A nurse realises she has just given 10 units of insulin aspart to the wrong patient, a non-diabetic man waiting for his lunch. What should she do first?

Check his blood glucose and level of consciousness

Complete an incident report on the hospital system

Ask the patient's family whether he has diabetes

Inform the nurse manager about the medication error

When should the nurse document an oral medication on the medication administration record?

Immediately after the patient has taken it

At the end of the shift with the other notes

Before taking the dose to the patient's bedside

When the dose is prepared in the medication room

As the nurse hands over his morning tablets, a patient says, "That white pill is new; I usually get a yellow one." What should the nurse do first?

Hold the tablet and recheck the order and the dispensed drug

Ask the patient to take it and report any new side effects

Give the other tablets and leave the white one at the bedside

Explain that generic tablets often change colour and give it

A Muslim patient admitted for a minor procedure wishes to fast during Ramadan. He takes metformin 500 mg three times a day. The most appropriate nursing action is to:

Ask the prescriber and pharmacist about moving doses to the pre-dawn and sunset meals

Omit the daytime doses while he fasts and give only the evening dose

Tell him that his illness means he must not fast while in hospital

Give the doses at the usual times because hospital patients cannot fast

Medication administration and dosage calculation

40 Gulf Prometric RN (DHA, DOH, MOH, SCFHS) practice questions on Medication administration and dosage calculation, part of Pharmacology and Medication Safety. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Easy
Before giving any medication, which pair of details is acceptable for identifying the patient?
1. AFull name and date of birth
2. BFull name and bed number
3. CDate of birth and ward name
4. DRoom number and diagnosis
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Answer: A · Full name and date of birth
The JCI International Patient Safety Goals require at least two patient-specific identifiers, such as full name, date of birth or medical record number, checked against the wristband and the order. Room and bed numbers change when patients move, so they never identify a person. Diagnosis is shared by many patients on the same ward. Two identifiers are needed for every medication, blood product and specimen.
- B: A bed number belongs to the location, not the person, and changes on transfer.
- C: The ward name is a location shared by every patient on it.
- D: Neither a room number nor a diagnosis is unique to one patient.
Question 2 · Medium
A nurse realises she has just given 10 units of insulin aspart to the wrong patient, a non-diabetic man waiting for his lunch. What should she do first?
1. ACheck his blood glucose and level of consciousness
2. BComplete an incident report on the hospital system
3. CAsk the patient's family whether he has diabetes
4. DInform the nurse manager about the medication error
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Answer: A · Check his blood glucose and level of consciousness
After any medication error the first priority is the patient's safety, so the nurse assesses him, here by checking glucose and consciousness and making sure he eats. Rapid-acting insulin can cause hypoglycaemia within 15-30 minutes. The prescriber is then informed so that monitoring and treatment can be ordered. The incident report and the manager follow, and are not delayed or skipped.
- B: The incident report is required, but it comes after the patient is safe.
- C: His history is in his record; the urgent need is to assess and treat him.
- D: Informing the manager is needed but does not protect the patient from hypoglycaemia.
Question 3 · Easy
When should the nurse document an oral medication on the medication administration record?
1. AAt the end of the shift with the other notes
2. BImmediately after the patient has taken it
3. CBefore taking the dose to the patient's bedside
4. DWhen the dose is prepared in the medication room
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Answer: B · Immediately after the patient has taken it
Documentation records what actually happened, so it is done right after the patient has taken the dose. Charting before giving creates a false record if the patient refuses, vomits or the dose is withheld. Charting at the end of the shift risks another nurse giving a second dose. Prompt, accurate recording is the right to documentation.
- A: Delayed recording can lead another nurse to repeat the dose.
- C: Charting before the bedside check records a dose that may never be given.
- D: Recording at preparation means a refused or withheld dose is falsely shown as given.
Question 4 · Medium
As the nurse hands over his morning tablets, a patient says, "That white pill is new; I usually get a yellow one." What should the nurse do first?
1. AAsk the patient to take it and report any new side effects
2. BHold the tablet and recheck the order and the dispensed drug
3. CGive the other tablets and leave the white one at the bedside
4. DExplain that generic tablets often change colour and give it
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Answer: B · Hold the tablet and recheck the order and the dispensed drug
A patient who questions a medicine is one of the last safety barriers, so the dose is held until the order, the drug, the strength and the patient are verified. The difference may be a brand change, but it may also be a wrong drug or another patient's dose. The nurse checks the order and contacts the pharmacist if needed, then explains the result to the patient. Leaving medicines at the bedside is unsafe in any case.
- A: Asking the patient to take an unverified tablet ignores a possible error.
- C: Medicines left at the bedside may be missed, shared or taken unsupervised.
- D: Reassuring without checking may give the wrong drug.
Question 5 · Medium
A Muslim patient admitted for a minor procedure wishes to fast during Ramadan. He takes metformin 500 mg three times a day. The most appropriate nursing action is to:
1. AOmit the daytime doses while he fasts and give only the evening dose
2. BTell him that his illness means he must not fast while in hospital
3. CGive the doses at the usual times because hospital patients cannot fast
4. DAsk the prescriber and pharmacist about moving doses to the pre-dawn and sunset meals
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Answer: D · Ask the prescriber and pharmacist about moving doses to the pre-dawn and sunset meals
Respecting a patient's religious wishes while keeping treatment safe means asking the prescriber and pharmacist to adjust timing and dose, usually to the suhoor (pre-dawn) and iftar (sunset) meals. Metformin alone carries a low hypoglycaemia risk, so fasting can often be supported with a plan and glucose monitoring. Omitting doses without an order is a medication error. The decision to fast belongs to the patient, guided by his doctor and religious advice.
- A: A nurse may not omit ordered doses without a new order from the prescriber.
- B: Imposing a religious ruling is outside the nurse's role and harms trust.
- C: Giving doses during fasting hours ignores the patient's informed wishes.
Question 6 · Hard
After her loading dose, a woman with severe pre-eclampsia continues on magnesium sulfate 1 g/hour. The bag holds 20 g in 500 mL. What pump rate delivers the maintenance dose?
1. A20 mL/hour
2. B25 mL/hour
3. C50 mL/hour
4. D2.5 mL/hour
Answer and explanation in LearnFree account
Question 7 · Medium
A colleague suggests using one patient's insulin pen for another patient after fitting a new needle. Why is this unsafe?
1. AA new needle is not able to deliver the dose accurately
2. BBlood can flow back into the cartridge and pass on infection
3. CThe insulin loses strength once a second needle is attached
4. DEach pen is calibrated to the first patient's skin thickness
Answer and explanation in LearnFree account
Question 8 · Medium
On the cardiology ward, a man with atrial fibrillation is due his morning digoxin. His apical rate, counted for a full minute, is 54/minute. The correct action is to:
1. AWithhold the dose and inform the prescriber
2. BGive the dose and recheck the pulse in an hour
3. CRecount the radial pulse for 30 seconds and give it
4. DGive half the dose and record the pulse rate
Answer and explanation in LearnFree account
Question 9 · Medium
A nurse approaches a patient with the 10:00 medicines and asks, "Are you Mr Khalid?" The patient nods. What is wrong with this approach?
1. AThe nurse should check the bed card rather than speak to him
2. BA confused or hard-of-hearing patient may agree to any name
3. CThe nurse should have asked the family instead of the patient
4. DThe nurse should have used the patient's room number as well
Answer and explanation in LearnFree account
Question 10 · Easy
Which medication is classed as a high-alert medication?
1. AOral amoxicillin
2. BIntravenous insulin
3. CTopical clotrimazole
4. DOral paracetamol
Answer and explanation in LearnFree account
Question 11 · Hard
In the ICU, noradrenaline 4 mg is diluted to 50 mL in glucose 5% for a syringe driver. The order is 8 micrograms/minute. What is the syringe-driver rate?
1. A60 mL/hour
2. B12 mL/hour
3. C0.1 mL/hour
4. D6 mL/hour
Answer and explanation in LearnFree account
Question 12 · Hard
A 90 kg patient with a pulmonary embolism starts a weight-based heparin protocol: bolus 80 units/kg, then 18 units/kg/hour. The bag contains heparin 25,000 units in 500 mL. What is the infusion rate?
1. A3.24 mL/hour
2. B16.2 mL/hour
3. C32.4 mL/hour
4. D144 mL/hour
Answer and explanation in LearnFree account
Question 13 · Medium
Insulin aspart is ordered before lunch for a patient on the medical ward. The best time to give it is:
1. AAt the same time as his bedtime glargine dose
2. BOne hour before the meal tray is due on the ward
3. CWhen the meal tray has arrived and he is ready to eat
4. DTwo hours after lunch, once the glucose has peaked
Answer and explanation in LearnFree account
Question 14 · Medium
Digoxin 0.25 mg orally is ordered. The ward stock is digoxin 125 microgram tablets. The number of tablets to give is:
1. A2 tablets
2. B1 tablet
3. C4 tablets
4. D0.5 tablet
Answer and explanation in LearnFree account
Question 15 · Easy
Writing drug names as hydrOXYzine and hydrALAZINE on labels and in the pharmacy system is done to:
1. AMark both drugs as controlled medications
2. BShow which part of the name is the active salt
3. CIndicate that both drugs need a double check
4. DHighlight the letters that differ between look-alike names
Answer and explanation in LearnFree account
Question 16 · Hard
On admission, a patient's home list is omeprazole 20 mg daily, amlodipine 5 mg daily and metformin 500 mg twice daily. The admission orders are pantoprazole 40 mg daily, omeprazole 20 mg daily, amlodipine 5 mg daily, metformin 500 mg twice daily and paracetamol 1 g as needed for pain. Which issue must the nurse raise with the prescriber?
1. AMetformin is continued at the same home dose
2. BAmlodipine is continued at the same home dose
3. CTwo proton pump inhibitors are ordered together
4. DParacetamol has been added as needed for pain
Answer and explanation in LearnFree account
Question 17 · Medium
While programming a heparin infusion, the smart pump shows a hard-stop alert that the rate exceeds the drug library limit. The nurse should:
1. AStart the infusion and ask pharmacy to review the limit
2. BOverride the alert because the order has been signed
3. CCancel, recheck the order and calculation, and reprogram
4. DProgram the pump without the drug library to avoid the stop
Answer and explanation in LearnFree account
Question 18 · Hard
Hypokalaemia (K+ 3.0 mmol/L; reference 3.5-5.0) is to be corrected with 20 mmol of KCl in 100 mL over 30 minutes through a forearm cannula. Policy caps peripheral potassium at 10 mmol/hour. What is the nurse's correct action?
1. AAdd the dose to a 1 L bag to dilute it before starting
2. BRun it as ordered with continuous cardiac monitoring
3. CRun the same bag over 2 hours on her own judgement
4. DWithhold it and clarify the order with the prescriber
Answer and explanation in LearnFree account
Question 19 · Medium
A patient refuses his evening amlodipine, saying it makes his ankles swell. The most appropriate nursing action is to:
1. ACrush the tablet into his food so that he takes the dose
2. BExplore his concern, document the refusal and inform the prescriber
3. CAsk a colleague to give it later when he may be more willing
4. DRecord the dose as given since he had it yesterday
Answer and explanation in LearnFree account
Question 20 · Hard
Ibuprofen 10 mg/kg is ordered for a 22 kg boy with juvenile arthritis pain. Stock: 100 mg in 5 mL. How many millilitres are needed?
1. A22 mL
2. B4.4 mL
3. C2.2 mL
4. D11 mL
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Question 21 · Hard
At 14:00 a patient has 750 mL left in an IV bag running by pump at 100 mL/hour. At what time will the bag finish if the rate is unchanged?
1. A21:00
2. B22:30
3. C21:50
4. D21:30
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Question 22 · Hard
Morphine 2 mg IV is ordered. The vial contains morphine 10 mg/1 mL, which the nurse dilutes with 9 mL of sodium chloride 0.9% in a 10 mL syringe. What volume of the diluted solution should she give?
1. A2 mL
2. B0.2 mL
3. C5 mL
4. D20 mL
Answer and explanation in LearnFree account
Question 23 · Easy
Concentrated KCl ampoules can kill if injected undiluted. Which way of giving them is forbidden?
1. ADirect IV push
2. BA central venous line
3. CA volumetric infusion pump
4. DA diluted premixed bag
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Question 24 · Medium
Amoxicillin 375 mg orally is ordered for a child. The suspension contains 250 mg/5 mL. The volume to give is:
1. A1.5 mL
2. B7.5 mL
3. C15 mL
4. D3.3 mL
Answer and explanation in LearnFree account
Question 25 · Hard
At 08:00 a nurse has four medication tasks. Which should she do first?
1. AFirst IV antibiotic for a new patient with suspected septic shock
2. BScheduled oral atorvastatin for a patient with coronary disease
3. COral paracetamol requested by a patient with a 37.8 °C fever
4. DRoutine subcutaneous enoxaparin for a stable post-operative patient
Answer and explanation in LearnFree account

15 more Medication administration and dosage calculation questions

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Medication administration and dosage calculation

Before giving any medication, which pair of details is acceptable for identifying the patient?

A nurse realises she has just given 10 units of insulin aspart to the wrong patient, a non-diabetic man waiting for his lunch. What should she do first?

When should the nurse document an oral medication on the medication administration record?

As the nurse hands over his morning tablets, a patient says, "That white pill is new; I usually get a yellow one." What should the nurse do first?

A Muslim patient admitted for a minor procedure wishes to fast during Ramadan. He takes metformin 500 mg three times a day. The most appropriate nursing action is to:

After her loading dose, a woman with severe pre-eclampsia continues on magnesium sulfate 1 g/hour. The bag holds 20 g in 500 mL. What pump rate delivers the maintenance dose?

A colleague suggests using one patient's insulin pen for another patient after fitting a new needle. Why is this unsafe?

On the cardiology ward, a man with atrial fibrillation is due his morning digoxin. His apical rate, counted for a full minute, is 54/minute. The correct action is to:

A nurse approaches a patient with the 10:00 medicines and asks, "Are you Mr Khalid?" The patient nods. What is wrong with this approach?

Which medication is classed as a high-alert medication?

In the ICU, noradrenaline 4 mg is diluted to 50 mL in glucose 5% for a syringe driver. The order is 8 micrograms/minute. What is the syringe-driver rate?

A 90 kg patient with a pulmonary embolism starts a weight-based heparin protocol: bolus 80 units/kg, then 18 units/kg/hour. The bag contains heparin 25,000 units in 500 mL. What is the infusion rate?

Insulin aspart is ordered before lunch for a patient on the medical ward. The best time to give it is:

Digoxin 0.25 mg orally is ordered. The ward stock is digoxin 125 microgram tablets. The number of tablets to give is:

Writing drug names as hydrOXYzine and hydrALAZINE on labels and in the pharmacy system is done to:

While programming a heparin infusion, the smart pump shows a hard-stop alert that the rate exceeds the drug library limit. The nurse should:

Hypokalaemia (K+ 3.0 mmol/L; reference 3.5-5.0) is to be corrected with 20 mmol of KCl in 100 mL over 30 minutes through a forearm cannula. Policy caps peripheral potassium at 10 mmol/hour. What is the nurse's correct action?

A patient refuses his evening amlodipine, saying it makes his ankles swell. The most appropriate nursing action is to:

Ibuprofen 10 mg/kg is ordered for a 22 kg boy with juvenile arthritis pain. Stock: 100 mg in 5 mL. How many millilitres are needed?

At 14:00 a patient has 750 mL left in an IV bag running by pump at 100 mL/hour. At what time will the bag finish if the rate is unchanged?

Morphine 2 mg IV is ordered. The vial contains morphine 10 mg/1 mL, which the nurse dilutes with 9 mL of sodium chloride 0.9% in a 10 mL syringe. What volume of the diluted solution should she give?

Concentrated KCl ampoules can kill if injected undiluted. Which way of giving them is forbidden?

Amoxicillin 375 mg orally is ordered for a child. The suspension contains 250 mg/5 mL. The volume to give is:

At 08:00 a nurse has four medication tasks. Which should she do first?