Rose state college

ROSE STATE COLLEGE
NURSING SCIENCE PROGRAM
Preparation For The Dosage Calculation Challenge Examination

Introduction
An essential skill in nursing practice is dosage calculation - the ability to correctly calculate and
check medication dosages before administering them. As a Nursing Science Major, you are
eligible to challenge out of HSNS 1101, Dosage Calculation for Nurses, by taking an
examination. You will have one opportunity to pass the challenge examination with a score of
90% or higher. If you do not pass the exam, you will need to successfully complete HSNS
1101, Dosage Calculation for Nurses, prior to admission to the program if you are a Career
Ladder Track applicant, or along with HSNS 1117 Fundamentals of Nursing if you are a
Beginning Track applicant. The challenge exam or the course must be completed no more than
one year prior to admission to the program.
Procedure For Challenge-
1. According to Rose State College policy, a student must be enrolled in Rose State
2. Go to the Office of Admissions in the Administration Building and request a form called "Application for Credit by Examination". Complete the application, indicating the name of the course as “HSNS 1101: Dosage Calculation for Nurses.” Obtain the necessary signatures on that form in the Health and Environmental Science Building. 3. Return the form to the Office of Admissions, and go to the Cashier's window to pay a 4. Take the form to the Testing Center, Room 103 in the Learning Resources Center, at least 1½ hours prior to their closing time. They will administer the test and notify the Director of the Nursing Science Program that it is complete. 5. You will be notified of your results on the exam in approximately one week. If you are successful on the exam, the Director will complete the form for credit by examination and send it to the Office of Admissions, so that the credit will be noted on your transcript. If you are not successful on the exam, you will need to enroll in HSNS 1101 Dosage Calculation for Nurses. What You Will Need To Know Dosage calculation incorporates a number of math skills, including: Addition and subtraction Multiplication and division Fractions, especially multiplying and dividing Decimal points: adding, subtracting, multiplying, and dividing Converting decimals to fractions and vice-versa Solving equations to determine the value of X The Dosage Calculation Challenge Exam will incorporate the above math skills to help you solve dosage problems in these areas: Calculating drug dosages in the metric system Calculating drug dosages in the apothecary system Calculating drug dosages using household measurements Dosage calculations using conversions within & between systems of measurements Calculating drug dosages in units & milliequivalents Calculating pediatric dosages Reconstituting powdered drugs for injection & related dosage calculations Calculating drip rates Calculating IV infusion rates Calculating dosages of critical care medications To help you determine areas of strength and weakness in mathematics, your professors have prepared a short self-assessment test. (See attached) You may take and grade this test yourself. If you miss more than one question per section, you will want to review that section. How To Prepare There are a number of ways that you can review dosage calculation skills, depending on the amount of review needed and your personal preference. Some suggested methods follow. If you did well on the test overall, but had problems in one or two sections, you might wish to utilize a dosage calculation book from the Learning Resources Center. There are several dosage calculation books available for checkout in the LRC. If you feel highly insecure about your basic mathematics skills and did poorly on the self-assessment test, you will want to spend more time in review and preparation. There are several options available to you. These are discussed in the following paragraphs. In the RSC Bookstore, there are mathematics and dosage calculation books available for purchase. One self-study book on basic math skills that is available is Essential Mathematics With Application, by Barker and Aufmann. The dosage calculation book that we would recommend for purchase is Calculate with Confidence by Gray & Morris.
If you find it difficult to learn just by reading the book and would like personalized help with
basic math skills, you can obtain it in various ways. In the Science and Math Division, there is
a Math Lab in Room 119, which is available for all students on campus. In this lab are
computer-assisted learning packages and audiovisual materials. Although there are no tutors
in this lab, there are lab monitors who are available to assist you to locate and utilize the
appropriate learning materials. The lab is open Monday through Thursday, 8:00 a.m. to 8:00
p.m., Friday, 8:00 a.m. to 12:00 noon, and 3:00 p.m. to 5:00 p.m., and on Saturday, 9:00
a.m. to 1:00 p.m.
Math tutors are available in the Learning Resources Center. Although these services are
primarily meant for individuals who are taking math classes, Nursing Science students can
utilize these services, since a part of the program focuses on math. These tutors can help
with basic math skills, but be sure to have a specific type of problem in mind with which you
are requesting help. To schedule a session with a general math tutor, go to the tutoring desk
in the Learning Resources Center. Dosage calculation tutors may also be available there.
Another option for math help is to take a course called MATH 0103 Arithmetic Skills
Development. One hour of class and four hours per week in the Math Lab are required for this
course. If you are weak in basic math skills, you may want to consider taking this course. In
order to evaluate your basic math skills, you may take the COMPASS Pre-Algebra/Numerical
Skills test in the Testing Center of the Student Services Building. A score of less than 31
indicates a definite need for the Arithmetic Skills Development course.
If you do not choose to take the Dosage Calculation challenge examination, you should enroll
in HSNS 1101, Dosage Calculation for Nurses. This course meets the first and second eight-
weeks of the Fall or Spring semester and is also offered in the Summer. Instruction on dosage
calculation skills will be provided. However, instruction in basic math skills is not provided. If
you feel you need work on basic math skills, you should consider the above mentioned Math
class prior to enrolling in Dosage Calculation. In order to pass the Dosage Calculation course,
a 90% or higher on the final exam, which is similar to the challenge examination, must be
earned by the second attempt.
Please feel free to talk with your professors individually if you have questions or concerns.
Rounding Your Answers
Students frequently have questions about whether an answer should be rounded. In dosage
calculation, you must consider the equipment you will use! Dosages of 1 cc or less should be
drawn up in a 1-cc syringe. The dosage can be measured out to the hundredth place, for
example, 0.75 cc. Therefore, if you obtain an answer of 0.383 cc, then you would round it to
0.38 cc. Dosages of between 1 and 3 cc are given in a 3 cc syringe. The dosage can be
measured out to the tenth place, for example, 1.2 cc. Therefore, if you obtain an answer of
1.26 cc, then you would round it to 1.3 cc.
Generally, numbers of 5 or more are rounded up to the next number. Numbers of less than 5
are rounded down. The exception would be pediatric and heparin dosages which are always
round down. See attached RSC Rounding Rules for more information on rounding.
ROSE STATE COLLEGE
NURSING SCIENCE PROGRAM
Self-Assessment On Dosage Calculation Skills
Instructions:
The purpose of this self-assessment is to help you to determine areas of strength and
weakness, so that you may review as needed. Complete the problems to the best of your
ability. On the last page of the test are the answers. If you miss more than one problem per
section, you will need to review material related to that section. The self-assessment includes
practice problems on basic arithmetic skills. Although these are not included as such on the
challenge exam, they are basic knowledge needed for dosage calculation.
Section I: Addition, Subtraction, Multiplication and Division
1.
Section IV: Solving Equations To Determine The Value of X – (Including Ratio And Proportion). 14. 75/30 Section V: Calculating Drug Dosages In The Metric System 18. Mysoline 375 mg is ordered. Scored tablets available are 250 mg. How many tablets would you give? A dosage of 25 mg of methazolamide has been ordered. Scored tablets available are 50 mg. How many tablets would you give? Estinyl tablets are 0.05 mg. How many tablets would you prepare to give a 0.1 mg dosage? Section VI: Calculating Drug Dosages In The Apothecary System And With Household Measurements 21. Terpin hydrate 2 tsp. has been ordered. How many mLs would you give? You are preparing a gr ½ IM dosage of phenobarbital from a solution with a strength of gr 3/4 per mL. How many mLs will you give? Codeine IM is available in a gr ss per mL solution. How many mLs would you prepare to give a gr i dosage? Section VII: Converting Within & Between Systems 24. Benztropine mesylate 1500 mcg has been ordered t.i.d. The dosage strength available is 0.5 mg per tablet. How many tablets would you give? An initial dose of 1.1 g has been ordered. Capsules are 550 mg in strength. How many capsules would you give? You are preparing a 15 mg dosage of morphine from a solution labeled gr 1/6 per mL. How many mL will you draw up? Section VIII: Calculating Drug Dosages in Milliequivalents & Units 27. The order is for Phizerpen-AS 400,000 U q12h. Vial strength is 300,000 U per mL. How many mLs would you give? A 5,000 U per mL solution of heparin sodium is available. How many mLs would you prepare to give a 7,500 U dosage? Section IX: Reconstituting Powdered Drugs For Injection 29. Amoxil oral suspension is prepared as a 7.5 g powder for reconstitution. The directions are to add 111 mL of water and shake until dissolved. The reconstituted solution has a strength of 250 mg per 5 mL. How many mLs would you prepare to give a 0.5 g dosage? To prepare a 100 mg/cc solution of Chloromycetin from the powdered drug, you must add 10 cc of sterile water to the vial. How many ccs would you draw up to give a 0.25 g dosage? 31. The doctor orders the IV to run at 125 cc per hour. The drip chamber delivers 10 gtts per cc. How many gtts per minute will the nurse set the infusion rate? 32. The doctor orders the IV to run at 150 cc per hour. The drip chamber delivers 20 gtts per cc. How many gtts per minute will the nurse set the infusion rate? Section XI: Calculating IV Infusion Rates The doctor orders 1 gram of Ampicillin. The Ampicillin is packaged in 125cc. The infusion rate is 125 cc/hr. How long will it take to infuse the Ampicillin? The doctor orders gentamicin 350 mg q 8 hr. The gentamicin is packaged in 150cc. The prescribed rate of infusion is 75 cc per hour. How long will it take to infuse the gentamicin? How many hours will it take to infuse 1000 mL of D5NS if the ordered infusion rate is 125 cc per hour? The nurse hangs an IVPB with 1 gram of Ampicillin in 50 cc. The ordered infusion rate is 100 cc per hour. How long will it take to infuse the Ampicillin? __________________________ Section XII: Calculating Pediatric Dosages and Critical Care Dosages 37. The recommended daily dosage of PO Keflex is 25-50 mg/kg/day in divided doses q6h. For a child weighing 44 lbs., what is the safe recommended dosage range for a 24 hour period? Ordered Erythromycin 30 mg/kg/day in divided doses tid. For a child weighing 11 lbs., how many mg of Erythromycin should be given in a single dose? Order: Regular Insulin IV at 12 U/hr. The concentration is Insulin 200U in 500mL of 0.9% NS. The IV pump should be programmed for how many mL/hr? ANSWER SHEET

Section I Section V Section X

Section II
Section VI
Section XI
Section VII
Section XII
Section III
Section VIII
Section IV
Section IX
ROSE STATE COLLEGE
NURSING SCIENCE PROGRAM
Rounding Rules for Dosage Calculation
The rationale for the rounding rules in dosage calculation comes from the desire to deliver the most accurate dosage of medication with the available equipment. Different health care settings will have different equipment and for the purposes of grading the following rules for rounding will be used through out the Rose State College Nursing program. 1. For answers of less than 1 ml round to the nearest 1/100th mL. (Carry it out to 3 places beyond the decimal point then round back to 2 places beyond the decimal point) For answers of greater than 1 mL round to the nearest 1/10th mL. (Carry it out to 2 places beyond the decimal point then round back to 1 place beyond the decimal point) When rounding is needed, if the last digit in the number is 5 or greater, then the number will be rounded up. If the last digit in the number is less than 5 the number will be rounded down. For pediatric dosage calculations, you will never round up. Always round
down.
For heparin dosages, you will never round up. Always round down.
Round to the nearest 1/100th on all calculations prior to the final answer. You may round according to the above rules on the final answer but do not round further until the last calculation. For IV infusion pump calculations, round to the nearest mL/hr.

Source: http://my.rose.edu/students/hsdiv/ns_prog/ns_files/2007/Dsg-Calc%20Prep%20for%20Challenge%20Exam%20for%20Career%20Ladder%20Applicants2.pdf