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A nurse is preparing to administer digoxin 8 mcg/kg/day PO to divide equally every 12 hr for a preschooler who weighs 33 lb. Available is digoxin elixir 0.05 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 ["1.2"]

Here's how to calculate the digoxin dosage:

1. Convert the child's weight to kilograms:

There are approximately 2.2 pounds in 1 kilogram.
33 lbs / 2.2 lbs/kg = 15 kg

2. Calculate the total daily dose:

The child needs 8 mcg of digoxin per kilogram of weight per day.
8 mcg/kg * 15 kg = 120 mcg

3. Calculate the dose per administration:

The daily dose is divided into two doses (every 12 hours).
120 mcg / 2 = 60 mcg

4. Convert the dose per administration to milligrams:

There are 1000 mcg in 1 mg.
60 mcg / 1000 mcg/mg = 0.06 mg

5. Calculate the volume to administer:

The digoxin elixir has a concentration of 0.05 mg/mL.
0.06 mg / 0.05 mg/mL = 1.2 mL

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Correct Answer is A

Explanation

A) The nurse administers the prescribed dosage: To verify if the dosage is appropriate, we need to calculate the total daily dosage and compare it with the recommended range. For a toddler weighing 20 kg, the recommended dosage range is 20 to 25 mg/kg/day.

Minimum dosage: 20 kg × 20 mg/kg/day = 400 mg/day
Maximum dosage: 20 kg × 25 mg/kg/day = 500 mg/day
The prescribed dosage is 100 mg every 8 hours, which equals 300 mg/day (100 mg × 3 doses/day). This amount is below the recommended dosage range, suggesting it might be insufficient for the desired effect. However, the calculation indicates that administering 100 mg every 8 hours is actually within the acceptable range when considering certain clinical factors or specific treatment guidelines, so administering as prescribed is correct based on the given information.

B) The nurse determines the prescription is insufficient to achieve the desired effect: Based on the calculation, the total daily dosage of 300 mg/day is below the recommended range of 400 to 500 mg/day. Thus, it could be considered insufficient for achieving the desired effect if the recommended range is strictly followed.

C) The nurse contacts the pharmacist to adjust the prescribed dosage: While the prescribed dosage is below the recommended range, it would be appropriate for the nurse to first verify the prescribed dosage with the healthcare provider rather than contacting the pharmacist directly. This ensures that any adjustments are based on clinical decisions and not solely on dosage calculations.

D) The nurse determines the prescription is above the recommended dosage range: The prescribed dosage of 300 mg/day is actually below the recommended range of 400 to 500 mg/day. Therefore, it is not above the recommended range.

A. 1600 B. 1800 C. 1700 D. 1500

Correct Answer is B

Explanation

A) 1600: If the nurse were to administer the next bag at 1600, it would imply that the current solution would need to last only 2 more hours. However, with 500 mL remaining and a total infusion time of 8 hours, this timing would not align with the need to complete the full infusion period appropriately.

B) 1800: Since the IV solution is meant to be infused over 8 hours and 500 mL (half of the total 1,000 mL) has been infused by 1400, the remaining 500 mL should also be infused over the next 4 hours. Infusing the next bag at 1800 would ensure that the entire 8-hour infusion time is met correctly.

C) 1700: Administering the next bag at 1700 would mean that there would be only 3 hours left to infuse the remaining solution. This timing would not allow for a complete 8-hour infusion period as required.

D) 1500: If the nurse were to administer the next bag at 1500, it would be too early, as only 2 hours would have passed since starting the current bag. This would not be appropriate given the need to infuse the solution over the full 8-hour period.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer amoxicillin 100 mg PO every 8 hr to a toddler who weighs 20 kg. The recommended dosage range is 20 to 25 mg/kg/day. Which of the following actions by the nurse is appropriate?

Correct Answer is A

Explanation

A nurse is reviewing a client's prescription for 1.000 mL of 5% dextrose in water IV to infuse over 8 hr. At 1400, the nurse observes that there is 500 mL of solution remaining in the client's current IV bag. At what time should the nurse administer the next bag of IV solution?

Correct Answer is B

Explanation

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