Question 1
I understand the value of doing my own work and learning this skill to support my future independent practice as a nurse practitioner.
I understand that while there may be opportunities beyond my faculty’s control to collaborate or share answers with peers, that it would not benefit my own personal and professional growth to do so.
I agree to do my own work and take personal responsibility for my learning.
Correct!
Question 2
Refill Henry Xia’s hydrochlorothiazide prescription for hypertension. He takes 25 mg a day and gets a 3-month supply with enough refills for a year. NKDA; DOB 6/9/67.
Patient Name:
DOB:
Allergies:
Medication:
Strength:
Quantity:
Directions for Use:
Indication for Use:
Refills:
Answer 1:
Answer 2:
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Answer 3:
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Answer 4:
Answer 5:
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Answer 6:
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Answer 7:
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Answer 8:
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Correct Answer
Answer 9:
Medication: hydrochlorothiazide
Spell out the medication and avoid abbreviations to minimize errors.
Strength: 25mg
Directions for Use: Take one tablet by mouth daily in the morning
Spell out by mouth and daily. Specifying time of day is appropriate for some medications such as a diuretic like this medication.
Quantity: 90
A 3-month supply will be a default of 90 days. There is no need to consider if months have 28, 30, or 31 days.
Refills: 3
There are 12 months in a year and each prescription is providing 3 months’ worth of pills so 3 refills will total 12 months. The original prescription covers 3 months, then 3 refills x 3 months is 9 months for a total of 12 months.
Indication for Use: hypertension
Question 3
Prescribe antibiotic therapy for 14-month old Brandy Mitchell who has acute otitis media. You will prescribe an antibiotic that has an established pediatric dose by weight. She weighs 10 kilograms and has no allergies. She has not had otitis media previously and has no allergies.
What calculation is necessary for this prescription?
Correct!
For the medication to be ordered for this patient, a weight-based dosage calculation will be needed. Body surface area is not used for these types of drugs. Rule of 9s are used when calculating the percentage of the body when someone is burned across several parts of their body. Gestational age is not a consideration for this patient or treatment.
Question 4
Your Answer:
To calculate a drug dose per weight (ml/dose), we need to convert the patient’s weight in pounds to kilograms first. To do this, we divide the weight in pounds by 2.2 (1kg= 2.2lbs). For instance
22 lbs/2.2= 10kg.
The second step involves calculating the correct dose in mg that the patient should be given based on his weight in kg
=patient’s weight (kg) x mg/kg
= 10 x 40 = 400mg
The third step involves calculating the amount of milliliters to give the patient based on the weight of the dose per day (24 hours)
= 400 x 5/400
= 5ml/dose daily
Divide the dose by two to determine what the patient should receive after 12 hours (When the dose is given twice a day)
=5/2
= 2.5ml/dose after twelve hours
| Step 1. Convert pounds to kg: | 22 lb × 1 kg/2.2 lb = 10 kg |
| Step 2. Calculate the dose in mg: | 10 kg × 40 mg/kg/day = 400 mg/day |
| Step 3. Divide the dose by the frequency: | 400 mg/day ÷ 2 (BID) = 200 mg/dose BID |
| Step 4. Convert the mg dose to mL: | 200 mg/dose ÷ 400 mg/5 mL = 2.5 mL BID |
Question 5
Your patient weighs 22lbs. If you order Amoxicillin 80mg/kg/day by mouth divided into 2 doses in 24 hours for 10 days, how much should this patient receive? The medication strength is 400mg/5ml
This patient would receive ml every hours for days.
Answer 1:
Answer 2:
Answer 3:
The correct answer is 5.
Question 6
Give 74-year-old Robert Popovich, a post-operative hip replacement patient with no allergies, a hydrocodone/acetaminophen prescription to last for 5 days.
What special number that belongs to the provider is needed to prescribe this medication specifically?
Correct!
A DEA Number is required to order and prescribe scheduled drugs such as hydrocodone. An NPI number is a National Provider Identification number that is required to write prescriptions in general but not specific to this medication. A Medicare number is patient specific and not provider specific and not needed to write prescriptions. A patient’s driver’s license number may be needed to pick up this prescription from the pharmacy, but it does not belong to the provider and is not needed to write this prescription.
Question 7
Give Robert Popovich, a post-operative hip replacement patient a prescription for hydrocodone/acetaminophen 5/325 to be taken every 4-6 hours prescription to last for 5 days. Patient should be allowed to take one or two pills at a time. Patient is allergic to amoxicillin. DOB is 2/8/1946.
Patient Name:
Allergies:
Date of Birth:
Medication:
Strength:
Quantity:
Directions for Use:
Indication for Use:
Refills:
Answer 1:
Answer 2:
Answer 3:
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Answer 4:
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Answer 5:
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Answer 6:
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Answer 7:
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Answer 8:
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Answer 9:
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Patient Name: Robert Popovich
Allergies: Amoxicillin
Date of Birth: 2/8/46
Medication: Lortab or hydrocodone/acetaminophen
Strength: 5mg/325mg
Directions for Use: Take 1-2 tablets by mouth every 4-6 hours
Quantity: 60
24 hours divided by 4 since that would yield the most doses needed in a 24 hour period equals 6. 6 times 2 pills at a time if max dose is taken equals 12. 12 times 5 days equals 60 total pills. 24/4=6, 6×2=12, 12×5= 60
Refills: 0
This is a 5 day script only. If patient needs more pain medication beyond this, a re-evaluation is needed.
Indication for use: Post operative pain or post-operative hip replacement. When prescribing pain medication, be sure to state what the pain is for on the script so the patient knows for which pain the medication should be taken.
Question 8
Prescribe triamcinolone cream for 40-year-old Ismail Kahn who has eczema. DOB 12/9/66 with NKDA.
Using one of the resources listed for assistance, complete the prescription:
Patient Name:
Date of Birth:
Allergies:
Medication:
Strength:
Quantity:
Directions for Use:
Indication for Use:
Refills:
Answer 1:
Answer 2:
Correct Answer
Answer 3:
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Answer 4:
Answer 5:
Answer 6:
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Answer 7:
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Answer 8:
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Answer 9:
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Patient Name: Ismail Kahn
Date of Birth: 12/9/66
Allergies: NKDA
Medication: Triamcinolone Cream
Strength: 0.1%, 0.025%, 0.5%
Feedback for strength: 0.025%, 0.5%, or 0.1% can be prescribed for eczema depending on the source utilized to determine dosing.
Quantity: 1 tube
Directions for Use: apply up to four times a day to affected area
Indication for Use: eczema
Refills: There is no right or wrong answer here.
Question 9
Prescribe alendronate for Nancy Kozlosky to combat her recently diagnosed osteoporosis. She can get a 3-month supply and be seen in one year for a follow-up unless there are any complications or concerns. DOB 7/11/38. Nancy is allergic to codeine.
Patient Name:
Date of Birth:
Allergies:
Medication:
Strength:
Quantity:
Directions for Use:
Indication for Use:
Refills:
Answer 1:
Answer 2:
Correct Answer
Answer 3:
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Answer 4:
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Answer 5:
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Answer 6:
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Answer 7:
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Answer 8:
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Answer 9:
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Patient Name: Nancy Kozlosky
Date of Birth: 7/11/38
Allergies: Codeine
Medication: alendronate
Strength: 70 mg or 10 mg
This is the only dose for postmenopausal osteoporosis. The age of this patient indicates she is post-menopausal. There is a potential alternative dosing schedule if the patient does not tolerate the one time a week dosing, but there is no indication this is the case since this is a new diagnosis of osteoporosis.
Directions for Use: Take 1 tablet by mouth one time per week or take 1 tablet by mouth one time per day
Quantity: 12 or 90
Since the patient is taking one pill per week and doing a 3 month supply, this is 4 weeks x 3 months for a total of 12 pills. Or, if you prescribed 10mg daily, the quantity would be 90.
Refills: 3
There are 12 months in a year and each prescription is providing 3 months’ worth of pills so 3 refills will total 12 months. The original prescription covers 3 months, then 3 refills x 3 months is 9 months for a total of 12 months.
Indication for use: osteoporosis
Question 10
Correct!
Correct!
Correct!
Alendronate should be taken with water 30 minutes before first food, drink, or medication as it requires the acidic environment of the stomach to be activated. The patient should avoid lying down for 30 minutes.
Question 11
You Answered
Correct Answer
Creatinine should be drawn before starting treatment and routinely throughout treatment with alendronate. Bisphosphonates are not recommended for patients with creatinine levels below 30–35 mL/min.
