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A nurse is preparing to administer cefotaxime 100 mg/kg /IV bolus divided in equal doses every 8 hr to a toddler who weighs 26.4 lb. Available is cefotaxime injection 300 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Answer and Explanation

The Correct Answer is ["1.3"]

Order: Cefotaxime 100 mg/kg IV bolus, divided into equal doses every 8 hours

Toddler Weight: 26.4 lb

Available Solution: Cefotaxime injection 300 mg/mL

Desired Dose: mL per dose

Step 1: Convert Toddler Weight to Kilograms (kg)

1 kg = 2.2 lbs

Toddler Weight in kg: 26.4 lbs / 2.2 lbs/kg = 12 kg

Step 2: Calculate the Total Daily Dose

Ordered Dose: 100 mg/kg

Toddler Weight: 12 kg

Total Daily Dose: 100 mg/kg x 12 kg = 1200 mg

Step 3: Determine the Number of Doses per Day

Doses are given every 8 hours.

Hours in a Day: 24 hours

Number of Doses: 24 hours / 8 hours/dose = 3 doses

Step 4: Calculate the Dose per Administration

Total Daily Dose: 1200 mg

Number of Doses: 3

Dose per Administration: 1200 mg / 3 doses = 400 mg/dose

Step 5: Calculate the Volume to Administer per Dose

Dose per Administration: 400 mg

Concentration: 300 mg/mL

Volume to Administer: 400 mg / 300 mg/mL = 1.333 mL

Step 6: Round to the Nearest Tenth

The calculated volume is 1.333 mL.

Rounded to the nearest tenth: 1.3 mL

Answer: 1.3 mL

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Correct Answer is A

Explanation

A) Digoxin 25 mcg/kg via IV bolus every 8 hr x 2 doses: This prescription should be clarified. Digoxin is typically prescribed in micrograms (mcg), but the dose of 25 mcg/kg is very high and could lead to toxicity. For a client with heart failure, the usual dosage for digoxin is 0.125–0.25 mg daily, not 25 mcg/kg per dose, which is excessive and potentially dangerous. Therefore, this order should be clarified with the provider.

B) Dobutamine 15 mcg/kg via continuous IV infusion: This is an appropriate dose for dobutamine, which is commonly used in heart failure for its inotropic effects. Dobutamine is typically dosed between 2–20 mcg/kg/min for continuous IV infusion, so 15 mcg/kg/min is within a safe range.

C) Bumetanide 0.1 mg/kg via IV bolus every 12 hr: Bumetanide is a loop diuretic used in heart failure, and the prescribed dose of 0.1 mg/kg every 12 hours is an appropriate dosing regimen for this medication. It is within the typical dosing range, and the interval is also reasonable for managing fluid overload in heart failure.

D) Dextrose 5% in 0.45% sodium chloride with 20 mEq KCl via continuous IV infusion at 50 mL/hr: This IV fluid prescription is generally appropriate. The combination of dextrose and sodium chloride with potassium is commonly used to maintain hydration and electrolyte balance in clients, particularly in the context of heart failure management. The infusion rate of 50 mL/hr is a typical rate for continuous IV infusions.

Correct Answer is ["0.25"]

Explanation

Order: Filgrastim 250 mcg (micrograms)

Desired Unit: mg (milligrams)

Step 1: Conversion Factor

We need to know the relationship between micrograms (mcg) and milligrams (mg).

1 mg = 1000 mcg

Step 2: Set Up the Conversion

We want to convert 250 mcg to mg. To do this, we'll divide the given dose (250 mcg) by the conversion factor (1000 mcg/mg):

250 mcg x (1 mg / 1000 mcg)

Step 3: Perform the Calculation

Multiply the numerators: 250 x 1 = 250

Multiply the denominators: 1 x 1000 = 1000

Divide the result: 250 / 1000 = 0.25

Step 4: Answer with Correct Units and Rounding

The result is 0.25 mg.

The problem asks us to round to the nearest hundredth, which we already have (0.25).

The problem also states to use a leading zero if it applies (which it does) and not use a

trailing zero (which we don't have).

Answer: 0.25 mg

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medication orders for a client who has heart failure. Which of the following prescriptions should the nurse clarify with the provider

Correct Answer is A

Explanation

A nurse is preparing to administer filgrastim 250 mcg, subcutaneous. How many mg should the nurse administer? (Round the answer to the nearest hundredth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["0.25"]

Explanation

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A nurse is preparing to administer methylprednisolone 250 mg IV to a client. Which of the following information should the nurse interpret from the medication label?

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