Credit by Examination for MATH 1020
In order to qualify to receive credit by examination for MATH 1020, students must follow the steps outlined below:

You must be an LPN.

You must have some prior training in IV flow rate applications.

You must obtain an Application for Credit by Examination form at the Business Office at the Dyersburg campus or at the front desk in the Jimmy Naifeh Building at the Jimmy Naifeh Center at Tipton County.

Complete the top portion of the Application for Credit by Examination.

At the Business Office or the front desk in the Jimmy Naifeh Building at the Jimmy Naifeh Center at Tipton County, pay $135 to take the test. This money only covers the fee for the test. If you do not pass the test, none of the fee will be applied to the fee for taking the course.

The form will be sent to the Assistant Vice President for Learning in campus mail

You must take the test at one of the following scheduled times:
Jimmy Naifeh Center: August 16, 2012
1:30 p.m. – 3:30 p.m.
Jimmy Naifeh Building, Rm. 111
There will not be a proficiency exam given at Dyersburg.

Arrive at the testing site 15 minutes prior to the beginning of the test. Only 2 hours will be allowed for the testing session.

You must correctly answer 80% of the questions on the test to receive credit by examination.

The instructors of the course will grade the tests and will inform the Assistant Vice President for Learning of the results. At that time, the paperwork to grant or deny credit for MATH 1020 will be processed.
MATH for NURSES STUDY SHEETS
BASIC ARITHMETIC SKILLS (You should do these without a calculator.)

Convert: a) 3/7 to a decimal b) 3/7 to a percent 1a. 1b.

a. Convert 0.015 to a fraction (Reduce to lowest terms) 2a.
b. Convert 0.015 to a percent. 2b.

Perform each of the following calculations:

4/15 + 2/5 – 1/3 3a.

4/5 x 25/28 x 7/12 3b.

2 3/5 ÷ 26/55 3c.

5.23 x 0.04 3d.

4.972 + 28.6 + 1.88 + 12.725 3e.

0.357 ÷ 0.52 (Round to the nearest 100th) 3f.

Convert each of the following percents to a fraction or a decimal:
a. 36% 4a.
b. 10 ½ % 4b.
c. 0.3% 4c.

Find the requested quantity in each of the following:

Find 65% of 40. 5a.

What percent of 25 is 12? 5b.

36 is 12 ½ % of what number? 5c.

Solve the following Proportions:

x = 0.2
1.5 0.75 6a.

½ : 28 :: ¾ : x 6b.

Solve the following proportions: a) ½ : 27 :: ¾ : x a) x =
b) x : 2.3 :: 0.15 : 0.625 b) x =

Percents:

Convert 45 ½% into a fraction. a)

Convert 0.5% into a decimal. b)

Convert 4/30 to a fractional percent. c)

Convert 62.5 to a percent. d)

Find 36% of 12.4. e)

16 is what percent of 320? f)

24 is 30% of what number? g)
PRACTICAL APPLICATION SKILLS

A physician’s orders read: Tylenol c codeine gr i p.o. q4h p.r.n. for pain.
You have a supply of Tylenol with codeine in 7.5 mg, 15 mg, 30 mg, and 60 mg. How many mg do you need per dose? How many of which type tablet would you use?
mg/dose Number tabs/type:

How many grams of salt would you need to prepare 1 L of a 3% saline solution? b) How many milliliters of distilled water must be added?
a) g NaCl b) mL H_{2}O

A patient is receiving a total of 1500 mL of IV solution. The IV is infusing at a rate of 30 gtt / min. If the drop factor is 15 gtt / mL. a) How many hours will it take to complete the infusion? b) If the IV was started at 8am when would you expect it to complete (in International time). a) hrs b)

How many mL of a 40% stock solution will you use if you want to prepare 2 liters of a 1:10 strength solution? b) How much solvent should you add to get the 2 liters?
mL stock solution mL solvent

A physician orders 120 gtt per dose of a pediatric medication, you provide the parent with a plastic measuring cup and mark the number of milliliters required per dose with an indelible marker. This mark would be at how many mL? A couple of days later, the parent calls to say they have misplaced the plastic measuring cup. How many teaspoons should you tell the parent to administer for each dose?
mL t

Edith Ann is sixyearsold and weighs 33 pounds. She has a temperature of an unknown origin and complains of burning on urination. The doctor notes that her urinalysis shows an E.coli bacterial infection and prescribes Kantrex 75 mg IV q8h in 25 mL D5W1/2NS followed by 15 mL flush over 1 hour. The Kantrex label indicates that the maximum recommended dose of Kantrex is 15mg/kg/day administered in 3 doses and that there are 75mg of drug per 2 mL. Is the ordered dosage safe? If so, calculate the flow rate for the IV.
Safe? Flow Rate: mL/hr

50 mg of Lidocaine has been ordered.

Referring to the drug label, how many mL should the patient receive?
mL

Show the appropriate dosage on the syringe below.

According to the label, what should be done with the unused portion of the drug in this container? Waste or destroy it

For a specific medication, 0.45 g/kg is the recommended dosage for an adult. a) What would be the appropriate dosage for an adult weighing 185 pounds?
a) g
b) What would be the appropriate dosage of the same medication for a child weighing 27kg and having a height of 3 feet 4 inches?
b) g

A physician prescribes 8 ounces of Ensure q4h for a patient recovering from gastric surgery. If Ensure comes in 120 mL containers, how many containers must be given to the patient for each administration? How many cups are in each container of Ensure?
containers cups

A patient is to receive 250,000 U of Bicillin IVPB. Bicillin is packaged in 500,000 U/10mL. If the drop factor is 60 gtt/mL and the medication is infused over 30 minutes, find the flow rate.
gtt/min

A physician orders 1500 mL of D5W infused over 6 hours. The nurse starts the IV and checks it after one hour. 200 mL has infused. If the drop factor for the IV setup is 15 gtt/mL, what drop rate should have been used initially? What was the actual drop rate for the first hour? What drop rate should be set for the remaining 5 hours to fulfill the doctor’s orders?
Initial drop rate: gtt/min Actual drop rate for 1^{st} hour: gtt/min
New drop rate for completion: gtt/min

A medication has a recommended dosage of 6 mg/kg for an adult. The label for this drug indicates that there are 120 mg of drug per mL. What would be the appropriate dosage for an adult weighing 150 pounds? mL

The number of milliliters in a teaspoon:
a) 2.5 b) 120 c) 45 d) 60 e) 15

A microdrop is equivalent to __?__ gtt/mL.
a) 60 b) 20 c) 15 d) 10 e) b, c, & d

To change Celsius temperature to Fahrenheit,
a) Subtract 32 as the first step b) Add 32 as the last step
c) Multiply by 9/5 d) b & c e) a & c

When using International time,
a) Add 12 hours to times after noon b) use a 24hour clock
c) Represent midnight as 0000 d) Use four digits to express time e) All of the above

If a doctor wishes medication to be administered four times a day, she orders
a) q4h b) qid c) q6h d) b & c e) all of the above

Which of the following illustrates a medication error?

Administering a 10 am dose at 10:20

Giving digoxin IM when digoxin 0.25 mg is ordered

Pouring 5mL of cough syrup when 1 tsp is ordered

Giving 2 tablets of Gantrisin 500mg when 1 g is ordered

Under what condition does a nurse have a right to refuse to administer a drug?

The drug is prescribed by a licensed practitioner

The drug is manufactured by two different companies

The pharmacist orders the drug

The dose is within the range given in the PDR

A teaspoon is equivalent to:

3 tbsp c. 5 mL

approximately 1 dram d. all of the above

The equivalent of .3 g

30 mg c. 0.0003 mcg

300 mg d. 3000 mg

The equivalent of 1 ounce is

15 mL c. 30 mL

240 mL d. 60 mL

Which of the following is(are true)?

1 mL = 1cc

1 minim = 1 drop (gtt) d. 15 grain = 1 gram

1 grain = 60 mg e. all of the above

35 F. =

17.2C.

1.7C. d. 3C.

95C. e. 0C.

The abbreviation “ac” means

After meals c. Before meals

All d. Acute

35 C. =

0F.

5.4F. d. 95F.

1.7F. e. 17.2F.

The abbreviation “prn” means

Give anytime and any amount as requested by the patient

Give according to doctor’s orders assuring that all doses are given

Give according to doctor’s orders if the patient requests the medication

Give according to doctor’s orders and if the patient requests at night only

Per rectum

For the apothecary system

The abbreviation for grains (gr) precedes the ordered dose

Conversion between apothecary system and metric system is exact

The metric system is replacing it and medical orders rarely use the apothecary system

a & c only are true

a, b, & c are true

The abbreviation q4h might be used in place of

qid

ac plus hs d. all of the above

pc plus hs e. none of the above

Order: elixir of Dimetane 25 mg bid
Stock: liquid in bottle labeled 10mg/4mL
Dosage: mL

Order: morphine sulfate 12 mg SC stat
Supply: vial of liquid labeled 15mg/mL
Dosage: mL
Mark the dosage on the accompanying syringe:

Order: adrenalin 400 mcg SC stat
Supply: ampule of liquid labeled 1:1000
Dosage: mL
Mark the dosage on the accompanying syringe:

Order: Regular Insulin 10 Units with NPH insulin 40 Units qd SC at 7:30 am
Dosage: Units
Mark the dosages on the accompanying syringe:

Order: 1200 milliliters of D5W is started at 6 am infused at 75mL/hr
Available: an infusion pump.
a) How long will the infusion take? b) At what time will this infusion end (in International
Time)? hrs International Time:

Order: 600,000 U penicillin V potassium p.o. q.6h.
Supply: VCillin K; 250mg (400,000Unit) scored tablets
How many tablets would be administered for each dose? tablets

Order: Erythromycin suspension 600mg p.o. q.6h.
Supply: Erythromycin 400mg/5mL in 60mL bottles mL/dose

How many grams of Epsom salts would you need to prepare 500 mL of 25% solution? And how many mL of distilled water (solvent) would you add?
g Epsom salts mL water

Order: quinidine gluconate gr iii ss p.o. q.12h.
How many mg should be administered in each dose? mg

How many mL of a 50% stock solution will you use if you want to prepare 240 mL of a 20% solution? b) How much solvent should you add to get the 240 mL?
mL stock solution mL solvent

Order: Kantrex 90 mg t.i.d.
Supply: see label below
Patient: child weighing 55 pounds
Is this order safe? Why or why not?
Whether the dose is safe or not, calculate the dosage and indicate the prescribed dose to be administered on the following syringe. mL

Your patient weighs 37.5 kg and stands 120 cm tall. The physician orders a medication with recommended pediatric dosage of 100 mg / m^{2}. If the medication is available in 50 mg tablets, how many tablets will you administer for each dose?
BSA: m^{2 }^{ } tabs

Order: 250,000 U of Bicillin IVPB.
Supply: Bicillin labeled 500,000 U/10mL to be infused over 30 minutes; microtubing is available
Drop rate:

Order: ampicillin 400 mg IM q8h
Stock: vial of powder 1 gram
Directions: Dissolve 1 gram of powder with 3.4 mL sterile water for injection to make a
concentration of 250mg/ml. The resulting solution must be used within 1 hr after
reconstitution.
Dosage: mL

Order: heparin sodium 650 units/hr IV
Available: infusion pump; standard solution of 25,000 units in 250 mL D5W
Pump Setting: mL/hr

Order: Penicillin G 250,000 U IM q.6h.
Supply:
Select the mL of diluent will you use to reconstitute the drug. mL of diluent
a) Show the appropriate dosage based on the way you reconstituted the drug on the following syringe.
Dosage based on your reconstitution: mL
b) How many doses are available after the first dose is administered?
Remaining Doses:

What is the ratio of the weight of dextrose to the volume of IV fluid in D_{5}W?
a.

5 grams of dextrose to 1 liter of IV fluid

c.

5 milligrams of dextrose to 1 liter of IV fluid

b.

5 milligrams of dextrose to 1 milliliter of IV fluid

d.

5 grams of dextrose to 100 mL of IV fluid


A patient’s order for IV fluid states that NS is to be infused. Which of the following IV fluids should be given?
a.

0.9% Sodium Chloride

c.

0.225% Sodium Chloride

b.

0.45% Sodium Chloride

d.

5% Dextrose


Decide which of the following tablets is appropriate to meet the doctor’s order.
Order: codeine gr p.o. q.4h p.r.n. pain
Supply: 15 mg, 30 mg, and 60 mg tablets
a.

2 – 15 mg tablets

c.

1 – 15 mg tablet

b.

1 – 30 mg tablet

d.

½  60 mg tablet

Compute the amount of medication you will give to administer one dose of the following medication orders. Assume all tablets are scored, when necessary. Round all parenteral administration orders that are over 1 mL to one decimal place. Round all parenteral administration orders under 1 mL to two decimal places. Do not include zeros at the end of decimal numbers. Place a zero before a decimal if there is no whole number.

Order: furosemide 80 mg p.o. b.i.d.
Supply: Bottle containing 50 tablets of Lasix (furosemide), 80 mg per tablet
Give: tablet(s)

Order: Axid 0.15 g p.o. b.i.d.
Supply: Bottle containing 60 capsules of Axid, 150 mg per capsule
Give: capsule(s)

Order: penicillin G potassium 400,000 U IM q.i.d.
Supply: penicillin G potassium 500,000 U per 2 mL
Give: mL

Order: morphine sulfate gr IM q.4h p.r.n., pain
Supply: morphine sulfate 10 mg/mL
Give: mL

Order: Claforan 1 g IM q.12h
Supply: Vial containing 6 mL of reconstituted Claforan, 330 mg/mL
Give: mL
Number of these doses per vial:
Compute the amounts of solutes and solvents for the following solutions.

When preparing 300 mL of 1/3 strength hydrogen peroxide solution for wound irrigation, how many mL of hydrogen peroxide and sterile water should be mixed?
mL hydrogen peroxide mL sterile water


Mandy, a child who weighs 15 kilograms, is to be given amoxicillin. The recommended dosage of amoxicillin for children is 20 to 40 mg/kg/day p.o. in equally divided doses administered q.8h.

What is the recommended range of milligrams of medication for this child per day?
minimum: mg maximum: mg

What is the recommended range of milligrams of medication for this child per q.8h dose?
minimum: mg maximum: mg
The pediatrician has ordered amoxicillin 125 mg p.o. q.8h for Mandy.
The available supply of amoxicillin is 125 mg/5 mL.

Is her order within the recommended range for this medication? (yes/no)

If so, how many mL of amoxicillin should be given per q.8h administration? mL

How many teaspoons should the parent be instructed to give as the equivalent dose? t
Calculate the flow rates of the IV fluids based on the order given.

1.5 L D_{5} NS IV to infusion 20 hours by controller Flow rate: _____ mL/h

1250 mL D_{5}W with 10,000 U heparin to infuse at 1000 U/h
The drop factor is 20 gtt/mL. Flow rate: gtt/min

1 L NS IV to infuse in 10 hours
The drop factor is 10 gtt/mL. Flow rate: gtt/min

1000 mL D_{5}W IV to infuse at 25 gtt/min
The drop factor is 15 gtt/mL
The IV is initiated at 2:30 pm. Flow rate: mL/h
Total infusion time: hours Time at completion: (int’l time)

What is the dosage of one dose of Interferon Alpha2b required for a child with a BSA of 0.82m^{2} if the recommended pediatric dosage is 2 million units/m^{2}? units

A child’s order for Pepcid states that she should receive an IV of 20 mg Pepcid diluted in NS to a total volume of 15 mL which is to be injected over 2 minutes and followed by a 10 mL flush. The supply is Pepcid 10 mg/mL. Given that a volume control set is being used, compute the volume of Pepcid, the volume of NS to be added to the volume chamber, and the injection rate.
Pepcid: mL NS: mL mL/15sec

Determine the BSA for the following child using the BSA computation formulas. Include two decimal places with your answers. Leah, who is 80 cm tall and weighs 20 lb BSA = m^{2}

Select an amount of diluent to be added, and compute the amount of medication to be given.
Order: penicillin G potassium 250,000 U IM q.i.d.
The supply is a vial containing 1,000,000 units of powdered penicillin G potassium with the following instructions:
Amount of diluent to be added

Approximate concentration

9.6 mL

100,000 U/mL

4.6 mL

200,000 U/mL

1.6 mL

500,000 U/mL

Add mL diluent, give mL

A patient’s IV flow needs to be checked frequently so that any adjustments in rate will be small. The allowable percent of change varies according to the institution’s policy, patient’s condition, and other factors. For this problem, assume that the patient’s flow rate may be reset if the maximum variation from the physician’s order is not more than 25%. The following IV order will be regulated manually.
Order: 1000 mL D_{5}W IV to infuse in 10 hours
The drop factor is 15 gtt/mL.

Calculate the flow rate of the IV fluid in gtt/min. gtt/min

After 6 hours, 200 mL of IV fluid remains, what would the adjusted rate have to be?
gtt/min

Compute the percent of change in the flow rate.

According to guidelines given, is the new rate allowable? (yes/no)

Order: Add nitroglycerin 200mcg to IV stat
Stock: vial labeled 0.8mg/mL
mL
Mark your dosage on the most appropriate syringe

Order: 35 Units Novolin N NPH U100 Insulin with Novolin R Regular U100 insulin 19 U subcut ā breakfast. Show the two on the appropriate syringe below

A patient’s IV fluids are to be limited. His continuous IV order is for 2500 mL of NS every 24 hours. He is to receive an IV PB of 100 mg of netromycin in 150 mL NS infused in 2 hours, every 12 hours. His IV flow rate is controlled by an infusion pump.

What is the flow rate of his IV PB? mL/h

How many milliliters per day flow for his IV PB? mL/day

How many milliliters per day will he receive with his regular IV? mL/day

What will his regular IV flow rate be, in mL/hour? mL/h
For the following questions, specify the amount of diluent to add, the resulting solution concentration, and the amount to give. Indicate the dose with an arrow on the accompanying syringe.

Order: Vancomycin 750 mg IV q.6h
Package Insert Instructions: For IV use, dilute each 500 mg with 10 mL sterile water. Prior to administration, dilute further with 200 mL of dextrose or saline solution and infuse over 60 minutes. Aqueous solution is stable for two weeks.

Reconstitute with mL diluent for a total solution volume of mL with a concentration of g/ mL.

Give: mL (See label below)

Order: Tazidime 300 mg IM q.6h

Reconstitute with mL diluent for a total solution volume of mL with a concentration of mg/mL.

Give: mL

The following questions refer to your patient who is on IV heparin therapy according to the “Standard Weight Based Heparin Protocol” noted below. The patient weighs 144 pounds. On admission the patient’s APTT is 30 seconds. You initiate IV heparin therapy at 1130 on 06/06/XX.
Standard Weight Based Heparin Protocol

For all patients on heparin drips:

1. Weight in KILOGRAMS. Required for order to be processed: ______ kg

2. Heparin 20,000 U in 250 mL of 1/2 NS. Boluses to be given as 1100 U/mL.

3. APTT q.6h or 6 hours after rate change; q.d. after two consecutive therapeutic APTTs.

4. CBC initially and repeat every ______ day(s).

5. Obtain APTT and PT/INR on day one prior to initiation of therapy.

6. Guaiac stool initially then every ______ day(s) until heparin discontinued. Notify if positive.

7. Neuro checks every ______ hours while on heparin. Notify physician of any changes.

8. D/C APTT and CBC once heparin drip is discontinued unless otherwise ordered.

9. Notify physician of any bleeding problems.

10. Bolus with 80 U/kg. Start drip at 18 U/kg/h.

11. If APTT is 35 secs: Rebolus with 80 U/kg and increase rate by 4 U/kg/h

12. If APTT is 36–44 secs: Rebolus with 40 U/kg and increase rate by 2 U/kg/h

13. If APTT is 45–75 secs: Continue current rate

14. If APTT is 76–90 secs: Decrease rate by 2 U/kg/h

15. If APTT is 90 secs: Hold heparin for 1 hour and decrease rate by 3 U/kg/h


What is the patient’s weight in kilograms? (Round to the nearest kg.) kg

Calculate the dosage of heparin that should be administered for the bolus for this patient. U

Calculate the dose volume of heparin that should be administered for the bolus for this patient. mL

Calculate the dosage of heparin this patient should receive each hour. U/h

Calculate the heparin solution volume this patient should receive each hour to provide correct infusion for the patient’s weight. mL/h

At 1730, the patient’s APPT id 33 seconds, Rebolus with heparin U ( mL)

How much should you change the infusion rate? (increase or decrease) heparin infusion rate by mL/h.

The new infusion rate will be heparin mL/h.
MATH for NURSES STUDY SHEETS  KEY
BASIC ARITHMETIC SKILLS (You should do these without a calculator.)
1a. 0.429 1b. 42.9% 2a. 3/200 2b. 1.5%
3a. 1/3 3b. 5/12 3c. 5 1/2 3d. 0.2092 3e. 48.177 3f. 0.69
4a. 9/25 or 0.36 4b. 21/200 or 0.105 4c. 3/1000 or 0.003
5a. 26 5b. 48% 5c. 288
6a. 0.4 6b. 42 7a) x = _40.5 or 40 1/2 7b) x = __0.552
8a) 91/200 8b) 0.005 8c)13 1/3% or 13.33% 8d) 6250% 8e) 4.464 8f) 5% 8g) 80
PRACTICAL APPLICATION SKILLS
13. 60 mg/dose Number tabs/type: 160mg tablet
14. a) 30 g NaCl b) 1000 mL H_{2}O
15.a) 12.5 or 12 ½ hrs b) 2 0 3 0
16. 500 mL stock solution 1500 mL solvent
17. 7.5 mL 1.5 t
18.Safe? Yes Flow Rate: 42 mL/hr
19. 2.5 mL
19d. Waste or destroy it
20. a) 37.8 g b) 10.6 g
21. 2 containers ½ or 0.5 cups
22. 10 gtt/min
23. Initial drop rate: 63 gtt/min ;Actual drop rate for 1^{st} hour: 50 gtt/min; New drop rate
for completion: 65 gtt/min
24. 3.4 mL
25. c 26. a 27. d 28. d 29. e 30. d 31. b
32. c 33. b 34. c 35. e 36. b 37. c 38. d
39. c 40. d 41. e
42. 10 mL
43. Dosage: 0.8 mL
44.Dosage: 0.4 mL
45. Dosage: 50 Units
NPH R
46. a) 16 hrs b) 2 2 0 0 47. 1.5 tablets
48. 7.5 mL/dose (30mL/day) ½ bottle(s)/day
49. 125g Epsom salts 500 mL water 50. 210mg
51. 96 mL stock solution 144 mL solvent
52. Yes ;125mg is the maximum dose based on 25 kg x 15mg/kg/day divided into 3 doses (t.i.d.);
90 mg is less than the maximum dose.; 2.4mL
53. BSA: _1.12m^{2};^{ }2 tabs 54. 10 gtt/min or ; 2.5 mL/hr
55. 1.6 mL 56. 6.5mL/hr
57. 1.6/4.6/9.6 mL of diluent; 0.5/1.25(1.3)/2.5 mL ; Remaining Doses: 3
0.5 1.3 2.5
58. d 59. a 60. c
61. 1 tablet(s) 62. 1 capsule(s)
63. 1.6 mL 64. 0.6 mL
65. 3.0 mL; doses per vial: 2
66. 100 mL hydrogen peroxide;200mL sterile water
67. a)min: 300 mg; max 600mg b) min 100mg; max 200 mg c) yes d) 5 mL e) 1 t
68. 75_mL/h 69. 42 gtt/min 70. 17 gtt/min

/h; 10hours; 0030 72.1.64 million units
73. Pepcid: 2mL; NS: 13mL; 3.1 mL/15sec 74. 0.45 m^{2}
75. 4.6 mL diluent, 1.3 mL
76. a) 25 gtt/min b) 13 gtt/min c) 48% d) No
77. 0.25 mL
.
78. NHP R
79. a) 75mL/h b) 300 mL/day c) 2200 mL/day d) 110 mL/h
80. Reconstitute with 20mL diluent; total solution volume 20mL; concentration of 1g/20mL; 15mL
81. Reconstitute with 1.5 mL diluent; total solution volume 1.8 mL; concentration of 280mg/mL; 1.1mL
82. a) 65kg b) 5200U c) 4.7 mL d) 1170U/h e) 15 mL/h f) 5200 U;( 4.7 mL) g) 3 mL/h. h) 18mL/h. 