RELIAS RN ADVANCED MATH
ABILITY EXAM 2023-2024
VERSION 1 | Questions &
Verified Answers | Grade A |
Pass Guaranteed
repared in accordance with The Joint Commission standards, NCLEX-RN medication
P
calculation guidelines, and current safe medication administration practices.
========================================================================
========
## PART A – MULTIPLE CHOICE (Q1–20)
* *Q1 (Oral tablets):** A patient is ordered metoprolol 25 mg orally daily. Available is metoprolol
50 mg scored tablets. How many tablets should the nurse administer?
. 0.25 tablet
A
B. 0.5 tablet
C. 1 tablet
D. 2 tablets
**[CORRECT]** B (0.5 tablet)
* Rationale: Formula: Desired ÷ Have × Vehicle = 25 mg ÷ 50 mg × 1 tablet = 0.5 tablet.
Metoprolol is a scored tablet, so it can be safely split. Distractor A (0.25) would result from
dividing 25 by 100 (incorrect available strength); Distractor C (1 tablet) would give 50 mg,
double the ordered dose; Distractor D (2 tablets) would give 100 mg, a dangerous overdose for
a cardiac medication. Always verify tablet scoring before splitting.*
---
* *Q2 (Oral liquid):** The provider orders amoxicillin 500 mg PO q8h. Available: amoxicillin
suspension 250 mg/5 mL. How many mL should the nurse administer?
, . 5 mL
A
B. 7.5 mL
C. 10 mL
D. 12.5 mL
**[CORRECT]** C (10 mL)
* Rationale: Formula: Desired ÷ Have × Vehicle = 500 mg ÷ 250 mg × 5 mL = 2 × 5 mL = 10 mL.
Distractor A (5 mL) would give only 250 mg; Distractor B (7.5 mL) is a random miscalculation;
Distractor D (12.5 mL) would result from incorrectly using 125 mg/5 mL or multiplying 250 × 0.5.
Always shake suspensions well and use an oral syringe for accuracy.*
---
* *Q3 (Injectable – IM):** Order: morphine sulfate 8 mg IM q4h PRN for pain. Available: morphine
sulfate 10 mg/mL in a 1 mL vial. How many mL should the nurse draw up?
. 0.6 mL
A
B. 0.8 mL
C. 1.0 mL
D. 1.2 mL
**[CORRECT]** B (0.8 mL)
* Rationale: Formula: Desired ÷ Have × Vehicle = 8 mg ÷ 10 mg × 1 mL = 0.8 mL. Distractor A
(0.6 mL) would give 6 mg, an underdose; Distractor C (1.0 mL) would give 10 mg, exceeding
the ordered dose; Distractor D (1.2 mL) would require drawing from a second vial and exceeds
a single vial's volume. Morphine is a high-alert medication requiring double-check.*
---
* *Q4 (Weight-based dosing):** A child weighs 22 kg. The pediatrician orders cephalexin 25
mg/kg/day divided q6h. How many mg per dose should the nurse administer?
. 110 mg
A
B. 137.5 mg
C. 275 mg
D. 550 mg
**[CORRECT]** B (137.5 mg)
* Rationale: Step 1: Calculate total daily dose = 25 mg/kg/day × 22 kg = 550 mg/day. Step 2:
Divide by number of doses (q6h = 4 doses/day) = 550 mg ÷ 4 = 137.5 mg/dose. Distractor A
(110 mg) results from dividing by 5 instead of 4; Distractor C (275 mg) is the dose if divided BID
, ( 2 doses); Distractor D (550 mg) is the total daily dose, not per dose. Always verify the
frequency before dividing.*
---
* *Q5 (IV flow rate – mL/hr):** Order: D5W 1000 mL to infuse over 6 hours via infusion pump. At
what rate (mL/hr) should the nurse set the pump?
. 125 mL/hr
A
B. 150 mL/hr
C. 166.7 mL/hr
D. 200 mL/hr
**[CORRECT]** C (166.7 mL/hr)
* Rationale: Formula: Total Volume ÷ Total Time = 1000 mL ÷ 6 hr = 166.666... ≈ 166.7 mL/hr.
Distractor A (125 mL/hr) would be correct for 8 hours; Distractor B (150 mL/hr) would be correct
for 6.67 hours; Distractor D (200 mL/hr) would be correct for 5 hours. Always program the pump
to the nearest tenth when required.*
---
* *Q6 (IV drip rate – gtt/min):** Order: Lactated Ringer's 500 mL to infuse over 4 hours. The IV
tubing has a drop factor of 15 gtt/mL. Calculate the drip rate in gtt/min.
. 21 gtt/min
A
B. 31 gtt/min
C. 42 gtt/min
D. 63 gtt/min
**[CORRECT]** B (31 gtt/min)
* Rationale: Formula: (Volume × Drop Factor) ÷ Time in Minutes = (500 mL × 15 gtt/mL) ÷ 240
min = 7500 ÷ 240 = 31.25 ≈ 31 gtt/min. Distractor A (21 gtt/min) results from using 10 gtt/mL
drop factor; Distractor C (42 gtt/min) results from using 20 gtt/mL or forgetting to convert 4 hours
to 240 minutes (using 4 instead); Distractor D (63 gtt/min) results from dividing 7500 by 120
minutes (2 hours). Always convert hours to minutes first.*
---
* *Q7 (Infusion time):** An IV bag contains 750 mL of normal saline infusing at 125 mL/hr. How
many hours and minutes will it take to complete the infusion?
A. 5 hours
ABILITY EXAM 2023-2024
VERSION 1 | Questions &
Verified Answers | Grade A |
Pass Guaranteed
repared in accordance with The Joint Commission standards, NCLEX-RN medication
P
calculation guidelines, and current safe medication administration practices.
========================================================================
========
## PART A – MULTIPLE CHOICE (Q1–20)
* *Q1 (Oral tablets):** A patient is ordered metoprolol 25 mg orally daily. Available is metoprolol
50 mg scored tablets. How many tablets should the nurse administer?
. 0.25 tablet
A
B. 0.5 tablet
C. 1 tablet
D. 2 tablets
**[CORRECT]** B (0.5 tablet)
* Rationale: Formula: Desired ÷ Have × Vehicle = 25 mg ÷ 50 mg × 1 tablet = 0.5 tablet.
Metoprolol is a scored tablet, so it can be safely split. Distractor A (0.25) would result from
dividing 25 by 100 (incorrect available strength); Distractor C (1 tablet) would give 50 mg,
double the ordered dose; Distractor D (2 tablets) would give 100 mg, a dangerous overdose for
a cardiac medication. Always verify tablet scoring before splitting.*
---
* *Q2 (Oral liquid):** The provider orders amoxicillin 500 mg PO q8h. Available: amoxicillin
suspension 250 mg/5 mL. How many mL should the nurse administer?
, . 5 mL
A
B. 7.5 mL
C. 10 mL
D. 12.5 mL
**[CORRECT]** C (10 mL)
* Rationale: Formula: Desired ÷ Have × Vehicle = 500 mg ÷ 250 mg × 5 mL = 2 × 5 mL = 10 mL.
Distractor A (5 mL) would give only 250 mg; Distractor B (7.5 mL) is a random miscalculation;
Distractor D (12.5 mL) would result from incorrectly using 125 mg/5 mL or multiplying 250 × 0.5.
Always shake suspensions well and use an oral syringe for accuracy.*
---
* *Q3 (Injectable – IM):** Order: morphine sulfate 8 mg IM q4h PRN for pain. Available: morphine
sulfate 10 mg/mL in a 1 mL vial. How many mL should the nurse draw up?
. 0.6 mL
A
B. 0.8 mL
C. 1.0 mL
D. 1.2 mL
**[CORRECT]** B (0.8 mL)
* Rationale: Formula: Desired ÷ Have × Vehicle = 8 mg ÷ 10 mg × 1 mL = 0.8 mL. Distractor A
(0.6 mL) would give 6 mg, an underdose; Distractor C (1.0 mL) would give 10 mg, exceeding
the ordered dose; Distractor D (1.2 mL) would require drawing from a second vial and exceeds
a single vial's volume. Morphine is a high-alert medication requiring double-check.*
---
* *Q4 (Weight-based dosing):** A child weighs 22 kg. The pediatrician orders cephalexin 25
mg/kg/day divided q6h. How many mg per dose should the nurse administer?
. 110 mg
A
B. 137.5 mg
C. 275 mg
D. 550 mg
**[CORRECT]** B (137.5 mg)
* Rationale: Step 1: Calculate total daily dose = 25 mg/kg/day × 22 kg = 550 mg/day. Step 2:
Divide by number of doses (q6h = 4 doses/day) = 550 mg ÷ 4 = 137.5 mg/dose. Distractor A
(110 mg) results from dividing by 5 instead of 4; Distractor C (275 mg) is the dose if divided BID
, ( 2 doses); Distractor D (550 mg) is the total daily dose, not per dose. Always verify the
frequency before dividing.*
---
* *Q5 (IV flow rate – mL/hr):** Order: D5W 1000 mL to infuse over 6 hours via infusion pump. At
what rate (mL/hr) should the nurse set the pump?
. 125 mL/hr
A
B. 150 mL/hr
C. 166.7 mL/hr
D. 200 mL/hr
**[CORRECT]** C (166.7 mL/hr)
* Rationale: Formula: Total Volume ÷ Total Time = 1000 mL ÷ 6 hr = 166.666... ≈ 166.7 mL/hr.
Distractor A (125 mL/hr) would be correct for 8 hours; Distractor B (150 mL/hr) would be correct
for 6.67 hours; Distractor D (200 mL/hr) would be correct for 5 hours. Always program the pump
to the nearest tenth when required.*
---
* *Q6 (IV drip rate – gtt/min):** Order: Lactated Ringer's 500 mL to infuse over 4 hours. The IV
tubing has a drop factor of 15 gtt/mL. Calculate the drip rate in gtt/min.
. 21 gtt/min
A
B. 31 gtt/min
C. 42 gtt/min
D. 63 gtt/min
**[CORRECT]** B (31 gtt/min)
* Rationale: Formula: (Volume × Drop Factor) ÷ Time in Minutes = (500 mL × 15 gtt/mL) ÷ 240
min = 7500 ÷ 240 = 31.25 ≈ 31 gtt/min. Distractor A (21 gtt/min) results from using 10 gtt/mL
drop factor; Distractor C (42 gtt/min) results from using 20 gtt/mL or forgetting to convert 4 hours
to 240 minutes (using 4 instead); Distractor D (63 gtt/min) results from dividing 7500 by 120
minutes (2 hours). Always convert hours to minutes first.*
---
* *Q7 (Infusion time):** An IV bag contains 750 mL of normal saline infusing at 125 mL/hr. How
many hours and minutes will it take to complete the infusion?
A. 5 hours
