APPENDIX D Answers

Answers to section 1 questions

Section 1

Prescription

1. Date; name of medicine; dose; route; time or frequency; prescriber’s signature

2. Oncology patients and children

3. Prescription-only medicine

4. Do not give the medicine; ask senior member of nursing staff; in turn, prescriber may need to be notified

5. Only where the medicine has been prescribed within a range of doses

Label

1. Strength

2. They can assist in prompt identification of different strengths of medicines in an emergency but may cause mistakes if the correct colour is misidentified.

3. It may be more economical for health authorities/retail outlets to purchase a product from overseas (parallel imports)

4. No answer given

Label 1

(a) Doxepin

(b) No. It would be issued on prescription only

(d) 9 full days

Label 2

(a) The strength of the eye drops; 0.3% of active ingredient in 100 mL of the product (weight in volume)

(b) 10 mL

(d) This product may be bought over the counter in a pharmacy

Label 3

(a) Trade mark

(b) Coating on a tablet which remains intact in the acid conditions of the stomach but dissolves in the higher pH of the intestine. More recently referred to as gastro-resistant

(d) The European Pharmacopoeia

(e) Alliance

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Label 4

(a) Registered trade mark

(b) Product Licence

Metric system

(e) nanogram

2. (c)

3. Universal system of weights and measures which is used to express the strength of a medicine – the metric system

Decimal	Fraction	Percentage
0.1	1/10	10%
0.6	3/5	60%
0.75	¾	75%
0.5	1/2	50%
0.05	1/20	5%
0.2	1/5	20%

5. 1.2 g

6. 1000 mL

7. 1(b); 2(c); 3(d); 4(a)

8. 1 gram of active drug is contained in 1000 mL of solution

(a) Weight in weight

(b) Volume in volume

(d) Volume in weight

10. 5 mL

Arithmetic

(a) 9.75

(b) 22

(d) 662.5

(a) 3.75

(b) 17.5

(d) 1.25

(a) 0.3

(b) 2.5

(d) 150

(a) 25%

(b) 40%

(d) 75%

(a) 150%

(b) 80%

(d) 25%

(a) 7500 mg

(b) 125 micrograms

(d) 750 nanograms

(a) 2.25

(b) 2

(d) 9/65

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(a) 3

(b) 7

(d) 2

(a) divide by

(b) equivalent to

(d) greater than

10.

Do not proceed. Seek help from a senior nurse;

Prescription: if need be, refer back to prescriber;

Label: speak to pharmacist;

Arithmetic: do not hesitate to work your answer out on paper; check answer with more senior colleague independently.

Answers to section 2 questions

(a) Prescriber’s signature must be written in full

(b) 5 mg abbreviated to 5

(d) Co-amilofruse is a compound comprising amiloride hydrochloride 2.5 mg and furosemide 20 mg

2. With the label uppermost and at eye level in a good light

3. Only if the tablet is scored; an enteric-coated tablet must never be split

4. The curve formed at the surface of a liquid in a container the centre of which is used as the precise volume

5. Do not administer the medicine; check your calculations again; try using another method; ask a reliable colleague to make an independent calculation; refer back to the prescriber

6. British National Formulary

Product literature or Data Sheet Compendium

Local medicine information service

7. Insulin, heparin

8. They are unique preparations with fixed proportion of ingredients, prescribed as numbers of tablets or volume of liquid

9. They are safer to use since they are universally recognised

10. Other than the alimentary canal; by injection

11. A graphical presentation used to determine body surface area from height and mass (weight)

12. A sterile liquid such as water for injections or sodium chloride 0.9% used to reconstitute a powdered medicine prior to injection

Answers to calculation exercises

Chapter 2

2.1

(a) ½

(b) ¾

(c)

(d)

(e) ½

(f) ½

(g) ½

(h)

2.2

(a) 0.75

(b) 1.5

(d) 0.1

(e) 0.4

2.3

(a)

(b) ½

(d) ¾

(e)

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2.4

(a) 222 mL

(b) 3½ units

2.5

(a) 50%

(b) 75%

(d) 60%

(e) 80%

2.6

(a) ½

(b) ¾

(c)

(d)

(e)

2.7

(a) 50%

(b) 30%

(d) 35%

(e) 85%

2.8

(a) 0.3

(b) 0.7

(d) 0.25

(e) 0.85

2.9

(a) 20

(b) 30

(d) 126

(e) 117

2.10

(a) 10%

(b) 60%

(d) 2%

(e) 30%

Chapter 4

4.1 2 tablets

4.2 1½ tablets

4.3 ½ tablet

4.4 12 tablets

4.5 One 5 mg tablet and one 1 mg tablet or two 3 mg tablets

4.6 2 tablets

4.7 4 tablets

4.8 1½ tablets

4.9 2 tablets

4.10 2 capsules

4.11 3 tablets

4.12 3 tablets

4.13 2 tablets

4.14 3 tablets

4.15 2 tablets

4.16 2 tablets

4.17 2 tablets

4.18 2 tablets

4.19 3 tablets

4.20 1½ tablets

4.21 4 capsules

4.22 2 tablets

4.23 ½ tablet

4.24 2 tablets

4.25 2 tablets

4.26 2 tablets

4.27 1½ tablets

4.28 4 tablets

4.29 20 mL syrup

4.30 7.5 mL suspension

4.31 4 mL (2 respules)

4.32 2.5 mL suspension

4.33 ½ tablet

4.34 7.5 mL oral solution

4.35 2 tablets

4.36 1 tablet

4.37 10 mL suspension

4.38 2 tablets

4.39 4 mL elixir

4.40 20 mL suspension

4.41 15 mL suspension

4.42 20 mL syrup

4.43 2½ tablets

4.44 20 mL syrup

4.45 20 mL suspension

4.46 70 mL oral solution

4.47 15 mL suspension

4.48 4 capsules

4.49 15 mL suspension

4.50 1.5 mL oral solution

4.51 0.2 mL oral solution

4.52 6.25 oral suspension

4.53 2 actuations

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4.54 20 mL oral solution

4.55 One tablet

4.56 7.5 mL oral suspension

4.57 1.5 mL elixir

4.58 10 mL syrup

4.59 6 capsules

4.60 0.75 mL oral drops

4.61 5 tablets

4.62 10 drops

4.63 4 capsules

4.64 750 micrograms

4.65 1.25 mL oral solution

4.66 30 mL syrup

4.67 5 tablets

4.68 1 x 5 mg and 3 x 1 mg and half x 500 microgram capsules

4.69 6 tablets then 4 tablets

4.70 3 tablets

4.71 48 mL oral suspension

Chapter 5

5.1 2.9 mL

5.2 0.5 mL IV injection

5.3 2 mL slow IV injection

5.4 0.5 mL SC injection

5.5 3 mL deep IM injection

5.6 2 mL IM injection

5.7 4 mL IM injection

5.8 3 mL IM injection

5.9 0.5 mL deep IM injection

5.10 0.5 mL SC injection

5.11 2 mL IM injection

5.12 1.5 mL SC injection

5.13 1.5 mL IM injection

5.14 0.7 mL IM injection

5.15 1.5 mL IV injection

5.16 0.25 mL IV injection

5.17 0.6 mL IV injection

5.18 0.2 mL IV injection; 0.8 mL IV injection

5.19 0.02 mL IV injection

5.20 0.2 mL SC injection

5.21 0.75 mL SC injection

5.22 0.5 mL IM injection

5.23 0.25 mL intra-articular injection

5.24 4 mL IM injection

5.25 1.5 mL IV injection

5.26 0.3 mL IM injection

5.27 0.5 mL slow IV injection

5.28 1 mL IM injection x 4 daily

5.29 6 mL

5.30 2.8 mL

5.31 0.9 mL

5.32 0.6 mL

5.33 2 mL

Chapter 6

6.1 (a) 0.5 mL; (b) 49.5 mL

6.2 (a) 6.5 mL; (b) 162.5 mL

6.3 333 mL

6.4 (a) 3 mL; (b) 47 mL

6.5 30 mL

6.6 (a) 25 mg; (b) 50 mL

6.7 1 mL

6.8 1 mL

6.9 500 micrograms

6.10 (a) 900 mg; (b) 20 g

6.11 84 mg/mL

6.12 (a) 50 g; (b) 2.5 g

Critical care

6.13 56 mL

6.14 1000 mg

6.15 100 micrograms

6.16 3 mL

6.17 1.5 mg

6.18 1.25 mg

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TPN

6.19 0.063 megajoules

6.20 1.05 megajoules

6.21

(a) 300 g – monitoring

(b) 400 g – monitoring

(d) 150 g – no monitoring

Moles, ETC

6.23 (a) 150; (b) 0.15

6.24 One

6.25 77 mmol (usually taken as 75)

6.26 5 mL

6.27 6.7 mmol

6.28 Sodium 150 mmol; bicarbonate 150 mmol

6.29 5.6 mL

6.30 K+ 20, Na+ 154 and Cl⁻ 174

6.31 25 mL

6.32 101.4 mmol

6.33 288 mmol of each

Chapter 7

7.1 0.5 mL IV injection (risk of hypertension; use with caution)

7.2 8 doses by deep IM injection

7.3 2.5 mL

7.4 3 tablets

7.5 0.4 mL IM injection

7.6 (a) 4 mL IM injection; (b) dilute 4 mL to 20 mL

7.7 (a) 1 mL; (b) 3 mL; (c) 0.004 units per min

7.8 75 mg

7.9 0.5 mL

7.10 0.1 mL

7.11 350 micrograms

7.12 15 mg; 15 micrograms

Chapter 8

8.1 ½ tablet

8.2 1½ tablets

8.3 Expect prescription to have dealt with legal/ethical issues involved. Because the tablet is a modified-release form, it may not be suitable. Refer back to pharmacy/prescriber.

8.4 ½ tablet

8.5 2 tablets

8.6 6 tablets

8.7 3.75 mL oral suspension

8.8 0.25 mL SC injection

8.9 2.5 mL elixir

8.10 3 capsules

8.11 2 mL solution

8.12 0.15 mL IM injection

8.13 17 mL suspension

8.14 25

8.15 10 mL oral solution twice daily

8.16 1.5 mL sugar-free syrup

8.17 6 mL syrup

8.18 3

8.19 7.5 mL oral suspension

8.20 7.5 mL oral suspension

8.21 ½ tablet; 0.25 mL injection

8.22 75 mL

8.23 1 mL injection

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8.24 0.7 mL injection

8.25 2 mL injection

8.26 2 mL linctus

8.27 2.5 mL syrup

8.28 0.4 mL SC injection

8.29 2 mL paediatric liquid

8.30 0.5 mL injection

8.31 0.25 mL slow IV injection

8.32 2.5 mL syrup

8.33 2.5 mL oral solution

8.34 0.2 mL IV injection

8.35 2.5 ml oral suspension

8.36 2 tablets

8.37 7.2 mL suspension

8.38 0.4 mL IM injection

8.39 3.2 mL suspension

8.40 4 mL oral solution

8.41 1.8 mL syrup

8.42 10 mL suspension

8.43 4.6 mL oral liquid

8.44 8.75 mL sugar-free liquid

8.45 15 mL

8.46 0.45 mL oral solution

8.47 2 mL elixir

8.48 1.8 mL oral solution x 2 daily

8.49 1.5 mL elixir

8.50 0.2 mL oral drops

8.51 0.35 mL oral suspension (see BNF for precautions on administration)

8.52 2 mL

8.53 3.6 mL; 180 mg

8.54 1 mL

8.55 6 mL

8.56 7 mL

8.57 0.2 mL

8.58 (a) 4.6 mL; (b) 75 mg; (c) 0.6 mL

8.59 (a) 4.8 mL; (b) 192 micrograms

8.60 10 micrograms/kg/min

8.61 0.2 mL per hour

8.62 2 tablets

8.63 24 mL per hour

8.64 (a) 1 mL to 1 litre; (b) 0.34 mL

8.65 (a) 45 mg; (b) 1.8 mL; (c) 0.45 mL

8.66 (a) 0.9 mL; (b) 15 nanograms

8.67 (a) 900 mg; (b) 37.5 mL

8.68 24.4 mL

Chapter 9

9.1 20 mg

9.2 400 mg

9.3 5 mg

9.4 350 mg

9.5 50 mg

9.6 200 mg

9.7 1.25 mL syrup

9.8 500 mg

9.9 937.5 mg