Nursing

Pharmacology
 Definitions

• Pharmacology: is a science that studies

the effect of the drugs on the body.
• Pharmacopeias: are the total of all
authorized drugs available within the
country.
• Medication: is a substance administered
for diagnosis, cure, treatment, mitigation
or prevention.
• Prescription: the written direction for
the preparation and the administration of
the drug.
 Basic concepts of
Pharmacology
• Pharmacotherapeutics: is a clinical
using of drug.
• Pharmacognosy: The study of natural
(plant and animal) drug sources.
 Source of drugs
1. Plants: such as digitalis, vincristine.
2. Human and animals: such as
epinphrine, insulin and
adrenocoticotrpoic hormone.
3. Minirals: as iron, iodine and zinc
4. Synthetic and chemical substance: as
sodium bicarbonate
Names of Drugs
❑ The generic name: is given for the
drug to being official name.
❑ The chemical name: is the name
by which the chemist knows it.
❑ The trade mark or brand name
(proprietary name) : is name given
by the drug manufacture
 Phases of Drug
Action
❑ Pharmaceutic Phase
❑ Pharmacokinetics
❑ Pharmacodynamics
 Pharmaceutic Phase
❑ Process of making drug
into a solution to be
absorbed
❑ Oral route undergo
pharmaceutic phase
❑ Parenteral method have
no pharmaceutic phase
 Pharmaceutic Phase
❑ Tablets undergo 2 phases
✔ Disintegration
Breaking down tablet into
smaller particles
✔ Dissolution
Breaking particles into
smaller part in GI before it
absorbe
 Pharmacokinetics
❑ Process of drug movement to
achieve the drug action
1. Absorption
2. Distribution
3. Metabolism
4. Elimination
 Phases of
Pharmacokinetics
❑ Absorption
Passive Absorption – not require
energy, ex. Diffusion
Active Absorption- require
energy, movement of particles
against concentration gradient
❑ Distribution- the process of
drug become available to body
 Phases of
Pharmacokinetics
❑ Metabolism or
Biotransformation
Liver- the primary site of
metabolism and inactive drug
particles
Half-life- time it take for half of
drugs to be eliminated
❑ Elimination
Main route is kidney
Other- hepatic metabolism, bile,
sweat, saliva
??! !
 NCLEX Question
A tablet undergo which of the following
process before it is absorbed?

A. Metabolism and dissolution

B. Metabolism and disintegration
C. Biotransformation and distribution
D. Disintegration and dissolution
??! !
 NCLEX Question
The 4 sequential process of
pharmacokinetic phase are?

A. Distribution, metabolism, excretion,

absorption
B. Biotransformation, excretion,
absorption, metabolism
C. Absorption, distribution, metabolism,
excretion
D. Metabolism, distribution, absorption,
excretion
??! !
 NCLEX Question
Absorption, distribution, and
excretion may be increased by
which of the following diseases?
A. Hyperthyroidism
B. Renal insufficiency
C. Liver disease
D. Hypothyroidism
 Pharmacodynamics
• Study of drug concentration
and effect on body
 Cont …..

• The therapeutic effect: is the primary effect

intended that is the reason the drug is prescribed
such as morphine sulfate is analgesia.
• Type of Therapeutic Effect
❑ Pallative –relieve symptoms but those not affect
the underlying disease
❑ Curative- cure disease or condition
❑ Supportive- support other function until other
treatments or the body’s response can take over
 Cont …..

• Type of Therapeutic Effect

❑ Substitutive – replace body fluids or substance
❑ Chemotherapeutic – destroy malignant cells
❑ Restorative – return the body to health (vitamins)
 Cont …..

• Side effect: secondary effect of the drug is one

that unintended, side effects are usually
predictable and may be either harmless

• Adverse Reaction:
– any unexpected or dangerous reaction to a drug.
An unwanted effect caused by the administration
of a drug.
 Cont …..

• Drug toxicity: deleterious effect of the

drug on an organism or tissue, result from
overdose or external use.

• Drug allergy: is immunological reaction

to a drug.
 Cont …..

• Drug interaction: occur when

administration of one drug before or after
alter effect of one or both drug.

• Drug misuse: Is the improper use of

common medications in way that lead to
acute and chronic toxicity for example
laxative, antacid and vitamins.
 Cont …..

• Drug abuse: is an inappropriate intake

of substance either continually or
periodically.

• Drug dependence: is a persons reliance

on or need to take drug or substance
there are two type of dependence:
 Cont …..

• Physiological dependence: is due to

biochemical changes in the body tissue these
tissue come to require substance for normal
function.

• Psychological dependence: is emotional

reliance on a drug to maintain a since of
wellbeing accompanied feeling of need.
 Cont …..

– Drug habituation: denotes a mild

form of psychological dependence.

– Illicit drug: also called street drug are

those sold illegally.
 Drug Interaction
• Synergy: the effects of 2 drugs are
totally or partially additive.
• Potentiation: the effect of one drug is
greatly increased by the intake of
another drug itself without notable
effect
• Antagonism: the effect of one drug is
decreased or suppressed by another
drug.
 Drug Interaction
• An addictive effect occurs when two
drugs are given together and their
effects is equal to the sum of their
respective effects.
??! !
 NCLEX Question
An unexpected effect of the drug
is known as a(n):

A. Side effect
B. Adverse effect
C. Toxic reaction
D. Allergic reaction
??! !
 NCLEX Question
The interaction of one drug increased
by the presence of a second drug is
known as:

A. Potentiation
B. Addictive effect
C. Antagonism
D. Synergism
??! !
 NCLEX Question
When two drugs given together have an
effect equal to the sum of their respective
effects, the interaction is known as:
A. Potentiated
B. Antagonized
C. Agonist
D. Additive
??! !
 NCLEX Question
Safety of a drug is determined by
the degree between:

A. Therapeutic and toxic doses

B. Potency and efficacy
C. Subtherapeutic and toxic levels
D. Side and adverse effects
??! !
 NCLEX Question
When a drug binds to a receptor to
produce a pharmacologic effect,
the drug may be called a(n):

A. Agonist
B. Antagonist
C. Blocker
D. Accelerator
 Route of administration:

1. Oral is the most common

Advantage:
• Least expensive and most
convenient route for most clients.
• Safe, does not break the skin.
• Concoius, able to swallow.
Oral medication
 Oral Route
Disadvantage:
• Inappropriate for client nausea and
vomiting.
• Drug may have unpleasant taste.
• May cause irritation of gastro intestinal
tract.
• Drug may discolor teeth.
• Drug can be aspirated by ill client.
??! !
 NCLEX Question
The client’s ability to take oral
medications will be hindered by:

A. Age
B. Dental caries
C. Dysphagia
D. Lifestyl
 Route of administration:
2. Sublingual: a drug placed under the
tongue, where it dissolved.

Advantage:
• Same as oral plus
• Drug may administered for local effect.
• Drug rapidly absorbed into blood
stream.
• More potent than oral.
 Route of administration:
Disadvantage:
• If swallowed drug may be inactive.
• Drug must remain under the tongue until
dissolved.

3. Baccal: pertaining to the cheeks.

3. Rectal: can be used when drug
objectionable taste.
4. Translingual: on the tongue.
 Route of administration:

5. Subcutaneous (SC): hypodermic

into subcutaneous tissue, just below
the skin.
The maximum amount of fluid that can
be injected into the SC space is 1.0 mL.

Advantage: onset drug action faster

than oral.
 Route of administration:
• Disadvantage: SC

1. Must involve sterile technique because

breaks skin barrier.
2. More expensive than oral.
3. Can administer only small doses.
4. Slower than intramuscular injection.
5. Some drug can irritate tissue and can cause
pain.
 Route of administration:
6.Intramuscular (IM): into in the muscle.
Advantage:
• Pain from irritating drugs is minimized.
• Can administer large volume of drug.
• Drug rapidly absorbed.

Disadvantage:
• breaks skin barrier.

• Can be anxiety producing .

 Route of administration:
6.Intramuscular (IM): into in the muscle.
Possible injection sites for IM administration
include ventrogluteal, deltoid, dorsogluteal,
vastus lateralis, and rectus femoris.
• Vastus lateralis – good site for infant less
than 7 months
• Ventrogluteal site is preferred site for
adult and infat older than 7 months
 Route of administration:
7. Intradermal (ID): is the administrating of a drug
into the dermal layer of the skin just beneath the
epidermis, usually small amount of liquid is used for
example 0.1ml.
• Advantage: absorption is slow (this
advantage test for allergy).

• Disadvantage: amount of drug

administered must be small.
• Breaks skin barrier
 Route of administration:

8. Intravenous (IV): allow injection of

drugs and another substance directly
into bloodstream through the vein.

9. Inhalation: is apply to drugs directly

onto lungs.
 Specialized infusion

1. Intrathecal: inject onto CSF.

2. Intrapleural: injected onto plural
cavity.
3. Intraosseous: injected into rich
vascular network of long bone.
4. Epidural: inject to epidural space.
5. Intraarticular: inject onto joint.
 Topical Route

1. Skin (including transdermal patches)

2. Eyes
The ointment is placed in the lower
conjunctival sac so it will not scratch the
eye itself and will get well distributed.
3. Ears
4. Nose
5. Lungs (inhalation)
6. Vagina
 Testing of the new drugs before
use
• Not teratogenic ( causes birth defect)
• Carcinogenic ( causes cancer)
• Toxicity studies not harmful to body
system.
• It should specific in action and its
mechanism of action understood as
complitly as possible.
• Optimal route of administration.
 The Dose

• The aim to give patient a dose of the

drug that achieves the desired effect
with out causing with harmful side
effect.
• Therapeutic index: is a measure of the
danger of poisoning and the higher it is
safer of drug is.
• Aspirin (3.5), digoxin (2)
• Bioavailability: Means that the drug has
reached the circulation and is therefore
available for all the tissues. (ex: aspirin
600 mg).
• Tolerance: A decreasing response to
repetitive drug doses
??! !
 NCLEX Question
Which of the following muscles
is a possible site for IM
injections?

A. Outer aspect of the hip

B. Shoulder
C. Vastus gluteus
D. Vastus lateralis
??! !
 NCLEX Question
The nurse correctly administers
the PPD to a client when she:
A. injects thru a piggyback.
B. injects intradermally.
C. injects intramuscularly.
D. injects subcutaneously.
??! !
 NCLEX Question
The nursery nurse is putting
erythromycin ointment in the
newborn’s eyes to prevent
infection. She places it in the
following area of the eye:
A. under the eyelid
B. on the cornea
C. in the lower conjunctival sac
D. by the optic disc
??! !
 NCLEX Question
The correct method for determining the vastus lateralis
site for I.M. injection is to:
A. Locate the upper aspect of the upper outer
quadrant of the buttock about 5 to 8 cm below
the iliac crest
B. Palpate the lower edge of the acromion process
and the midpoint lateral aspect of the arm
C. Palpate a 1” circular area anterior to the umbilicus
D. Divide the area between the greater femoral
trochanter and the lateral femoral condyle into
thirds, and select the middle third on the anterior
of the thigh
??! !
 NCLEX Question
The mid-deltoid injection site is seldom used for
I.M. injections because it:
A. Can accommodate only 1 ml or less of
medication
B. Bruises too easily
C. Can be used only when the patient is lying
down
D. Does not readily parenteral medication
??! !
 NCLEX Question
Parenteral penicillin can be
administered as an:
A. IM injection or an IV solution
B. IV or an intradermal injection
C. Intradermal or subcutaneous
injection
D. IM or a subcutaneous injection
??! !
 NCLEX Question
The appropriate needle gauge for
intradermal injection is:

A. 20G
B. 22G
C. 25G
D. 26G
??! !
 NCLEX Question
The best way of determining whether a patient has
learned to instill ear medication properly is for the
nurse to:

A. Ask the patient if he/she has used ear drops

before
B. Have the patient repeat the nurse’s instructions
using her own words
C. Demonstrate the procedure to the patient and
encourage to ask questions
D. Ask the patient to demonstrate the procedure
??! !
 NCLEX Question
Which of the following types of medications can be
administered via gastrostomy tube?

A. Any oral medications

B. Capsules whole contents are dissolve in water
C. Enteric-coated tablets that are thoroughly
dissolved in water
D. Most tablets designed for oral use, except for
extended-duration compounds
??! !
 NCLEX Question
A patient who develops hives after
receiving an antibiotic is exhibiting
drug:
A. Tolerance
B. Idiosyncrasy
C. Synergism
D. Allergy
 Right Patient
• The correct way to identify a patient before giving a
medication is to check the name on the medication
administration record with the patient’s
identification band.
• The nurse should also ask the patient to state their
name.
• The name on the door or the census list are not
sufficient proof of identification.
• Calling the patient by name is not as effective as
having the patient state their name; patients may
not hear well or understand what the nurse is
saying, and may respond to a name which is not
their own.
??! !
 NCLEX Question
The volume of SC medication
must be no more than:

A. 0.5 mL
B. 1.0 mL
C. 1.5 mL
D. 3.0 mL
??! !
 NCLEX Question
James Perez, a nurse on a geriatric floor, is
administering a dose of digoxin to one of his
patients. The woman asks why she takes a different
pill than her niece, who also has heart trouble.
James replies that as people get older, liver and
kidney function decline, and if the dose is as high as
her niece’s, the drug will tend to:

A. have a shorter half-life.

B. accumulate.
C. have decreased distribution.
D. have increased absorption
??! !
 NCLEX Question
The extent to which drug is
absorbed and transported to target
tissue is known as:

A. Steady-state accumulation
B. Therapeutic drug levels
C. Bioavailability
D. Distribution
??! !
 NCLEX Question
As a knowledgeable nurse, you
know that the following are part
of the five rights except:

A. Right dose
B. Right route
C. Right drug
D. Right room
??! !
 NCLEX Question
When performing an assessment
about medication, the drug
history should include:

A. Complete vital signs

B. Client’s goal of therapy
C. Reason for medication
D. Administration of OTC
medications
??! !
 NCLEX Question
Which of the following will
determine nursing interventions
for a client on medication?

A. Assessment
B. Diagnoses
C. Implementation
D. Evaluation
??! !
 NCLEX Question
When deciding on what time of day
to give medications, the nurse
pays closest attention to the
client’s habits regarding:

A. Eating
B. Sleeping
C. Elimination
D. Activity
??! !
 NCLEX Question
When performing an assessment to
determine which medications can
be used, which of the following
elements is most important?

A. Physical examination
B. Allergies
C. Presence of illness
D. Weight
??! !
 NCLEX Question
When considering the
pharmacotherapeutic effects of
drugs administered to clients, the
nurse considers which property of
most importance:

A. Efficacy
B. Interaction with other drugs
C. Potency
D. Toxicity
??! !
 NCLEX Question
The physician orders penicillin for a patient with
streptococcal pharyngitis. The nurse administers the
drug as ordered, and the patient has an allergic
reaction. The nurse checks the medication order sheet
and finds that the patient is allergic to penicillin. Legal
responsibility for the error is:

A. only the nurse’s—she should have checked the

allergies before administering the medication.
B. only the physician’s—she gave the order, the
nurse is obligated to follow it.
C. only the pharmacist’s—he should alert the floor
to possible allergic reactions.
D. the pharmacist, physician, and nurse are all
liable for the mistake
??! !
 NCLEX Question
The nurse is administering augmentin to her
patient with a sinus infection. Which is the best
way for her to insure that she is giving it to the
right patient?

A. Call the patient by name

B. Read the name of the patient on the patient’s
door
C. Check the patient’s wristband
D. Check the patient’s room number on the unit
census list
??! !
 NCLEX Question
The most important instructions a nurse can give a
patient regarding the use of the antibiotic
ampicillin prescribed for her are to
A. call the physician if she has any breathing
difficulties
B. take it with meals so it doesn’t cause an upset
stomach
C. take all of the medication prescribed even if the
symptoms stop sooner
D. not share the pills with anyone else
??! !
 NCLEX Question
The nurse is administering an antibiotic to her pediatric
patient. She checks the patient’s armband and verifies
the correct medication by checking the physician’s
order, medication kardex, and vial. Which of the
following is not considered one of the five “rights” of
drug administration?

A. Right dose
B. Right route
C. Right frequency
D. Right time
??! !
 NCLEX Question
The nurse prepares to administer buccal
medication. The medicine should be
placed…

A. On the client’s skin

B. Between the client’s cheeks and gums
C. Under the client’s tongue
D. On the client’s conjuctiva
??! !
 NCLEX Question
A client complains of difficulty of swallowing,
when the nurse try to administer capsule
medication. Which of the following measures
the nurse should do?
A. Dissolve the capsule in a glass of water
B. Break the capsule and give the content with
an applesauce
C. Check the availability of a liquid preparation
D. Crash the capsule and place it under the
tongue
Medical
Abbreviation
Frequency Abbreviation

every day q.d.

every other day every other day (q.o.d.)

every hour q.h.

every 2 hours q.2.h.

every 3 hours q.3.h.

every 4 hours q.4.h.

Frequency Abbreviation

twice a day b.i.d

three times a
t.i.d
day
four times a
q.i.d
day
twice a day b.i.d
Frequency Abbreviation Explanation
Notice the use of q for
every.
every Notice also that we use
q.a.m. a.m. to represent morning
morning (for the Latin ante
meridiem meaning before
noon)

This stands for hour of

at bedtime h.s. sleep.

every Notice the use of q for

q.h.s. every. This literally means
bedtime "every hour of sleep"

a stands for before (ante

is the Latin for before -
before think of a.m. as in before
a.c. noon)
meals c stands for meals (cibum
is the Latin for meals -
Frequency Abbreviation Explanation
p stands for after (post is
the Latin for after - think of
after meals p.c. p.m. as in after noon)
c stands for meals (cibum
is the Latin for meals)

short for ad libitum, Latin

for "at one's pleasure" - in
everyday English we often
as desired ad lib use this term to describe
when someone is
improvising dialog

short for si opus sit, Latin

for "if it is necessary"
as (actually, it literally says, "if
s.o.s. there is work", which in
necessary Latin is the phrase used to
mean "if it is necessary")

when
short for pro re nata, Latin
necessary/requir p.r.n. for "as occasion requires"
Frequency Abbreviation Explanation
q stands for quantity
(quantum is the Latin for
quantity)
as much s stands for sufficient
q.s. (sufficiat is the Latin for
as required sufficient)
so literally, it means "a
sufficient quantity"

immediatel short for statim, which is

stat Latin for "immediately'
y
c stands for with (cum is
the Latin for with - think of
with c "cum laude", which means
"with honor")
Frequency Abbreviation Explanation
a stands for before (ante
is the Latin for before -
before a think of a.m. as in before
noon)

p stands for after (post is

after p the Latin for after - think of
p.m. as in after noon)
??! !
 NCLEX Question
Which medication order will be
given every other day?

A. qh
B. bid
C. qod
D. qd
??! !
 NCLEX Question
A client tells the nurse, “this pill is a
different color than that I usually take at
home”. Which is the best response by the
nurse?

A. “the doctor ordered a different

medication”
B. “ Go ahead and take your medication”
C. “ I’ll leave the pill here while check
with the doctor.”
D. “ I will recheck your medication
order”
??! !
 NCLEX Question
Which of the following is the
abbreviation of drops?

A. Gtt.
B. Gtts.
C. Dp.
D. Dr
??! !
 NCLEX Question
The abbreviation for micro drop
is…

A. µgtt
B. gtt
C. mdr
D. mgts
??! !
 NCLEX Question
Which of the following is the
meaning of PRN?

A. When advice
B. Immediately
C. When necessary
D. Now
Type of
Medication
Order
 Type of Medication Order
❑ Stat Order
❑ Single Order

❑ Standing Order
❑ PRN order
 Stat Order
❑ Indicate the medication to be
given immediately and only
once

❑ Example: Demerol 100mg IM

stat
 Single Order
❑ Medication to be given once at
a specified time
❑ Ex. Seconal 100mg hs before
surgery
 Standing Order
❑ May or may not have termination
date

❑ Can carried out indefinitely until

an order is written to cancel it or
it may be carried out for a
specified number of days
 Standing Order
❑ Example
✔ Multivitamins daily

✔ Demerol 100mg IM q4h x 5

days
 PRN order
❑ As needed order
❑ Permits the nurse to give a
medication when, in nurse
judgment, the client require it
 PRN order
❑ Example
Paracetamol 500mg prn
??! !
 NCLEX Question
Digoxin to maintain blood level
at 0.5-2 ng/ml.” this is example
of drug order

A. Standing
B. Single
C. PRN
D. STAT
??! !
 NCLEX Question
One (1) tsp is equals to how
many drops?

A. 15
B. 60
C. 10
D. 30
??! !
 NCLEX Question
The nurse is ordered to administer
ampicillin capsule TID p.o. The
nurse should give the medication…

A. Three times a day orally

B. Three times a day after meals
C. Two time a day by mouth
D. Two times a day before meals
??! !
 NCLEX Question
All of the following nursing interventions are
correct when using the Z-track method of
drug injection except:

A. Prepare the injection site with alcohol

B. Use a needle that’s a least 1” long
C. Aspirate for blood before injection
D. Rub the site vigorously after the injection to
promote absorption
??! !
 NCLEX Question
The physician orders gr 10 of aspirin
for a patient. The equivalent dose in
milligrams is:
A. 0.6 mg
B. 10 mg
C. 60 mg
D. 600 mg
Drug
Computation
 Conversions:
• 1 liter (L) = 1000 ml (milliters)
• 1 gram (g) = 1000 mgs (milligrams)
• 1 mg (milligrams) = 1000 mcgs
(micrograms)
• 1 gram (g) = 15 grain (gr)
• 1 grain (gr) = 64.8 mg (milligrams)
• 1 dram (dr) =4 ml (milliters)
• 1 ounce (oz) = 30 ml (milliters)
 Conversions:
• 1 tsp (teaspoon) = 5 ml (milliters)
• 1 tbs (tablespoon) = 15 ml (milliters)
• 1 kg (kilogram) = 2.2 lbs (pounds)
• 1 inch = 2.54 cm (centimeters)
• 16 ounces (ozs) = 1 lb (pound)
• 1 cup = 8 ounces (ozs)
• 1 ml (milliter) = 15 minims
• 1 tsp (teaspoon) = 5 ml (milliters)
• 1 tbs (tablespoon) = 15 ml (milliters)
• 1 drop (gtt) = 15 minims
 Converting using Ratio Proportion: mcg/mg cont’d

You have 18 mcg and you need to convert to mg.

1. Recall the equivalents
2. Set up the ratio proportion of equivalents
3. Cross multiply and solve for x

1000mcg = 18 mcg__
1 mg “x” mg
1000x = 18
x = 0.018 mg

151
 Converting using Ratio Proportion: lb/kg cont’d

The weight is 110 lbs and you need to convert to kg.

1. Recall the equivalents
2. Set up the ratio proportion of equivalents
3. Cross multiply and solve for x

2.2 lb = 110 lbs__

1 kg x kg
2.2x = 110

x = 50 kg

152
Basic Formula: Frequently used to calculate drug dosages.

D = dose ordered or desired dose

H = dose on container label or dose on hand
V = form and amount in which drug comes (tablet, capsule, liquid)

Example: Order-Dilantin 50mg p.o. TID

Drug available-Dilantin 125 mg/5ml
 Practice Problem #1
• The physician orders digoxin (Lanoxin)
5 mg.
The pharmacy sends 15 mg/5mL. How
many mL will you administer?

??????
5mg x 5mL/15mg = 1.67ml or
1.7 ml
 Rounding
• Do not round until you get to the
answer. You should always carry at
least two decimal places (hundredths
0.01)throughout the problem.
• Answers must be rounded to the
tenths (0.1)
• Follow the rules of rounding: if the
number being rounded is from 1-4
then round down, 5-9 round up
 Rounding cont
• Answers in drops (gtt) must be rounded to
the nearest whole number.
• Capsules must be rounded to the nearest
whole
• Enteric coated tablets must be rounded to
the whole.
• Unscored tablets should be rounded to the
whole.
In other words, round to the nearest
deliverable dose. Ex. If your answer is 1.9
suppositories or 21.7 gtts do these answers
make sense?
??! !
 Practice Problem #2
• The physician orders Mycostatin
250,000 units oral swish and swallow
QID
You have on hand: 100,000 units/mL
How many mL will you administer?

250,000 units x mL/100,000 units=

????
2.5mL
??! !
 Practice Problem #3
• You have an order for gr (grain) X
Acetaminophen (Tylenol) PO daily
You have Tylenol 15 mg/mL
How many mL will you administer?

10gr x 60mg/gr x mL/15mg= 40mL

??! !
 Practice Problem #3
• You have an order for gr (grain) X
Acetaminophen (Tylenol) PO daily
You have Tylenol 15 mg/mL
How many mL will you administer?

10gr x 60mg/gr x mL/15mg =

????
40ml
??! !
 Practice Question:
• The physician orders Ampicillin 500mg q6h
orally (po). Ampicillin is available: 250mg
capsule (cap). How many capsules would you
administer q6h?

*check answer:
????
2
capsule
??! !
 Practice Question:
• The physician orders Lanoxin 0.25mg IM every
day. Lanoxin is available: 0.5mg per
2 ml. How much Lanoxin would you
administer IM ?

*check answer:
????
1 ml
??! !
 Practice Question:
• The physician orders Theophylline 160mg q6h
orally (po). Theophylline is available:
80mg per 15 ml. How much Theophylline
would you administer q6h?

*check answer: ????

30ml
??! !
 Practice Question:
• The physician orders Morphine 5mg IM q4h.
Morphine is available: 1grain per 5 ml. How
much Morphine would you administer?

1 grain = 60mg
Morphine is available: 60mg per 5 ml

????
check answer: 0.416 or 0.42 ml
??! !
 Practice Question:
• The physician orders Morphine 1/100 grain
(gr) IM q6h for abdominal pain. Morphine is
available: 0.5mg per 0.5 ml. How much would
you administer?

1/100 grain = 0.01 grain = 0.6mg

check answer: 0.6 ml????

??! !
Administer 0.5 mg/kg of a drug to a client weighing 79
lbs. The vial supplied contains 10 mg/ml

1. Convert weight first using ratio proportion

2.2 lb = 79 lbs
1 kg x kg x = 35.9 kg
2. Calculate dose by multiplying weight by ordered
dose:
35.9 X 0.5 mg = 17.95 mg
3. Set up ratio proportion
17.95 mg x 1ml = x
10 mg

x=1.795 ml
Think volume and use a 3 ml syringe and round to
the nearest tenth. X= 1.8 ml 174
??! !
Administer heparin 64 units/kg to a client weighing 110
lbs rounding to the nearest 100 units. The vial
supplied contains 10000 units/ml

1. Convert weight first using ratio proportion

2.2 lb = 110 lbs
1 kg x kg x = 50 kg
2. Calculate dose by multiplying weight by ordered
dose:
50 X 64 units = 3200 units (no further rounding
of dose is required)

????
3. Set up ratio proportion

3200 units X 1 ml
10000 units
?????
X= o.32 ml
176
??! !
The nurse works in a NICU
(neonatal intensive care unit).
The doctor orders Digoxin
6mcg/kg/day IV in two divided
doses to be given to one of the
nurse’s patients. The patient
weighs 7 pounds. Calculate the
amount, in mcg, the nurse will
give per dose.

178
• First, convert the infant’s weight into
kilograms from pounds. There are a couple of
formulas to do this. You can divide the
number of pounds by 2.2 or multiply the

????
number of pounds by 0.454.
• 7lbs divided by 2.2 = 3.18kg
• Now calculate the medication to be given to
the patient per day.
• 6mcg x 3.18kg = 19.08mcg/day
???????

• Divide in 2 to get the per-dose amount:

19.08 ÷ 2 = 9.54mcg???????
per dose.

179
??! !
 NCLEX Question
• Nurse Clarisse is teaching a patient
about a newly prescribed drug. What
could cause a geriatric patient to have
difficulty retaining knowledge about
prescribed medications?
A. Decreased plasma drug levels
B. Sensory deficits
C. Lack of family support
D. History of Tourette syndrome
??! !
 NCLEX Question
Before administering the evening dose of a prescribed
medication, the nurse on the evening shift finds an
unlabeled, filled syringe in the patient’s medication
drawer. What should the nurse in charge do?
A. Discard the syringe to avoid a medication error
B. Obtain a label for the syringe from the pharmacy
C. Use the syringe because it looks like it contains the
same medication the nurse was prepared to give
D. Call the day nurse to verify the contents of the
syringe
??! !
 NCLEX Question
• When administering drug therapy to a
male geriatric patient, the nurse must stay
especially alert for adverse effects. Which
factor makes geriatric patients to adverse
drug effects?
A. Faster drug clearance
B. Aging-related physiological changes
C. Increased amount of neurons
D. Enhanced blood flow to the GI tract
??! !
 NCLEX Question
A patient is in the bathroom when the nurse
enters to give a prescribed medication. What
should the nurse in charge do?
A. Leave the medication at the patient’s bedside
B. Tell the patient to be sure to take the
medication. And then leave it at the bedside.
C. Return shortly to the patient’s room and
remain there until the patient takes the
medication.
D. Wait for the patient to return to bed, and
then leave the medication at the bedside
??! !
 NCLEX Question
The physician orders heparin, 7,500 units, to be
administered subcutaneously every 6 hours. The
vial reads 10,000 units per milliliter. The nurse
should anticipate giving how much heparin for
each dose?
A. ¼ ml
B. ½ ml
C. ¾ ml
D. 1 ¼ ml
??! !
 NCLEX Question
Which human element considered by the
nurse in charge during assessment can
affect drug administration?
A. The patient’s ability to recover
B. The patient’s occupational hazards
C. The patient’s socioeconomic status
D. The patient’s cognitive abilities
??! !
 NCLEX Question
The physician prescribes 250 mg of a drug.
The drug vial reads 500 mg/ml. how
much of the drug should the nurse give?
A. 2 ml
B. 1 ml

C. ½ ml
D. ¼ ml
??! !
 NCLEX Question
• When teaching a female patient how to
take a sublingual tablet, the nurse should
instruct the patient to place the table on
the:
A. Top of the tongue

B. Roof of the mouth

C. Floor of the mouth