Chapter 5, Liquids for Injection

Format:  Multiple Choice

Chapter:  5

Client Needs:  Physiological Integrity: Pharmacological and Parenteral Therapies

Cognitive Level:  Analyze

Difficulty:  Moderate

Page and Header:  142, Syringes and Rounding

Integrated Process:  Teaching/Learning

Objective:  1

1. The physician ordered 100 mg of Cleocin (clindamycin) IM q6h. The drug is available in a vial labeled 300 mg/2 mL. Using a 1-mL syringe and rounding off to the nearest tenth, how many milliliters of Cleocin would the nurse give for each dose? Use the formula method to calculate the dosage.

A) 0.4

B) 0.5

C) 0.6

D) 0.7

Difficulty:  Moderate

Page and Header:  142, Syringes and Rounding

Integrated Process:  Teaching/Learning

Objective:  1

2. The physician ordered 50 mg of gentamicin IM three times daily. The drug is available in a vial labeled 40 mg/mL. Using a 3-mL syringe and rounding off to the nearest tenth, how many milliliters of gentamicin would the nurse give for each dose? Use proportion (ratios) to calculate the dosage.

A) 1.1

B) 1.2

C) 1.3

D) 1.5

Difficulty:  Difficult

Page and Header:  142, Syringes and Rounding

Integrated Process:  Teaching/Learning

Objective:  1

3. The patient/client is to receive Sandostatin 0.05 mg subcutaneously daily. The medication is available as Sandostatin 100 mcg/1 mL. Which syringe should the nurse use to administer the medication? Use proportion (fractions) to calculate the dosage.

A) 3 mL

B) Insulin U-50

C) Insulin U-100

D) 1-mL precision

Difficulty:  Moderate

Page and Header:  142, Syringes and Rounding

Integrated Process:  Teaching/Learning

Objective:  1

4. The patient/client is to receive Valium (diazepam) 8 mg IM every 4 hours prn for agitation. The medication is available as Valium (diazepam) 5 mg/mL. Which syringe should the nurse use to administer the medication? Use dimensional analysis to calculate the dosage.

A) 3 mL

B) Insulin U-50

C) Insulin U-100

D) 1-mL precision

Difficulty:  Difficult

Page and Header:  142, Syringes and Rounding

Integrated Process:  Teaching/Learning

Objective:  1

5. The physician ordered heparin sodium 3000 units subcutaneously every 12 hours. The medication is available as 5000 units/mL. Select the syringe to use and the amount of heparin to give. Use the formula method to calculate the dosage.

A) 0.3 mL; 1-mL syringe

B) 0.6 mL; 1-mL syringe

C) 0.3 mL; Insulin U-50

D) 0.6 mL; Insulin U-100

Difficulty:  Difficult

Page and Header:  156, Special Types of Problems in Injections From a Liquid

Integrated Process:  Teaching/Learning

Objective:  2

6. The physician ordered 1.5 mg of subcutaneous epinephrine stat. The medication is available in an ampule labeled 1:1000. How many milliliters should the nurse give?

A) 0.5

B) 1

C) 1.5

D) 2

Difficulty:  Difficult

Page and Header:  156, Special Types of Problems in Injections From a Liquid

Integrated Process:  Teaching/Learning

Objective:  2

7. The physician ordered 10 mg of subcutaneous lidocaine. The medication is available in a multidose vial labeled lidocaine 2%. How many milliliters should the nurse prepare?

A) 0.5

B) 1

C) 1.5

D) 2

Difficulty:  Moderate

Page and Header:  156, Special Types of Problems in Injections From a Liquid

Integrated Process:  Teaching/Learning

Objective:  2

8. The patient/client is to receive morphine sulfate 4 mg IV stat. The medication is available as morphine sulfate 10 mg/mL. How many milliliters of medication would the patient/client receive?

A) 0.04

B) 0.4

C) 0.45

D) 0.5

Difficulty:  Difficult

Page and Header:  156, Special Types of Problems in Injections From a Liquid

Integrated Process:  Teaching/Learning

Objective:  2

9. The patient/client is to receive Dilantin (phenytoin sodium) 300 mg IV daily. The medication is available as Dilantin (phenytoin sodium) 250 mg/5 mL. How many milliliters of medication would the patient/client receive?

A) 5.5

B) 6

C) 6.5

D) 7

Difficulty:  Difficult

Page and Header:  156, Special Types of Problems in Injections From a Liquid

Integrated Process:  Teaching/Learning

Objective:  2

10. The patient/client is to receive Tigan (trimethobenzamide hydrochloride) 150 mg IM stat. The medication is available as Tigan (trimethobenzamide hydrochloride) 100 mg/mL. How many milliliters of medication would the patient/client receive?

A) 0.5

B) 1

C) 1.5

D) 2

Difficulty:  Difficult

Page and Header:  156, Special Types of Problems in Injections From a Liquid

Integrated Process:  Teaching/Learning

Objective:  2

11. The patient/client is to receive Nembutal sodium (pentobarbital sodium) 120 mg IM at bedtime prn. The medication is available as Nembutal sodium (pentobarbital sodium) 50 mg/mL. How many milliliters of medication would the patient/client receive?

A) 1.2

B) 1.4

C) 2.4

D) 2.8

Difficulty:  Difficult

Page and Header:  156, Special Types of Problems in Injections From a Liquid

Integrated Process:  Teaching/Learning

Objective:  2

12. The patient/client is to receive AquaMEPHYTON (phytonadione) 5 mg subcutaneously every day for 3 days. The medication is available as AquaMEPHYTON (phytonadione) 10 mg/mL. How many milliliters should the nurse give each day?

A) 0.25

B) 0.5

C) 0.75

D) 1

Difficulty:  Moderate

Page and Header:  156, Special Types of Problems in Injections From a Liquid

Integrated Process:  Teaching/Learning

Objective:  2

13. The patient/client is to receive Compazine (prochlorperazine) 10 mg IM every 4 hours prn for nausea and vomiting. The medication is available as Compazine (prochlorperazine) 5 mg/mL. How many milliliters should the nurse administer?

A) 0.5

B) 1

C) 1.5

D) 2

Difficulty:  Moderate

Page and Header:  164, Injections From Powders

Integrated Process:  Teaching/Learning

Objective:  3

14. The directions for reconstitution of ampicillin sodium for injection are on the drug label. Directions read: “For IM use, add 3.5 mL sterile water for injection. Resulting solution contains 250 mg ampicillin sodium per mL. The vial contains ampicillin sodium equivalent to 1 gram. Usual adult dosage of ampicillin is 250 mg–500 mg IM every 6 hours.” How much diluent is added to the vial to prepare the medication for IM use?

A) 1 mL

B) 3.5 mL

C) 250 mg/mL

D) 500 mg/mL

Difficulty:  Moderate

Page and Header:  164, Injections From Powders

Integrated Process:  Teaching/Learning

Objective:  3

15. The directions for reconstitution of oxacillin sodium for injection are on the drug label. Directions read: “For IM use, add 5.7 mL sterile water for injection. Resulting solution contains 250 mg oxacillin sodium per 1.5 mL. The vial contains oxacillin sodium equivalent to 1 gram. Usual adult dosage of oxacillin sodium is 250 mg–500 mg IM every 4 to 6 hours.” What is the final concentration of the prepared oxacillin solution for IM administration?

A) 50 mg/1.5 mL

B) 125 mg/5.7 mL

C) 250 mg/1.5 mL

D) 500 mg/1.5 mL

Difficulty:  Difficult

Page and Header:  164, Injections From Powders

Integrated Process:  Teaching/Learning

Objective:  3

16. The directions for reconstitution of oxacillin sodium for injection are on the drug label. Directions read: “For IM use, add 5.7 mL sterile water for injection. Resulting solution contains 250 mg oxacillin sodium per 1.5 mL. The vial contains oxacillin sodium equivalent to 1 gram. Usual adult dosage of oxacillin sodium is 250 mg–500 mg IM every 4 to 6 hours.” The patient/client is to receive 400 mg IM every 6 hours. How many milliliters would the nurse administer?

A) 1.7

B) 2.1

C) 2.4

D) 5.7

Difficulty:  Difficult

Page and Header:  164, Injections From Powders

Integrated Process:  Teaching/Learning

Objective:  3

17. The directions for reconstitution of mezlocillin IV injection read: “For IV use, reconstitute with 30 mL sterile water for injection. Each 30 mL of reconstituted solution will contain 3 grams of mezlocillin.” The patient/client is to receive 1.5 g of mezlocillin IV every 6 hours. How many milliliters would the nurse administer?

A) 1.5

B) 3

C) 15

D) 30

Difficulty:  Moderate

Page and Header:  164, Injections From Powders

Integrated Process:  Teaching/Learning

Objective:  3

18. The directions for reconstitution of a 5,000,000 unit vial of Pfizerpen (penicillin G potassium) reads: “For IM reconstitution, add sterile water for injection using these mL diluent units, per mL of solution:

18 mL/250,000

8 mL/500,000

3 mL/1,000,000”

The patient/client is to receive Pfizerpen (penicillin G potassium) 500,000 units IM now. What would be the best amount of diluent to add to the powder for reconstitution for IM use?

A) 3

B) 8

C) 18

D) 23

Difficulty:  Moderate

Page and Header:  176, Insulin Injections

Integrated Process:  Teaching/Learning

Objective:  4

19. The patient/client is to receive Humulin R 15 units subcutaneously daily at 7:30 am. Which syringe should the nurse use to administer the medication?

A) 3 mL

B) Insulin 50 unit

C) Insulin 100 unit

D) 1-mL precision

Difficulty:  Moderate

Page and Header:  176, Insulin Injections

Integrated Process:  Teaching/Learning

Objective:  4

20. The patient/client is to receive Humulin NPH 56 units subcutaneously every morning hour before breakfast. Which dosage and syringe is correct for the nurse to administer the medication?

A) 1-mL syringe drawn up with Humulin NPH at the 0.56-mL mark

B) 3-mL syringe drawn up with Humulin NPH at the 0.56-mL mark

C) Insulin 100-unit syringe drawn up with Humulin NPH at the 56-unit mark

D) Insulin 50-unit syringe drawn up with Humulin NPH at the 50-unit mark

Difficulty:  Moderate

Page and Header:  176, Insulin Injections

Integrated Process:  Teaching/Learning

Objective:  4

21. A patient/client receives Humalog 7 units subcutaneously daily at 7:30 am. The nurse knows that this type of insulin will reach its peak effectiveness at which time?

A) 8:30 am

B) 9:30 am

C) 10:30 am

D) 12:30 pm

Difficulty:  Moderate

Page and Header:  176, Insulin Injections

Integrated Process:  Teaching/Learning

Objective:  4

22. The healthcare provider has ordered the patient/client to receive insulin IV. Which insulin would the nurse have to use?

A) Humalog

B) Lantus

C) NPH

D) Regular

Difficulty:  Difficult

Page and Header:  176, Insulin Injections

Integrated Process:  Teaching/Learning

Objective:  4

23. The nurse has to administer Humulin R 18 units and NPH 35 units subcutaneous daily at 7:30 am. What is the correct order for drawing up these medications?

1) Inject into the Humulin R vial 18 units of air

2) Inject into the NPH vial 35 units of air

3) Withdraw 18 units of Humulin R insulin

4) Withdraw 35 units of NPH insulin

A) 1, 2, 3, 4

B) 1, 2, 4, 3

C) 2, 1, 3, 4

D) 2, 1, 4, 3

Difficulty:  Difficult

Page and Header:  176, Insulin Injections

Integrated Process:  Teaching/Learning

Objective:  4

24. A patient/client has a sliding scale for insulin dosage. The order is for Humulin R every 6 hours as follows. (Note: “BG” is used for blood glucose.) The physician's order reads:

Accucheck every 6 hours

BG 0–180 mg/dL no coverage

BG 181 mg/dL–240 mg/dL 2 units subcutaneously

BG 241 mg/dL–300 mg/dL 4 units subcutaneously

BG 301 mg/dL–400 mg/dL 6 units subcutaneously

BG >400 mg 8 units subcutaneously and call the physician

At 11 am, the patient/client's Accucheck reading was 242 mg/dL. How many units of Humulin R insulin would the patient/client receive?

A) 2 units subcutaneously

B) 4 units subcutaneously

C) 6 units subcutaneously

D) 8 units subcutaneously and call the physician

Difficulty:  Difficult

Page and Header:  176, Insulin Injections

Integrated Process:  Teaching/Learning

Objective:  4

25. A patient/client has a sliding scale for insulin dosage. The order is for Humulin R every 6 hours as follows. (Note: “BG” is used for blood glucose.) The physician's order reads:

Accucheck every 6 hours

BG 0–80 mg/dL give 1 amp of D50 and call healthcare provider

BG 81–100 mg/dL 0 units subcutaneously

BG 101–150 mg/dL 2 units subcutaneously

BG 151–200 mg/dL 3 units subcutaneously

BG 201–250 mg/dL 5 units subcutaneously

BG 251–300 mg/dL 8 units subcutaneously and call healthcare provider

BG >300, call healthcare provider

At 6 am, the patient/client's Accucheck reading was 79 mg/dL. What would be the correct actions by the nurse?

A) Call the healthcare provider first

B) Give 1 amp of D50 and call the healthcare provider

C) Give 2 units of Humulin R insulin

D) Give 8 units of Humulin R insulin and call the healthcare provider

Difficulty:  Moderate

Page and Header:  142, Syringes and Rounding

Integrated Process:  Teaching/Learning

Objective:  1

26. The patient/client is to receive Stelazine (trifluoperazine HCL) 3 mg IM every 6 hours prn. The medication is available as Stelazine (trifluoperazine HCL) 2 mg/mL. Which syringe should the nurse use to administer the medication? Use dimensional analysis to calculate the dosage.

A) 3 mL

B) Insulin U-50

C) Insulin U-100

D) 1-mL precision

Difficulty:  Difficult

Page and Header:  156, Special Types of Problems in Injections From a Liquid

Integrated Process:  Teaching/Learning

Objective:  2

27. The patient/client is to receive Demerol (meperidine) 50 mg IM stat. The medication is available as Demerol (meperidine) 100 mg/mL. How many milliliters of medication would the patient/client receive?

A) 0.5

B) 1

C) 1.5

D) 2

Difficulty:  Moderate

Page and Header:  164, Injections From Powders

Integrated Process:  Teaching/Learning

Objective:  3

28. The patient/client is to receive 250 mg of Ancef, IM, every 12 hours. The directions for reconstitution of Ancef (cefazolin) for injection are on the drug label in the form of a table. Directions read: “Use 2 mL of sterile water as a diluent. Resulting solution contains approximately 125 mg/mL with an approximate available volume of 2 mL.” What is the final concentration of the prepared cefazolin solution for IM administration?

A) 50 mg/1.5 mL

B) 100 mg/1.5 mL

C) 125 mg/ mL

D) 150 mg/ mL

Difficulty:  Difficult

Page and Header:  164, Injections From Powders

Integrated Process:  Teaching/Learning

Objective:  3

29. The directions for reconstitution of a 500 mg vial of Omnipen (ampicillin sodium) in powder format for injection reads: “Reconstitute with 1.8 mL of sterile water for 500 mg. Each mL of reconstituted solution will contain 250 mg of Omnipen.” The patient/client is to receive 500 mg of Omnipen every 6 hours. How many milliliters would the nurse administer?

A) 0.5

B) 1

C) 15

D) 2

Difficulty:  Moderate

Page and Header:  176, Insulin Injections

Integrated Process:  Teaching/Learning

Objective:  4

30. A patient/client receives a combination of 18 units of Regular insulin and 20 units of NPH or Lente insulin, subcutaneously daily at 8:00 am. The nurse knows that this combination of insulin will have an onset at what time?

A) 8:30 am

B) 9:00 am

C) 9:30 am

D) 10:00 am