Question

A prescriber orders a heparin drip to run at 1600 units/hr. The pharmacy sends a bag of IV fluid with 25,000 units of heparin in 500 mL D5W. What is the hourly flow rate you will set on the IV pump?

Answer 1

Correct Answers:

32

Rationale :

🟦Concentration = 25,000 units ÷ 500 mL = 50 units/mL

♦️ mL/hr = Ordered units/hr ÷ units/mL

♦️mL/hr = 1,600 ÷ 50

➡️32 mL/hr

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Answer 2

Correct Answers:

12

Rationale :

🟩 Convert lbs → kg = 145 ÷ 2.2 = 65.9 kg

🟩 Units/hr = 18 × 65.9 = 1,186 units/hr

🟩 Concentration = 25,000 ÷ 250 = 100 units/mL

🟩 mL/hr = 1,186 ÷ 100 = 11.86

♦️ 12 mL/hr

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Answer 3

Correct Answers:

67

Rationale :

🟨 Time in hours = 45 min ÷ 60 = 0.75 hr

🟨 mL/hr = Volume ÷ Time (hr)

🟨 mL/hr = 50 ÷ 0.75 = 66.67

✔️67 mL/hr

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Answer 4

Correct Answers:

no

Rationale :

🟧 Weight in kg = 55 ÷ 2.2 = 25 kg

🟧 Doses/day (q6h) = 24 ÷ 6 = 4 doses/day

🟧 Total daily dose = 950 × 4 = 3,800 mg/day

🟧 mg/kg/day = 3,800 ÷ 25 = 152 mg/kg/day → Above 133 mg/kg/day

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Answer 5

Correct Answers:

2

Rationale :

🟥 mL = Ordered dose ÷ Concentration

🟥 mL = 500 mg ÷ (250 mg/mL)

♦️ 2 mL

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Answer 6

Correct Answers:

400

Rationale :

🟪 Time in hours = 15 ÷ 60 = 0.25 hr

🟪 mL/hr = Volume ÷ Time (hr)

🟪 mL/hr = 100 ÷ 0.25

✔️400 mL/hr

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Answer 7

Correct Answers:

0.75 mL

Rationale :

🟦 Use the formula mL = ordered dose ÷ concentration to calculate IM volume accurately.

🟦 The ordered dose is 3 mg and the vial concentration is 4 mg/mL.

🟦 3 ÷ 4 = 0.75 mL, which is the exact volume needed to deliver the prescribed dose.

🟦 Correct dose calculation prevents underdosing (inadequate pain control) and overdosing (respiratory depression risk).

🟦 Always verify the concentration is in mg/mL before drawing up the medication.

0.8 mL

🟦This would deliver 0.8 × 4 = 3.2 mg, which is more than ordered.

🟦Small decimal errors can cause clinically significant overmedication.

0.45 mL

🟦This would deliver 0.45 × 4 = 1.8 mg, which is less than ordered.

🟦 Underdosing may leave pain uncontrolled and prompt unnecessary repeat dosing.

0.5 mL

🟦This would deliver 0.5 × 4 = 2 mg, which is below the prescribed dose.

🟦 Incorrect volume leads to inconsistent analgesia and poor symptom control.

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Answer 8

Correct Answers:

use of sensitivity tests
ensuring patient completes prescribed treatment

Rationale :

Use of sensitivity tests

🟦 Sensitivity (culture and susceptibility) testing identifies the specific organism and which antibiotics it is susceptible to.

🟦 This supports choosing the narrowest effective antibiotic, which limits unnecessary exposure to broad-spectrum agents.

🟦 Reducing broad or incorrect antibiotic use decreases selective pressure, a major driver of resistance.

🟦 Targeted therapy also improves treatment success by matching the drug to the pathogen’s resistance pattern.

🟦 This is a key element of antimicrobial stewardship and resistance prevention.

Ensuring patient completes prescribed treatment

🟦 Completing the full prescribed course helps fully eradicate susceptible bacteria and prevents partial suppression.

🟦 Stopping early can allow surviving bacteria to multiply and adapt, increasing the chance of resistant strains emerging.

🟦 Full adherence reduces the likelihood of relapse and repeat antibiotic exposure, which further drives resistance.

🟦 Teaching adherence includes correct timing, not skipping doses, and understanding why finishing matters even when symptoms improve.

🟦 This practice protects both the individual client and the community by reducing resistant organism spread.

Use of antibiotics in animal feed

🟦 This promotes ongoing low-dose antibiotic exposure, which increases the development of resistant bacteria in animals.

🟦 Resistant organisms can spread to humans through food, water, and contact, worsening community resistance rates.

Prescription of antibiotics for viral infections

🟦 Antibiotics do not treat viruses, so this creates unnecessary exposure that encourages bacterial resistance selection.

🟦 It also increases avoidable adverse effects and disrupts normal flora, raising superinfection risk.

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Answer 9

Correct Answers:

superinfection

Rationale :

🟨 A superinfection occurs when antibiotics disrupt normal flora, allowing resistant or opportunistic organisms to overgrow.

🟨 Common examples include C. difficile-associated diarrhea and yeast infections after broad-spectrum antibiotics.

🟨 The original antibiotic kills susceptible bacteria, removing competition that normally keeps other organisms controlled.

🟨 The new infection is “secondary” because it develops during therapy for another infection.

🟨 Recognizing superinfection early supports prompt intervention such as changing therapy and restoring microbial balance.

Toxicity

🟨Toxicity refers to harmful effects from a drug due to high levels or sensitivity, not altered flora causing a new infection.

🟨It does not specifically describe a secondary infection mechanism.

Organ toxicity

🟨Organ toxicity means damage to organs (e.g., liver, kidney) from medication exposure.

🟨It is not defined by development of a secondary infection.

Hypersensitivity

🟨Hypersensitivity is an immune-mediated allergic reaction such as rash or anaphylaxis.

🟨It does not involve overgrowth of organisms from disrupted flora.

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Answer 10

Correct Answers:

how quickly the drug begins to act

Rationale :

💎 Onset is the time it takes for a medication to start producing a therapeutic effect after administration.

💎 It focuses on the beginning of action, meaning when the drug first reaches an effective level at its target site.

💎 A faster onset means the client will feel effects sooner, which is important for pain meds, rescue inhalers, and emergencies.

💎 Onset is influenced by route of administration, circulation, and absorption rate.

💎 Knowing onset helps nurses plan monitoring, reassessment timing, and safety precautions (e.g., fall risk after opioids).

how long the drug works

💎This describes duration, not onset.

💎Duration is how long the medication maintains its effect after it starts working.

how fast the drug is excreted

💎This relates to excretion/clearance, mainly kidney or liver removal.

💎It does not define when the medication begins acting.

how long it takes to achieve maximum effective concentration

💎This describes peak effect time (time to maximum concentration/effect).

💎Peak occurs after onset and is not the first moment the drug begins working.

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QLexNursing

1 :
A prescriber orders a heparin drip to run at 1600 units/hr. The pharmacy sends a bag of IV fluid with 25,000 units of heparin in 500 mL D5W. What is the hourly flow rate you will set on the IV pump?

2 :
The heparin protocol reads: "Begin IV heparin drip at 18u/kg/hr." Your IV bag reads Heparin 25,000u in 250 mL. Your patient weighs 145 lbs. What is the IV flow rate? (round to the nearest whole number)

3 :
Ampicillin 1 gram in 50 mL NS IVPB q6 hours over 45 minutes. What is the pump rate? (round to nearest mL)

4 :
A 4-year-old weighs 55 pounds and is to receive cefuroxime 950 mg IV every 6 hours. The recommended dose of cefuroxime for children older than 1 month is 50–133 mg/kg every 24 hours. Is the ordered dose within the recommended limits?

5 :
A patient is to receive ceftriaxone 500 mg IM q8hrs. The vial reads: Ceftriaxone 4 grams. Reconstitute with 8 mL of normal saline for a concentration of 250 mg/mL. How much will the nurse draw up?

6 :
The provider has ordered amiodarone (Cordarone) 300 mg in 100 mL to be infused over 15 min. How many mL/hr will the nurse set the pump to deliver? Round your answer to the nearest whole number.

7 :
Order: Give Dilaudid 3 mg IM q3h for pain. Available: Dilaudid 4 mg/mL ampule. How many milliliters will you administer?

8 :
Which of the following help to prevent bacterial resistance to antibiotics? (Select all that apply)

9 :
A condition that occurs when the normal flora is disturbed during antibiotic therapy which causes a secondary infection is known as:

10 :
Which of the following best describes a drug's onset?

QLexNursing

1 : A prescriber orders a heparin drip to run at 1600 units/hr. The pharmacy sends a bag of IV fluid with 25,000 units of heparin in 500 mL D5W. What is the hourly flow rate you will set on the IV pump?

2 : The heparin protocol reads: "Begin IV heparin drip at 18u/kg/hr." Your IV bag reads Heparin 25,000u in 250 mL. Your patient weighs 145 lbs. What is the IV flow rate? (round to the nearest whole number)

3 : Ampicillin 1 gram in 50 mL NS IVPB q6 hours over 45 minutes. What is the pump rate? (round to nearest mL)

4 : A 4-year-old weighs 55 pounds and is to receive cefuroxime 950 mg IV every 6 hours. The recommended dose of cefuroxime for children older than 1 month is 50–133 mg/kg every 24 hours. Is the ordered dose within the recommended limits?

5 : A patient is to receive ceftriaxone 500 mg IM q8hrs. The vial reads: Ceftriaxone 4 grams. Reconstitute with 8 mL of normal saline for a concentration of 250 mg/mL. How much will the nurse draw up?

6 : The provider has ordered amiodarone (Cordarone) 300 mg in 100 mL to be infused over 15 min. How many mL/hr will the nurse set the pump to deliver? Round your answer to the nearest whole number.

7 : Order: Give Dilaudid 3 mg IM q3h for pain. Available: Dilaudid 4 mg/mL ampule. How many milliliters will you administer?

8 : Which of the following help to prevent bacterial resistance to antibiotics? (Select all that apply)

9 : A condition that occurs when the normal flora is disturbed during antibiotic therapy which causes a secondary infection is known as:

10 : Which of the following best describes a drug's onset?

1 :
A prescriber orders a heparin drip to run at 1600 units/hr. The pharmacy sends a bag of IV fluid with 25,000 units of heparin in 500 mL D5W. What is the hourly flow rate you will set on the IV pump?

2 :
The heparin protocol reads: "Begin IV heparin drip at 18u/kg/hr." Your IV bag reads Heparin 25,000u in 250 mL. Your patient weighs 145 lbs. What is the IV flow rate? (round to the nearest whole number)

3 :
Ampicillin 1 gram in 50 mL NS IVPB q6 hours over 45 minutes. What is the pump rate? (round to nearest mL)

4 :
A 4-year-old weighs 55 pounds and is to receive cefuroxime 950 mg IV every 6 hours. The recommended dose of cefuroxime for children older than 1 month is 50–133 mg/kg every 24 hours. Is the ordered dose within the recommended limits?

5 :
A patient is to receive ceftriaxone 500 mg IM q8hrs. The vial reads: Ceftriaxone 4 grams. Reconstitute with 8 mL of normal saline for a concentration of 250 mg/mL. How much will the nurse draw up?

6 :
The provider has ordered amiodarone (Cordarone) 300 mg in 100 mL to be infused over 15 min. How many mL/hr will the nurse set the pump to deliver? Round your answer to the nearest whole number.

7 :
Order: Give Dilaudid 3 mg IM q3h for pain. Available: Dilaudid 4 mg/mL ampule. How many milliliters will you administer?

8 :
Which of the following help to prevent bacterial resistance to antibiotics? (Select all that apply)

9 :
A condition that occurs when the normal flora is disturbed during antibiotic therapy which causes a secondary infection is known as:

10 :
Which of the following best describes a drug's onset?