C HAPTER 17: V ERIFYING S AFE D OSE
Castillo: Calculating Drug Dosages: A Patient -Safe Approach to Nursing
and Math 2nd Edition
MULTIPLE CHOICE
1. The nurse is researching the recommended dos e of a drug in the drug
reference. Information about the drug includes the following:
Patients should receive a test dose of 0.5 mg subcut before full dosing
schedule. No loading dose is required for this drug.
Subcut (Adults and Children) : If favorable r esponse to test dose, begin
with initial dose of 1 mg dail y for 1 week; may increase dose to
maintenance dose of 2 -5 mg/day.
Which statement by the nurse indicates a correct understanding of drug
dosage terminology?
A. “An initial dose is a large dose of the medication, administered
quickl y to achieve therapeutic levels of the drug.”
B. “An initial dose is the same as a loading dose.”
C. “A maintenance dose is the total amount of medication given dail y.”
D. “A maintenance dose is the dose required to sustain the thera peutic
effects of the drug.”
ANS: D
Feedback
, The nurse must understand the terminology about drug dosages. An
initial dose is the first dose of a drug given to a patient. A loading dose
is an initial large dose of medication administered quickl y to achi eve
therapeutic levels in the body. A maintenance dose is the dose required
to sustain the desired therapeutic effects of a drug (not the total
amount of medication given dail y, which is called the total daily dose).
2. The physician renews an order for lith ium 300 mg PO QID for a 27 -year-
old patient who has been taking the drug for 6 months. The nurse verifies
the ordered dose by comparing it with the recommended dose in the drug
reference:
Route/Dosage: PO (Adults and Children 12 yr or older) :
Tablets/capsules—300-600 mg 3 times daily initiall y; usual maintenance
dose is 300 mg 3 -4 times dail y.
Based on this information, which clinical judgment by the nurse is correct
regarding the ordered dose of lithium?
A. It is a safe dose.
B. It is safe to give this patient as an initial or a maintenance dose.
C. It should be increased to 400 mg QID as a maintenance dose.
D. It should be divided into 4 doses.
ANS: A
Feedback
, The order for lithium is a maintenance order, so the recommendations
for a maintenance dose of the medic ation should be compared to the
physician’s order. The ordered dose of 300 mg QID correlates with the
recommended maintenance dose (“300 mg 3 -4 times dail y”). The nurse
may administer the ordered dose of lithium.
3. The patient has been taking imipramine 150 mg dail y at bedtime. The
visiting nurse checks the patient’s dose with the drug reference to validate
that the dose the patient is taking is a safe dose. The drug reference states
that the recommended dose for imipramine is as follows:
Route/Dosage: PO ( Adults): 25-50 mg 3-4 times dail y (not to exceed 300
mg/day); total dail y dose may be given at bedtime.
Based on this information, which clinical judgment by the nurse is correct
regarding the ordered dose?
A. It should be given four times a day.
B. It should b e divided into three 50 mg doses and taken TID.
C. It is more than the usual recommended dose and is not safe.
D. It is a safe dose as the total amount may be taken at one time.
ANS: D
Feedback
The drug reference gives several options for taking imipramine. T he
recommendation is a dosage range which can be taken TID or QID or
once at bedtime. The nurse calculates the range:
25 mg taken 3 times dail y = 75 mg/day
, 25 mg taken 4 times dail y = 100 mg/day
50 mg taken 3 times dail y = 150 mg/day
50 mg taken 4 times dail y = 200 mg/day
The total dosage should not exceed 300 mg/day. The recommended
dosage range is 75-200 mg/day. The entire dose can be taken at once at
bedtime.
The ordered dose of 150 mg is within all of these recommendations. It
is a safe dose.
4. MD Order: Bumetanide 1 mg PO dail y. The nurse verifies the ordered
dose by comparing it to the recommended dose in the drug reference:
Route/Dosage: PO (Adults): 0.5-2 mg/day given in 1-2 doses….
Based on this information, which clinical judgment by the nurse is c orrect
regarding the ordered dose of bumetanide?
A. It is a safe dose.
B. It is not a safe dose.
C. It should be divided into 2 doses.
D. It is not an effective dose.
ANS: A
Feedback
The recommended dose of bumetanide is a dosage range (0.5 -2 mg).
This dosage range can be administered all at once (in 1 dose) or
divided into 2 doses. The ordered dose of bumetanide (1 mg) falls
within the recommended range. It is a safe dose to administer.
Castillo: Calculating Drug Dosages: A Patient -Safe Approach to Nursing
and Math 2nd Edition
MULTIPLE CHOICE
1. The nurse is researching the recommended dos e of a drug in the drug
reference. Information about the drug includes the following:
Patients should receive a test dose of 0.5 mg subcut before full dosing
schedule. No loading dose is required for this drug.
Subcut (Adults and Children) : If favorable r esponse to test dose, begin
with initial dose of 1 mg dail y for 1 week; may increase dose to
maintenance dose of 2 -5 mg/day.
Which statement by the nurse indicates a correct understanding of drug
dosage terminology?
A. “An initial dose is a large dose of the medication, administered
quickl y to achieve therapeutic levels of the drug.”
B. “An initial dose is the same as a loading dose.”
C. “A maintenance dose is the total amount of medication given dail y.”
D. “A maintenance dose is the dose required to sustain the thera peutic
effects of the drug.”
ANS: D
Feedback
, The nurse must understand the terminology about drug dosages. An
initial dose is the first dose of a drug given to a patient. A loading dose
is an initial large dose of medication administered quickl y to achi eve
therapeutic levels in the body. A maintenance dose is the dose required
to sustain the desired therapeutic effects of a drug (not the total
amount of medication given dail y, which is called the total daily dose).
2. The physician renews an order for lith ium 300 mg PO QID for a 27 -year-
old patient who has been taking the drug for 6 months. The nurse verifies
the ordered dose by comparing it with the recommended dose in the drug
reference:
Route/Dosage: PO (Adults and Children 12 yr or older) :
Tablets/capsules—300-600 mg 3 times daily initiall y; usual maintenance
dose is 300 mg 3 -4 times dail y.
Based on this information, which clinical judgment by the nurse is correct
regarding the ordered dose of lithium?
A. It is a safe dose.
B. It is safe to give this patient as an initial or a maintenance dose.
C. It should be increased to 400 mg QID as a maintenance dose.
D. It should be divided into 4 doses.
ANS: A
Feedback
, The order for lithium is a maintenance order, so the recommendations
for a maintenance dose of the medic ation should be compared to the
physician’s order. The ordered dose of 300 mg QID correlates with the
recommended maintenance dose (“300 mg 3 -4 times dail y”). The nurse
may administer the ordered dose of lithium.
3. The patient has been taking imipramine 150 mg dail y at bedtime. The
visiting nurse checks the patient’s dose with the drug reference to validate
that the dose the patient is taking is a safe dose. The drug reference states
that the recommended dose for imipramine is as follows:
Route/Dosage: PO ( Adults): 25-50 mg 3-4 times dail y (not to exceed 300
mg/day); total dail y dose may be given at bedtime.
Based on this information, which clinical judgment by the nurse is correct
regarding the ordered dose?
A. It should be given four times a day.
B. It should b e divided into three 50 mg doses and taken TID.
C. It is more than the usual recommended dose and is not safe.
D. It is a safe dose as the total amount may be taken at one time.
ANS: D
Feedback
The drug reference gives several options for taking imipramine. T he
recommendation is a dosage range which can be taken TID or QID or
once at bedtime. The nurse calculates the range:
25 mg taken 3 times dail y = 75 mg/day
, 25 mg taken 4 times dail y = 100 mg/day
50 mg taken 3 times dail y = 150 mg/day
50 mg taken 4 times dail y = 200 mg/day
The total dosage should not exceed 300 mg/day. The recommended
dosage range is 75-200 mg/day. The entire dose can be taken at once at
bedtime.
The ordered dose of 150 mg is within all of these recommendations. It
is a safe dose.
4. MD Order: Bumetanide 1 mg PO dail y. The nurse verifies the ordered
dose by comparing it to the recommended dose in the drug reference:
Route/Dosage: PO (Adults): 0.5-2 mg/day given in 1-2 doses….
Based on this information, which clinical judgment by the nurse is c orrect
regarding the ordered dose of bumetanide?
A. It is a safe dose.
B. It is not a safe dose.
C. It should be divided into 2 doses.
D. It is not an effective dose.
ANS: A
Feedback
The recommended dose of bumetanide is a dosage range (0.5 -2 mg).
This dosage range can be administered all at once (in 1 dose) or
divided into 2 doses. The ordered dose of bumetanide (1 mg) falls
within the recommended range. It is a safe dose to administer.
