Med calculations NCLEX-RN Practice Questions

Med calculations NCLEX-RN Practice Questions

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Med calculations NCLEX-RN Practice Questions equip you to safely compute dosages, IV rates, weight-based dosing, and reconstitutions under exam pressure. Pharmacological and Parenteral Therapies demand precision across drip factors, pump programming, titratable drips, pediatric safe ranges, and insulin/heparin protocols. In this topic-wise practice set, you will apply conversion factors (mg–mcg, lb–kg), choose correct rounding (gtt/min to whole numbers; mL/hr to tenths when appropriate), and validate safe dose ranges. These 30 exam-level MCQs mirror real clinical scenarios—macro/microdrip sets, time-to-infuse, divided dosing, IV push rates, and high-alert medications—to build accuracy and confidence. Work each problem methodically, label units, and check reasonableness to minimize errors and ensure patient safety.

Q1. The provider prescribes 1,000 mL of 0.9% NS to infuse over 8 hours via gravity tubing with a drop factor of 15 gtt/mL. What is the flow rate in gtt/min? (Round to the nearest whole drop.)

  • 26 gtt/min
  • 31 gtt/min
  • 38 gtt/min
  • 42 gtt/min

Correct Answer: 31 gtt/min

Q2. A child weighing 18 kg is prescribed ceftriaxone 75 mg/kg/day IM in two divided doses. How many milligrams should the nurse administer per dose?

  • 600 mg
  • 675 mg
  • 750 mg
  • 900 mg

Correct Answer: 675 mg

Q3. A heparin infusion is ordered at 12 units/kg/hr for a client weighing 70 kg. The IV bag contains 25,000 units of heparin in 500 mL D5W. What is the infusion rate in mL/hr? (Round to the nearest tenth.)

  • 14.0 mL/hr
  • 16.8 mL/hr
  • 17.5 mL/hr
  • 20.0 mL/hr

Correct Answer: 16.8 mL/hr

Q4. Dopamine 5 mcg/kg/min is ordered for a client weighing 80 kg. The premixed bag contains 400 mg in 250 mL D5W. What is the IV pump setting in mL/hr?

  • 10 mL/hr
  • 12 mL/hr
  • 15 mL/hr
  • 18 mL/hr

Correct Answer: 15 mL/hr

Q5. The provider orders to mix NPH insulin 18 units and regular insulin 12 units in one syringe. After properly preparing the dose, what total volume (units) will be in the syringe?

  • 12 units
  • 18 units
  • 30 units
  • 36 units

Correct Answer: 30 units

Q6. Vancomycin 1 g in 250 mL NS is to infuse over 2 hours via infusion pump. What is the setting in mL/hr?

  • 100 mL/hr
  • 120 mL/hr
  • 125 mL/hr
  • 150 mL/hr

Correct Answer: 125 mL/hr

Q7. Infuse 120 mL of antibiotic over 3 hours using microdrip tubing (60 gtt/mL). What is the drip rate in gtt/min? (Round to the nearest whole drop.)

  • 20 gtt/min
  • 30 gtt/min
  • 40 gtt/min
  • 60 gtt/min

Correct Answer: 40 gtt/min

Q8. The prescription is metoprolol 37.5 mg PO once. Available: metoprolol 25 mg tablets. How many tablets should the nurse administer?

  • 1 tablet
  • 1.5 tablets
  • 2 tablets
  • 2.5 tablets

Correct Answer: 1.5 tablets

Q9. A cefazolin vial is reconstituted to a final concentration of 330 mg/mL. The order is cefazolin 600 mg IM now. What volume will you draw up? (Round to the nearest tenth mL.)

  • 1.5 mL
  • 1.8 mL
  • 2.0 mL
  • 2.2 mL

Correct Answer: 1.8 mL

Q10. Recommended acetaminophen dosing is 10–15 mg/kg/dose q6h PRN. For a 10 kg child, what is the maximum single dose?

  • 100 mg
  • 125 mg
  • 150 mg
  • 200 mg

Correct Answer: 150 mg

Q11. Furosemide 40 mg IV push is ordered. The recommended rate is 20 mg/min. What is the minimum time to administer this dose?

  • 1 minute
  • 2 minutes
  • 3 minutes
  • 4 minutes

Correct Answer: 2 minutes

Q12. Gentamicin 6 mg/kg/day IV divided q8h is prescribed for a 72 kg adult. The pharmacy provides gentamicin 40 mg/mL. How many mL per dose? (Round to the nearest tenth if needed.)

  • 2.5 mL
  • 3.0 mL
  • 3.6 mL
  • 4.0 mL

Correct Answer: 3.6 mL

Q13. Administer 100 mL of an IVPB over 45 minutes with tubing calibrated at 10 gtt/mL. What is the drip rate in gtt/min? (Round to the nearest whole drop.)

  • 18 gtt/min
  • 20 gtt/min
  • 22 gtt/min
  • 25 gtt/min

Correct Answer: 22 gtt/min

Q14. An amoxicillin order reads 500 mg PO q12h for a child weighing 44 lb. The recommended dose is 45 mg/kg/day divided BID. Is this dose safe?

  • Yes, within the recommended daily dose
  • No, exceeds recommended daily dose
  • No, below recommended daily dose
  • Cannot determine from given information

Correct Answer: No, exceeds recommended daily dose

Q15. A vial label states: “Add 3.2 mL sterile water to yield 500 mg per 2 mL.” The order is for 375 mg IM. What volume should be administered?

  • 1.0 mL
  • 1.5 mL
  • 1.8 mL
  • 2.0 mL

Correct Answer: 1.5 mL

Q16. A PCA is programmed for morphine basal infusion at 2 mg/hr. The PCA concentration is 1 mg/mL. What is the basal rate in mL/hr?

  • 1 mL/hr
  • 2 mL/hr
  • 3 mL/hr
  • 4 mL/hr

Correct Answer: 2 mL/hr

Q17. For anaphylaxis, the order is epinephrine 0.3 mg IM using 1 mg/mL (1:1,000) solution. What volume will you administer?

  • 0.15 mL
  • 0.3 mL
  • 0.5 mL
  • 1.0 mL

Correct Answer: 0.3 mL

Q18. A continuous enteral feeding of 900 mL is to run over 12 hours. What rate should be set on the pump in mL/hr?

  • 50 mL/hr
  • 60 mL/hr
  • 75 mL/hr
  • 90 mL/hr

Correct Answer: 75 mL/hr

Q19. The order is digoxin 0.125 mg PO daily. The pediatric elixir is 0.05 mg/mL. What volume should be administered?

  • 1.25 mL
  • 2.0 mL
  • 2.5 mL
  • 3.0 mL

Correct Answer: 2.5 mL

Q20. Phenytoin loading dose 15 mg/kg IV is ordered for a 60 kg client. The solution is 50 mg/mL. What volume is required for the loading dose?

  • 9 mL
  • 12 mL
  • 15 mL
  • 18 mL

Correct Answer: 18 mL

Q21. Calculate maintenance IV fluid rate using the 4-2-1 rule for a 25 kg child. What is the hourly rate in mL/hr?

  • 55 mL/hr
  • 60 mL/hr
  • 65 mL/hr
  • 70 mL/hr

Correct Answer: 65 mL/hr

Q22. The prescription is trimethoprim-sulfamethoxazole 320 mg trimethoprim PO q12h. The DS tablet contains 160 mg trimethoprim/800 mg sulfamethoxazole. How many tablets per dose?

  • 1 tablet
  • 1.5 tablets
  • 2 tablets
  • 2.5 tablets

Correct Answer: 2 tablets

Q23. Convert levothyroxine 0.075 mg to micrograms.

  • 0.75 mcg
  • 7.5 mcg
  • 75 mcg
  • 750 mcg

Correct Answer: 75 mcg

Q24. Administer a heparin bolus of 80 units/kg for a 95 kg patient. The vial contains 5,000 units/mL. What volume will you give? (Round to the hundredth mL.)

  • 1.2 mL
  • 1.5 mL
  • 1.52 mL
  • 1.6 mL

Correct Answer: 1.52 mL

Q25. Nitroprusside 0.5 mcg/kg/min is ordered for a 70 kg client. The infusion is 50 mg in 250 mL D5W. What is the infusion rate in mL/hr?

  • 7.5 mL/hr
  • 9.0 mL/hr
  • 10.5 mL/hr
  • 12.0 mL/hr

Correct Answer: 10.5 mL/hr

Q26. The provider orders warfarin 7.5 mg PO daily. Available: warfarin 5 mg tablets. How many tablets should the nurse administer?

  • 1 tablet
  • 1.5 tablets
  • 2 tablets
  • 2.5 tablets

Correct Answer: 1.5 tablets

Q27. Regular insulin IV infusion: Mix 100 units in 100 mL NS (1 unit/mL). Start at 0.1 units/kg/hr for a 68 kg client. What is the pump rate in mL/hr?

  • 3.4 mL/hr
  • 5.0 mL/hr
  • 6.8 mL/hr
  • 10.0 mL/hr

Correct Answer: 6.8 mL/hr

Q28. The recommended ibuprofen dose is 10 mg/kg/dose q6–8h. For a 33 lb child, the suspension is 100 mg/5 mL. What volume per dose should be given?

  • 5 mL
  • 6 mL
  • 7.5 mL
  • 10 mL

Correct Answer: 7.5 mL

Q29. You mix 2 mL of lidocaine 2% with 8 mL NS. What is the final lidocaine concentration?

  • 0.2%
  • 0.4%
  • 1.0%
  • 2.0%

Correct Answer: 0.4%

Q30. An IV has 650 mL remaining and is infusing at 75 mL/hr. How long will it take to complete the infusion?

  • 8 hours
  • 8 hours 20 minutes
  • 8 hours 40 minutes
  • 9 hours

Correct Answer: 8 hours 40 minutes

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