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ATI Dosage Calculation RN Fundamentals Proctored
Assessment Actual Exam 2026/2027 | Comprehensive
Practice Exam with Verified Detailed Answers |
RATED A+ | Blueprint Aligned | Pass Guaranteed
SECTION 1: SAFE DOSAGE ADMINISTRATION (6 Questions) — 24%
Safe Dose Range Question #1:
Q1: A provider orders amoxicillin 500 mg PO every 8 hours for a child weighing 44 lbs. The
safe dose range for amoxicillin is 20-40 mg/kg/day divided every 8 hours. Is this dose safe?
A. Yes, 500 mg is within safe range.
B. No, 500 mg is below safe range.
C. No, 500 mg is above safe range. [CORRECT]
D. Unable to determine without more information.
Correct Answer: C
Rationale:
Step 1: Convert weight from pounds to kilograms
• 44 lbs ÷ 2.2 = 20 kg
Step 2: Calculate total daily dose ordered
• 500 mg × 3 doses (every 8 hours = 3 doses/day) = 1,500 mg/day
Step 3: Calculate mg/kg/day
• 1,500 mg/day ÷ 20 kg = 75 mg/kg/day
Step 4: Compare to safe dose range
• Safe range: 20-40 mg/kg/day
• Ordered: 75 mg/kg/day
• 75 mg/kg/day EXCEEDS the maximum safe dose of 40 mg/kg/day
,2
This dose is UNSAFE and requires provider notification.
Why other options are incorrect:
• Option A: Incorrect conclusion—fails to complete full calculation or compare to range
• Option B: Incorrect—dose is actually above, not below, safe range
• Option D: Incorrect—all necessary information is provided
Nursing Implication: Never administer a dose exceeding safe range without provider
clarification. Hold medication and contact prescriber immediately.
Safe Dose Range Question #2:
Q2: A provider orders digoxin 0.25 mg PO daily for an adult patient. The safe maintenance dose
range for digoxin in adults is 0.125-0.25 mg/day. The patient's serum digoxin level is 2.5 ng/mL
(therapeutic range: 0.5-2.0 ng/mL). What should the nurse do?
A. Administer the 0.25 mg dose as ordered
B. Hold the dose and notify the provider [CORRECT]
C. Administer 0.125 mg instead
D. Administer the dose and recheck level in 24 hours
Correct Answer: B
Rationale:
Step 1: Analyze serum level
• Patient's level: 2.5 ng/mL
• Therapeutic range: 0.5-2.0 ng/mL
• Patient is TOXIC (level exceeds 2.0 ng/mL)
Step 2: Evaluate dose appropriateness
• Ordered dose: 0.25 mg (maximum of safe range)
• Current level indicates toxicity at this dose
Step 3: Clinical decision
• Hold medication due to toxic serum level
• Notify provider for dose reduction (likely to 0.125 mg every other day or 0.0625 mg
daily)
, 3
Why other options are incorrect:
• Option A: Unsafe—patient already toxic; additional dose worsens toxicity
• Option C: Nurse cannot independently alter doses; requires provider order
• Option D: Delaying treatment allows toxicity to progress; digoxin toxicity can cause life-
threatening arrhythmias
Nursing Implication: Digoxin is a high-alert medication. Always check apical pulse (hold if
<60 bpm in adults) AND recent serum levels before administration.
Safe Dose Range Question #3:
Q3: A provider orders acetaminophen 1,000 mg PO every 6 hours PRN for pain for an adult
patient weighing 70 kg. The maximum safe dose is 4,000 mg/day (or 75 mg/kg/day, whichever is
less). Is this order safe?
A. Yes, 1,000 mg every 6 hours is within safe range [CORRECT]
B. No, the single dose exceeds maximum
C. No, the daily dose exceeds maximum
D. No, the dosing frequency is too frequent
Correct Answer: A
Rationale:
Step 1: Calculate daily dose if given around the clock
• 1,000 mg × 4 doses (every 6 hours) = 4,000 mg/day
Step 2: Calculate mg/kg/day
• 4,000 mg ÷ 70 kg = 57.1 mg/kg/day
Step 3: Compare to maximum safe doses
• Standard maximum: 4,000 mg/day ✓ (not exceeded)
• Weight-based maximum: 75 mg/kg/day × 70 kg = 5,250 mg/day ✓ (not exceeded)
Step 4: Determine limiting factor
• 4,000 mg/day is LESS THAN 75 mg/kg/day (5,250 mg)
• Therefore, 4,000 mg/day limit applies and is not exceeded
Why other options are incorrect:
ATI Dosage Calculation RN Fundamentals Proctored
Assessment Actual Exam 2026/2027 | Comprehensive
Practice Exam with Verified Detailed Answers |
RATED A+ | Blueprint Aligned | Pass Guaranteed
SECTION 1: SAFE DOSAGE ADMINISTRATION (6 Questions) — 24%
Safe Dose Range Question #1:
Q1: A provider orders amoxicillin 500 mg PO every 8 hours for a child weighing 44 lbs. The
safe dose range for amoxicillin is 20-40 mg/kg/day divided every 8 hours. Is this dose safe?
A. Yes, 500 mg is within safe range.
B. No, 500 mg is below safe range.
C. No, 500 mg is above safe range. [CORRECT]
D. Unable to determine without more information.
Correct Answer: C
Rationale:
Step 1: Convert weight from pounds to kilograms
• 44 lbs ÷ 2.2 = 20 kg
Step 2: Calculate total daily dose ordered
• 500 mg × 3 doses (every 8 hours = 3 doses/day) = 1,500 mg/day
Step 3: Calculate mg/kg/day
• 1,500 mg/day ÷ 20 kg = 75 mg/kg/day
Step 4: Compare to safe dose range
• Safe range: 20-40 mg/kg/day
• Ordered: 75 mg/kg/day
• 75 mg/kg/day EXCEEDS the maximum safe dose of 40 mg/kg/day
,2
This dose is UNSAFE and requires provider notification.
Why other options are incorrect:
• Option A: Incorrect conclusion—fails to complete full calculation or compare to range
• Option B: Incorrect—dose is actually above, not below, safe range
• Option D: Incorrect—all necessary information is provided
Nursing Implication: Never administer a dose exceeding safe range without provider
clarification. Hold medication and contact prescriber immediately.
Safe Dose Range Question #2:
Q2: A provider orders digoxin 0.25 mg PO daily for an adult patient. The safe maintenance dose
range for digoxin in adults is 0.125-0.25 mg/day. The patient's serum digoxin level is 2.5 ng/mL
(therapeutic range: 0.5-2.0 ng/mL). What should the nurse do?
A. Administer the 0.25 mg dose as ordered
B. Hold the dose and notify the provider [CORRECT]
C. Administer 0.125 mg instead
D. Administer the dose and recheck level in 24 hours
Correct Answer: B
Rationale:
Step 1: Analyze serum level
• Patient's level: 2.5 ng/mL
• Therapeutic range: 0.5-2.0 ng/mL
• Patient is TOXIC (level exceeds 2.0 ng/mL)
Step 2: Evaluate dose appropriateness
• Ordered dose: 0.25 mg (maximum of safe range)
• Current level indicates toxicity at this dose
Step 3: Clinical decision
• Hold medication due to toxic serum level
• Notify provider for dose reduction (likely to 0.125 mg every other day or 0.0625 mg
daily)
, 3
Why other options are incorrect:
• Option A: Unsafe—patient already toxic; additional dose worsens toxicity
• Option C: Nurse cannot independently alter doses; requires provider order
• Option D: Delaying treatment allows toxicity to progress; digoxin toxicity can cause life-
threatening arrhythmias
Nursing Implication: Digoxin is a high-alert medication. Always check apical pulse (hold if
<60 bpm in adults) AND recent serum levels before administration.
Safe Dose Range Question #3:
Q3: A provider orders acetaminophen 1,000 mg PO every 6 hours PRN for pain for an adult
patient weighing 70 kg. The maximum safe dose is 4,000 mg/day (or 75 mg/kg/day, whichever is
less). Is this order safe?
A. Yes, 1,000 mg every 6 hours is within safe range [CORRECT]
B. No, the single dose exceeds maximum
C. No, the daily dose exceeds maximum
D. No, the dosing frequency is too frequent
Correct Answer: A
Rationale:
Step 1: Calculate daily dose if given around the clock
• 1,000 mg × 4 doses (every 6 hours) = 4,000 mg/day
Step 2: Calculate mg/kg/day
• 4,000 mg ÷ 70 kg = 57.1 mg/kg/day
Step 3: Compare to maximum safe doses
• Standard maximum: 4,000 mg/day ✓ (not exceeded)
• Weight-based maximum: 75 mg/kg/day × 70 kg = 5,250 mg/day ✓ (not exceeded)
Step 4: Determine limiting factor
• 4,000 mg/day is LESS THAN 75 mg/kg/day (5,250 mg)
• Therefore, 4,000 mg/day limit applies and is not exceeded
Why other options are incorrect:
