Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A child has just spilled hot tea on his arm. What is the correct first aid?
A 6-year-old is prescribed codeine for pain after a tonsillectomy. What should the nurse do?
Practice exercise (made-up values, not clinical guidance). An infusion contains 50 units of regular insulin in 250 mL. The order is 0.05 units/kg/h for a patient who weighs 50 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 85 kg has an order for norepinephrine at 10 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 8-hour shift. The patient weighs 45 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 infusion starts at 09:30 at 80 mL/h. After 2 hours the rate is changed to 100 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 · Cool the burn under cool running water for about 20 minutes
Cool running water for about 20 minutes, within the first hours, limits burn depth and pain. Ice can cause further tissue damage and hypothermia, butter or toothpaste trap heat and add infection risk, and blisters should be left intact.
Answer: A · Question the order with the prescriber before giving it
Codeine is contraindicated in children under 12 and after tonsillectomy or adenoidectomy in children under 18, because of fatal respiratory depression in ultra-rapid metabolisers. The nurse should question the order.
Answer: R = 12.5 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 = 18.8 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 = 2.71 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 = 5.4 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 5 h 24 min, so the bag runs out at about 14:54.
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