Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which task can the registered nurse delegate to a healthcare assistant (nursing assistant) on a children's ward?
The nurse has taught the parents of a newborn about safe sleep. Which statement shows a need for further teaching?
Practice exercise (made-up values, not clinical guidance). A practice protocol calls for a heparin bolus of 70 units/kg for a patient who weighs 107 kg. The vial contains 5 000 units/mL. What volume V do you draw up? Round to one decimal place.
Practice exercise (made-up values, not clinical guidance). A bag contains dopamine 800 mg in 500 mL. The order is 6 mcg/kg/min for a patient who weighs 51 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). The record shows a patient's intake and output for one 8-hour shift. The patient weighs 83 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 16:30 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: A · Measuring and recording the vital signs of a stable child
Routine tasks with predictable outcomes for stable patients, such as recording vital signs, can be delegated. Assessment, care planning, teaching and evaluation remain the responsibility of the registered nurse, who also reviews the results.
Answer: D · "We will put a soft bumper and a pillow in the cot so she is comfortable."
Soft bedding, pillows and bumpers increase the risk of suffocation and sudden infant death. Back sleeping, a separate cot in the parents' room and a smoke-free environment all reduce the risk.
Answer: V = 1.5 mL
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 = 11.5 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.
Answer: U = 0.94 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 21:54.
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