that most febrile seizures are harmless.
Answer: R = 4.1 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: R = 30 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: B = −100 mL
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.
Negative: the patient lost more fluid than went in.
Answer: V = 775 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.
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