HESI Practice Test Assessment PDF

Return to Overview Practice Test Assessment Performance You're learning! 89% Let's review your results from 9/17/2024 at 11:39 am EST Correct Incorrect...

Return to Overview Practice Test Assessment Performance You're learning! 89% Let's review your results from 9/17/2024 at 11:39 am EST Correct Incorrect Correct 24 An IV seondary infusion of 0.9% normal saline 100 ml with inamrinone (Inocor) 0.1 grams/100 ml is prescribed for client with heart failure. The medication is to be delivered at a rate of 400 mcg/minute. The nurse should https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 1 of 30 :  program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Rationale First calculate the number of mcg/hour: 400 mcg x 60 minutes = 24000 mcg/hour Next calculate the number of ml/hour needed to administer 24,000 mcg/hour: 100,000 mcg: 100ml :: 24,000 mcg : X 100,000/24,000 :: 100/X 100,000X = 2,400,000 X = 24 ml/hour 125 The healthcare provider prescribes a continuous intravenous infusion of Dextrose 5% in 0.45% sodium chloride ((D51/2 NS) with KCl 20 mEq / 1000 ml to be infused over 8 hours. How many ml/hour should the nurse program the infusion pump? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Rationale Using the formula, volume/time: https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 2 of 30 :  1000 ml/8 hours = 125 ml/hour 100 The healthcare provider prescribes a secondary infusion of Dextrose 5% in Water (D5W) 50 mg IV with magnesium sulfate 4 gram/50 mI to be infused over 30 minutes for a client with preeclampsia. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Rationale Using ratio and proportion to calculate the rate of infusion for ml/hour: 50 ml: 30 minutes :: X ml : 60 minutes 50 ml / X ml :: 30 min / 60 minutes 3000 = 30X X = 100 ml/hour 11.3 A client with cardiogenic shock who weighs 220 pounds is receiving a solution of Dextrose 5% in Water (D5W) 250 ml with dopamine 400 mg at the rate of 3 mcg/kg/minute. https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 3 of 30 :  The nurse should set the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Rationale First, convert pounds to kg, 220 lb : X = 2.2 lb : 1 kg = 100 kg Next, calculate the dosage per minute, 3 mcg/kg/min x 100 kg = 300 mcg/minute Convert mcg/min to mcg/hour, 300 mcg/min x 60 min=18,000 mcg/hour and Convert mcg/hour to mg/hour, 18,000 mcg/hr = 18.0 mg/hour Calculate the rate, 400 mg : 250 ml = 18 mg : X ml 400X = 4500 X = 1.25 = 11.3 ml. So, 18 mg/11.3 ml should be infused at 11.3 ml/hour. What action should the nurse implement when accessing an implanted infusion port for a client who receives long term IV medications? Cleanse the site with iodine solution. Insert a Huber-point needle into the port. Flush tubing with 5 ml of normal saline. Place a sterile dressing over the port. Rationale An implanted infusion port needs to be accessed using a Huber-point needle (non- coring) to be prevent damage to the self-sealing septum of the port. The other actions are not necessary when accessing an implanted infusion port. https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 4 of 30 :  The healthcare provider prescribes furosemide (Lasix) 15 mg IV STAT for a client. On hand is an ampoule labeled, furosemide (Lasix) 20 mg/2ml. How many milliliters should the nurse administer? 1 ml. 1.5 ml. 1.75 ml. 2 ml. Rationale The correct calculation: Dosage on hand/amount on hand = Dosage desired/X amount. 20mg : 2ml = 15mg : X 20X = 30 X = 30/20 = 1 1/2 or 1.5 ml 1.2 A client who has AIDS is receiving octreotide (Sandostatin) 1,200 mcg by subcutaneous injection every day for symptoms of diarrhea. Octreotide is available for injection in 1 mg/ml vials. How many ml should the nurse administer? (Enter the numeric value only. If rounding is required, round to the nearest tenth.) Rationale https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 5 of 30 :  First, to convert micrograms to milligrams, divide the number of micrograms by 1000: 1,200/1000 = 1.2 mg. Using the Desired/Have available formula: 1.2 mg/1 mg x 1 ml = 1.2 ml Heparin 20,000 units in 500 ml D5W at 50 ml/hour has been infusing for 5.5 hours. How many units of heparin has the client received? 11,000 units. 13,000 units. 15,000 units. 17,000 units. Rationale The correct calculation: 20,000 units/500 ml = 40 units (the amount of units in one ml of fluid). 40 units/ml x 50 ml/hr = 2,000 units/hour (1,000 units in 1/2 hour). 5.5 x 2,000 = 11,000 units. OR, multiply 5 x 2,000 and add the 1/2 hour amount of 1,000 to reach the same conclusion = 11,000 units. 83 A client receives a prescription for an intravenous infusion of Dextrose 5% in 0.45% Sodium chloride (D51/2 NS) 500 ml to be infused over 6 hours. The nurse should program the infusion pump to deliver how many ml/hour? (Enter https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 6 of 30 :  numeric value only. If rounding is required, round to the nearest whole number.) Rationale Calculate using Volume/Time: 500 ml/6 hours = 83.3 ml/hour = 83 ml/hour 125 The nurse is administering an intravenous solution 250 ml to be infused over 2 hours. How many ml/hour should the nurse program the infusion pump? (Enter numeric value only, whole number.) Rationale 250 ml : 2 hours = X ml : 1 hour 2X = 250 X = 125 ml/hour 6 An IV infusion of Dextrose 5% in normal saline (D5NS) 1,000 ml with oxytocin (Pitocin) 20 units is prescibed for a client to control postpartum bleeding. The solution is to be administered at a rate of 2 mu/minute. How many ml/hour should the nurse program the infusion pump? (Enter numeric https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 7 of 30 :  value only. If rounding is required, round to the nearest whole number.) Rationale First calculate the number of units/hour.0.002 units/minute x 60 minutes = 0.12 units/hour Next calculate the number of ml/hour needed to administer 0.12 units/hour. 20 units : 1,000 ml :: 0.12 units : X 20 / 0.12 :: 1,000/X 20X : 120X = 6 150 A client receives a prescription for a dose of medication 300 mg IV every 6 hours. The preparation arrives from the pharmacy diluted in a secondary infusion of 0.9% Sodium Chloride (NaCl) 50 ml. The nurse plans to administer the dose over 20 minutes. How many ml/hour should the nurse program the infusion pump to deliver the secondary infusion? (Enter the numeric value only, rounded to a whole number.) Rationale The infusion rate is calculated as a ratio proportion problem. 50 ml : 20 minutes :: X ml : 60 minutes 20X = 3000 https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 8 of 30 :  3000/20 = 150 ml/hour 120 A loading dose of acetylcysteine (Mucomyst) 8 grams, which is available as a 20% solution (200 mg acetylcysteine per ml) is prescribed by nasogastric tube for a client with acetaminophen toxicity. How many ml of diluent should be added to the medication to obtain a 1:4 concentration? (Enter the numerical value only. If rounding is required, round to the whole number.) Rationale 8 grams = 8,000 mg prescribed dose. Using the formula, D/H x Q, 8,000 mg / 200 mg x 1 ml = 40 ml of the 20% solution. Dilute the 40 ml to a 1:4 concentration for administration using ratio and proportion, 1 : 4 solution :: 40 ml : X X= 160 ml total volume to administer. Subtract total volume of 160 ml - 40 ml of 20% concentration = 120 ml diluent is added to obtain a 1:4 concentration. 100 A client scheduled for surgery is to receive an IV infusion of 0.9% sodium chloride with prochlorperazine edisylate (Compazine) 10 mg/50 ml over 30 minutes. The nurse https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 9 of 30 :  should program the infusion pump to deliver how many ml/hour? (Enter numeric value only, as a whole number.) Rationale Calculate: 50 ml : 30 minutes :: X ml : 60 minutes 50/X :: 30/60 3000 = 15XX = 100 ml 167 The healthcare provider prescribes an IV infusion of 0.9% sodium chloride 500 ml with potassium chloride (KCl) 40 mEq to infuse over 3 hours for a client with hypokalemia. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Rationale To determine ml/hour: 500 ml : 3 hours :: X ml : 1 hour 500/X :: 3/1 500 = 3X X = 166.66 (rounded to)= 167 ml/hour https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 10 of 30 :  2.3 A client with Mycobacterium avium complex (MAC) is receiving an infusion of 5 % dextrose in water (D5W)with amikacin (Amikin) 0.572 grams/100 ml every 12 hours. The nurse prepares the dose of amikacin using a vial labeled, " 250 mg/ml." How many ml should the nurse add to the infusion? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Rationale First convert gram to milligram:1 gm = 1000 mg so 0.572 gram x 1000 = 572 mg Next use the formula D/H x Q:572/250 x 1 = 2.288 (rounded to) 2.3 ml 18 A client is receiving 5% Dextrose Injection 500 ml IV with Heparin Sodium 25,000 Units at 1,000 unit/hour per protocol for acute coronary syndrome (ACS). The client's partial thromboplastin time (PTT) is 76 seconds. Based on the ACS protocol, the infusion should be decreased by 100 units/hour for a PTT between 71 to 80 seconds. The nurse should program the infusion pump to deliver how many ml/hour? https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 11 of 30 :  (Enter numeric value only, whole number.) Rationale Adjust the infusion to 900 units/hour (1,000 units/hour minus 100 units/hour per protocol). Using the formula, D/H x Q, 900 units/1 hour divided by 25,000 units x 500 ml = 90/5= 18 ml/hour 2 A male client receives a prescription for ondansetron hydrochloride (Zofran) 4 mg IV to prevent postoperative nausea after an inguinal hernia repair. The medication is available in 2 mg/ml. How many ml should the nurse administer? (Enter numeric value only, whole number). Rationale Use ratio and proportion, 4 mg : X ml = 2 mg : 1 ml 2X = 4 X=2 The nurse prepares 5% Dextrose Injection, USP, 1,000 ml IV to be infused over 8 hours. The infusion set delivers 10 drops per milliliter. The nurse should regulate the IV to administer how many drops per minute? (Round to nearest whole number.) 80. https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 12 of 30 :  8. 21. 25. Rationale The accepted formula for figuring drops per minute is: amount to be infused in one hour x drop factor/time for infusion (min ) = drops per minute. Using this formula: 1,000/8 hours = 125 ml/ hour 125 x 10 (drip factor) = 1,250 drops in one hour. 1,250/ 60 (number of minutes in one hour) = 20.8 = 21 gtt/minute. 12 A client receives a prescription for inamrinone (Inocor) 0.75 mg/kg IV bolus to be delivered over 3 minutes. The client weighs 80 kg. Inamrinone is available for injection, 100 mg/20 ml. How many ml of inamrinone should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Rationale First calculate the mg/kg dosage needed:0.75 mg x 80 kg = 60 mg needed Then calculate: Desired / Have x ml 60 mg / 100 mg x 20 ml = 12 ml https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 13 of 30 :  11.3 A client who had mitral valve replacement surgery receives a prescription for Dextrose 5% in Water (D5W) 250 ml with dobutamine 0.5 grams for IV infusion at a rate of 5 mcg/kg/minute. The client weighs 75 kg. The nurse should program the infusion pump to deliver how many ml/hr? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Rationale First calculate the number of mcg/kg/minute: 5 x 75 = 375 mcg/minute Calculate the number of mcg/hour: 375 x 60 minutes = 22,500 mcg/hour Next calculate the number of ml/hour needed to administer 22,500 mcg/hour: 500,000 mcg : 250 ml :: 22,500 mcg/ X ml 500,000X = 5,625,000 X = 11.25 (rounded to 11.3 ml/hour 95 The nurse is preparing the change-of-shift report for a client who has a 265 ml secondary infusion that was started 2 hours ago at a rate of 85 ml/hour via an infusion pump. The nurse should report that how many ml remain to be infused by the on-coming nurse? (Enter numeric value only.) https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 14 of 30 :  Rationale 85 ml x 2 hours = 170 ml has infused. 265 ml (total amount to be infused) - 170 ml (amount infused) = 95 ml remain to be infused. The nurse is caring for a client who is receiving 24-hour total parenteral nutrition (TPN) via a central line at 54 ml/hr. When initially assessing the client, the nurse notes that the TPN solution has run out and the next TPN solution is not available. What immediate action should the nurse take? Infuse normal saline at a keep vein open rate. Discontinue the IV and flush the port with heparin. Infuse 10% dextrose and water at 54 ml/hour. Obtain a stat blood glucose level and notify the healthcare provider. Rationale TPN should be discontinued gradually to allow the client to adjust to decreased levels of glucose. Administering 10% dextrose in water at the prescribed rate should reduce the client's risk of hypoglycemia until the next TPN solution is available. The other actions are not indicated. A client who has been NPO for 3 days is receiving an infusion of Dextrose 5% in 0.45% Sodium chloride (D51/2 NS) with potassium chloride (KCl) 20 mEq at 83 ml/hour. The client's 8- hour urine output is 400 ml, blood urea nitrogen (BUN) is 15 mg/dl (5.355 mmol/L), lungs are clear bilaterally, serum https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 15 of 30 :  glucose is 110 mg/dl ( 6.1 mmol/L), and serum potassium is 3.7 mEq/L (3.7 mmol/L). Which action should the nurse implement? Notify healthcare provider and request to change the IV infusion to hypertonic D10W. Decrease in the infusion rate of the current IV and report to the healthcare provider. Document in the medical record that these normal findings are expected outcomes. Obtain potassium chloride 20 mEq in anticipation of a prescription to add to present IV. Rationale The results are all within normal range (BUN 10 to 20 mg/dl or 3.6-7.1 mmol/L (SI units), serum glucose 70 to 110 mg/dl or less than 6.1 mmol/L (SI), and serum potassium 3.5 to 5.0 mEq/L or 3.5-5.0 mmol/L (SI units). The other actions are not indicated. 100 A client who weights 176 pounds is receiving an IV infusion with esmolol hydrochloride (Brevibloc) at 48 ml/hour. The IV solution is labeled with the concentration of Brevibloc 10 mg/ml. How many mcg/kg/minute is the client receiving? (Enter numeric value only. Round to nearest whole number.) https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 16 of 30 :  Rationale Convert pounds to kg by dividing 176 pounds by 2.2 pounds = 80 kg. Convert the IV concentration from mg to mcg. 1 mg : 1000 mcg :: 10 mg : 10,000 mcg. Infusion rate (48 ml/hour) x concentration (10,000 mcg/ml) divided by 60 minutes/hour x 80 kg = 48 x 10,000 divided by 60 x 80 = 480,000 / 4800 = 100 mcg/kg/minute. A client is receiving a cephalosporin antibiotic IV and complains of pain and irritation at the infusion site. The nurse observes erythema, swelling, and a red streak along the vessel above the IV access site. Which action should the nurse take? Administer the medication more rapidly using the same IV site. Initiate an alternate site for the IV infusion of the medication. Notify the healthcare provider before administering the next dose. Give the client a PRN dose of aspirin while the medication infuses. Rationale A cephalosporin antibiotic that is administered IV may cause vessel irritation. Rotating the infusion site minimizes the risk of thrombophlebitis, so an alternate infusion site should be initiated before administering the next dose. The other actions are not indicated. 140 The healthcare provider prescribes acetazolamide (Diamox) 600 mg/m2/day divided into 3 doses. The nurse calculates the child's body surface area (BSA) as 0.7 https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 17 of 30 :  m2. How many mg should the child receive per dose? (Enter the numeric value, whole number, only.) Rationale Using the child's BSA, 0.7 m2, calculate the mg/dose, 600 mg x 0.7 m2 = 420 mg/day/3 doses = 140 mg/dose 8 A client with septic shock receives a prescription for dDextrose 5% in Water (D5W) 250 ml with dopamine (Intropin) 0.6 grams/250 ml at a rate of 5 mcg/kg/minute. The client's weight is 148 pounds The nurse should set the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Rationale First convert the weight into kilograms: 148 pounds/2.2 kg = 67 kg Next calculate the number of mcg/kg/minute: 5 x 67 x 1 minute = 335 mcg/minute Calculate the number of mcg/hour: 335 x 60 minutes = 20,100 mcg/hour Now calculate the number of ml/hour needed to administer 20,100 mcg/hour: 600,000 mcg : 250 ml :: 20,100 mcg : X ml 600,000 / 20100 :: 250 / X = 600,000X = 5,02500 X = 8.375 (rounded to) 8 ml/hour https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 18 of 30 :  A client's IV infusion of 0.9% Sodium Chloride (normal saline) infiltrated earlier today, and approximately 500 ml of normal saline infused into the subcutaneous tissue. The client is now complaining of excruciating arm pain and demanding "stronger pain medications." What action is most important for the nurse to take? Ask about any past history of drug abuse or addiction. Measure the pulse volume and capillary refill distal to the infiltration. Compress the infiltrated tissue to measure the degree of edema. Evaluate the extent of ecchymosis over the forearm area. Rationale Compartment syndrome occurs when external pressure (usually from a cast), or internal pressure (usually from subcutaneous infused fluid), exceeds capillary perfusion pressure resulting in decreased blood flow to the extremity. The most important action is to assess pulse volume and capillary refill distal to the infiltration site toetermin d loss of the peripheral pulse in the extremity, which is evidence of compartment syndrome. The other actions are of less priority than determining the effects of the infiltrate fluids on circulation and nerve function. 100 A client returns to the nursing unit from surgery with a prescription for Lactated Ringer's solution 1,000 ml to be infused over 10 hours. The IV administration set delivers 60 gtts/ml. The nurse should regulate the infusion to deliver how https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 19 of 30 :  many gtts/minute? (If rounding is required, enter a whole number.) Rationale First convert hours to minutes:10 hrs x 60 = 600 minutes Using the formula Volume/Time x drop factor: 1000 ml /600 minutes = 1.66666 x 60 = 100 gtts/minute 1 The nurse is preparing to administer bumetanide (Bumex) 0.25 mg IV. The medication is available in a vial labeled "1 mg/4 ml." How many ml of medication should the nurse administer? (Enter numeric value only.) Rationale Using the Desired/Have x Volume formula: 0.25 mg Desired / 1 mg Have x 4 ml Volume = 0.25 mg/1 mg x 4 ml = 1 ml 28 A client who is experiencing cardiogenic shock receives a prescription for an IV solution of 0.9% normal saline 100 ml with milrinone (Primacor) 10 mg in at an infusion rate https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 20 of 30 :  of 46 mcg/minute. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Rationale First calculate the number of mcg/hour: 46 mcg x 60 minutes = 2760 mcg/hour Next calculate the number of ml/hour needed to administer 2760 mcg/hour: 10,000 mcg : 100 ml :: 2760 mcg : X 10,000 / 2760 :: 100 / X = 10,000X = 276000 X = 27.6 (rounded to 28 ml/hour) The healthcare provider prescribes an IV infusion of Ringer's Lactate 1,000 ml with 30 Units of Pitocin to run in over 4 hours for a client who has just delivered a 10 pound infant by cesarean section. The tubing has been changed to a 20 gtt/ml administration set. The nurse plans to set the flow rate at how many gtt/minute? 42 gtt/min. 83 gtt/min. 125 gtt/min. 250 gtt/min. Rationale Ratio proportion using Dimentional analysis. https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 21 of 30 :  Drops/ Minutes (gtt/min) = 20gtt/ml X 1000 ml/4hrs X 1 hr/60 min = 83 gtts/minute 10 The nurse notes that a client is receiving an oxytocin (Pitocin) infusion via a pump that is programmed to deliver 30 ml/hour. The available solution is Ringer's Lactated 1,000 ml with Pitocin 20 units. How many milliunits/minute is the client receiving? (Enter numeric value only, whole number.) Rationale Convert units to milliunits, 20 units x 1,000 = 20,000 milliunits. Using D/H x Q = 30 ml/hour: X/20,000 milliunits x 1,000 ml = 30 ml/hour (60 minutes). X/20 = 30ml/60 minutes, reduce to: X/2 = 1/2, and 2X = 20, so X = 10 milliunits/minute 3 The healthcare provider prescribes trimethoprim-sulfamethoxazole (Bactrim-DS Oral Suspension) 120 mg BID for a child with bronchitis. The Bactrim bottle is labeled "200 mg/5ml." How many ml should the nurse administer at each dose? (Enter the numeric value, whole number, only. ) https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 22 of 30 :  Rationale Using the formula D/H x Q, 120/200 x 5 = 3 ml 2 A child who weighs 55 pounds receives a prescription for atovaquone with proguanil (Malarone Pediatric) 125 mg/50 mg PO daily. A drug reference states that children 11 to 20 kg should receive 1 pediatric tablet daily; 21 to 30 kg should receive 2 pediatric tablets daily; 31 to 40 kg should receive 3 pediatric tablets daily; and greater than 40 kg should receive 1 adult tablet daily with food. The drug is available as atovaquone 62.5 mg/proguanil 25 mg pediatric tablets. How many tablets should the nurse administer? Rationale Calculate each drug component dose, using the formula, D/H 125 mg / 62.5 mg (atovaquone) = 2 combined with 50 mg / 25 mg (proguanil) = 2 The child should receive 2 tablets of the combination drug, Malarone Pediatric. 3 A client with hypertension receives a prescription for carteolol (Cartel) 7.5mg PO daily. The drug is available in https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 23 of 30 :  2.5 mg tablets. How many tablets should the nurse administer? (Enter numeric value only, whole number.) Rationale Using D/H: 7.5mg / 2.5mg = 3 tablets 1.1 A client is receiving an IV solution of sodium chloride 0.9% (Normal Saline) 250 ml with amiodarone (Cordarone) 1 gram at 17 ml/hour. How many mg/minute of amiodarone is infusing? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Rationale Convert grams to mg, 1 gram equals 1,000 mg. Using ratio and proportion - 1,000 mg : 250 ml :: X mg : 1ml 250X= 1,000 so X = 4 mg/ml is the solution concentration of amiodarone. The infusion rate (ml/hour) x concentration (mg/ml) divided by 60 minutes/hour 17 ml/hour x 4 mg/ml = 68/60 = 1.13 = 1.1 mg/minute. 0.5 The nurse is preparing to administer Hepatitis B Vaccine, Recombinant (Energix-B) 5 mcg IM to a school-aged child. The vaccine is labeled, 10 mcg/ml. How many ml should https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 24 of 30 :  the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth). Rationale Use ratio and proportion, 5 mcg : X ml :: 10 mcg : 1ml 10X = 5 X = 0.5 ml 78 A healthcare provider prescribes a continuous infusion of 0.9% sodium chloride 250 ml with pancuronium (Pavulon) 25 mg at a rate of 0.1 mg/kg/hour for a client with coronary artery bypass grafting. The client weighs 78 kg. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Rationale First calculate the number of mg the client will receive in 1 hour: 0.1 mg x 78 kg = 7.8 mg/hour Next calculate the number of ml containing 7.8 mg of medication: 25 mg : 250 ml :: 7.8 mg : X 25 mg/ 7.8 mg :: 250 ml/X 25X = 1950 X = 78 ml/hour https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 25 of 30 :  Nitroprusside sodium (Nipride) 50 mg is mixed in D5W 250 ml. The nurse plans to administer the solution at a rate of 5 mcg/kg/minute to a client weighing 182 pounds. Using a drip factor of 60 gtt/ml, how many drops per minute should the nurse regulate the infusion? 31 gtt/min. 62 gtt/min. 93 gtt/min. 124 gtt/min. Rationale Convert pounds to kg: 182/2.2 = 82.73 kg. Determine the dosage for this client: 5 mcg x 82.73 = 413.65 mcg/minute. Determine how many mcg are contained in 1 ml: 250/50,000 mcg = 200 mcg per ml. The client is to receive 413.65 mcg/minute. There are 200 mcg/ml, so the client is to receive 2.07 ml/minute. The nurse calculates the drip rate using the drip factor of 60 gtt/ml, then 60 x 2.07 = 124.28 gtt/minute OR, using dimensional analysis: gtt/min = 60 gtt/ml X 250 ml/50 mg X 1 mg/1,000 mcg X 5 mcg/kg/min X 1 kg/2.2 lbs X 182 pounds. 18 The healthcare provider prescribes acetaminophen elixir (Tylenol elixir) 600 mg PO every 6 hours for an adult client experiencing pain associated with maxillofacial surgery. The bottle is labeled 500 mg/15 ml. How https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 26 of 30 :  many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Rationale Using the formula D/H x Q: 600 mg/500mg x 15 ml = 18 ml An IV infusion of terbutaline sulfate 5 mg in 500 ml of D5W, infusing at a rate of 30 mcg/min, is prescribed for a client in premature labor. How many ml/hr should the nurse set the infusion pump? 30. 60. 120. 180. Rationale 180 ml/hr = 500 ml/5 mg X 1mg/1000 mcg X 30 mcg/min X 60 min/hr. A client is to receive an IV of Sodium Chloride 0.9% Injection (Normal Saline) 250 ml with KCl 10 mEq IV over 4 hours. What rate should the nurse program the client's IV infusion pump? 13 ml/hour. 63 ml/hour. https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 27 of 30 :  80 ml/hour. 125 ml/hour. Rationale To calculate the infusion rate, the dose of KCl is not used in the calculation. Using the total volume of Normal Saline solution, 250 ml/4 hours = 63 ml/hour. 180 A client who has a gastrostomy feeding tube is receiving 3/4 strength Ensure 240 ml every 6 hours. Full strength Ensure is available in a 240 ml can. The nurse should use how many ml of Ensure to prepare the feeding? (Enter numeric value only. If needed, round to the nearest whole number.) Rationale 240 ml Ensure : 1 :: X ml Ensure : 0.75 240/X : 1 / 0.75 X = 240 x 0.75 = 180 ml Ensure + 60 ml water = 240 ml 19632 An adult male who weighs 180-pound is admitted to the Emergency Center after receiving thermal burns to 60 percent of his body. Using the Parkland formula of https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 28 of 30 :  4 ml/kg/24 hours, the client should receive how many ml of fluid during the first 24 hours? (Enter the numeric value only. If rounding is required, round to the nearest whole number.) Rationale Using the Parkland formula, the client's fluid requirements for the first 24 hours after injury: 4 ml lactated Ringer's solution x Body weight (in kilograms) x Percent burn Convert 180 pounds to kg = 180 / 2.2 = 81.8 kg 4 ml x 81.8 kg x 60 = 19632 ml over the first 24 hours 1.9 A client who weighs 70 kg is receiving a solution of 0.9% Sodium Chloride (Normal Saline) 500 ml with dopamine 800 mg at 5 ml/hour. How many mcg/kg/minute is the client receiving? (Enter the numeric value only. If rounding is required, round to the nearest tenth.) Rationale To change ml/hour to mcg/kg/minute, use the formula: desired rate (5 ml/hour) / volume available (500ml) x dose available (800mg) = 8 mg/hour. Next, convert milligrams/hour to mcg/kg/minute: mg (8) x 1000 / kg (70) / 60 minutes = 1.904 = 1.9 mcg/kg/minute. https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 29 of 30 :  14 The healthcare provider prescribes a continuous infusion of 5% dextrose in 0.45% sodium chloride at 85 ml/hour. The IV administration set delivers 10 gtt/ml. The nurse should regulate the drop rate to deliver how many gtts/minute? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Rationale Volume/Time (minutes) x drop factor (gtt/ml) = 85 ml/ 60 minutes x 10 gtt/ml = 14.16 = 14 gtt/minute https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/3956036/10NJ2HGK9G0 11/10/24, 7 34 PM Page 30 of 30 :