Drug Assessment Paper

Name:

Results

Band:

Calculations

Area Applied For:

Drug Problem
Solving

Instructions
This test has been designed to assess your drug knowledge and ability to calculate simple
drug calculations.
You are allocated 40 minutes to complete the entire paper. You may not leave the room if you
complete the paper before this time. Calculators are allowed however you are not permitted
to use your mobile phone.
This paper is in 2 sections the first section is some drug calculations and the second section
assesses your ability to problem solve.
Please clearly identify your answer in the box provided and show your workings out in the
space provided.
Read the questions carefully, think about your answer, would you do this on the
ward?

Formulae
Converting Metric Units
1
1
1
1

kilogram (kg)
gram (g)
milligram (mg)
litre (L)

=
=
=
=

1000
1000
1000
1000

Dosage of Oral Medicines

grams (g)
milligrams (mgs)
micrograms (mcg)
millilitres (mls)

Volume required = strength required x

volume of stock solution
Stock solution
OR
What you want x what its
in

Calculating drip rates

Drop rate/minute = Volume to be infused x
drops per ml
Hours of infusion time x
60 (minutes in hour)
The giving set delivers 20 drops per ml.

Administer 1000 ml 5% Dextrose over 8 hours

whilst blood sugar < (less than) 10 mmol

What youve got

Sliding Scale
50 units Actrapid in 50 ml 0.9% Sodium
Chloride (1 unit of Actrapid per ml)
Blood Sugar (mmol)

Infusion rate

Less than 3.0

3.1 4.9
5.0 6.9
7.0 8.9
9.0 10.9
11.0 13.9
14.0 17.9
18.0 and above

Stop and call Dr.

1 ml per hr
2 ml per hr
3 ml per hr
4 ml per hr
6 ml per hr
8 ml per hr
8ml per hour and call
Dr.
Administer 1000 ml 0.9% Sodium Chloride
over 8 hours

whilst blood sugar > (greater than) 10 mmol

Drug Calculations
Question
1.

Convert 1.75 mgs into micrograms

2.

Convert 480mls into litres

3.

Patient B is prescribed 9 mgs of

Diazepam. Diazepam comes as 2mg,
5mg and 10mg tablets. Identify the
correct combination using the least
amount of tablets to ensure the
correct dose is given.

4.

Patient C has been prescribed 1L of 0.9%

sodium chloride IV to be administered
over 12 hours. However, 2 hours after
the infusion was commenced, the patient
pulls out the cannula. How much fluid
has been infused?

5.

Patient A is on 100mgs of Flucloxacillin

oral suspension QDS. The medication is
available as 125 mgs/5mls suspension
only. How many mls will a patient take in
a 24 hour period?

6.

What are the drops per minute for a

prescription of 1L of 5% Dextrose if the
infusion is to be run over 10 hours?

7.

A patient has been prescribed 100mgs of

methylprednisolone IV. The vial contains
125mgs/ml, how much
methylprednisiolone will you give?

8.

A dose of Frusemide 250mgs IV has been

prescribed. The maximum rate is not
more than 4mgs/minute, how long will it
take to give?

9.

Please
carefully
examine
the
prescriptions and sliding scale on the
formula page and answer the following
questions :What rate would the infusion need to be
set at if the patients blood sugar was
12.5 mmols?
Which IV Fluid would need to be running?

9a
.
9b
.
10
.

Answer

Mark

Stock Heparin has strength of 5000 units

per ml. What volume must be drawn up
to give 8400 units?

Drug Problem Solving

1.

Question
In the UK it is illegal for a registered nurse to administer drugs
which have not been prescribed. What would you do if a Doctor
asked you to do this

Answer

Mark

a) Give the drug to the patient it.

b) inform the Doctor that he must first write the prescription
before you administer it
c) give the drug after making the Doctor promise he will not
forget to come to the ward and documenting everything in the
patients notes
2.

You are on a night shift. The other Registered Nurse working with
you is off the ward on her break. A patient requires Morphine for
her extreme pain. Do you:a) give the Morphine and leave the chart and Controlled Drugs
(CD) book out as a reminder for the other nurse to sign when
she returns
b) Prepare the drug yourself but get a Health Care Support
Worker to go with you whilst you administer it
c) Tell the patient they will have to wait for your colleagues to
return
d) Bleep the Site Manager / Practitioner and request they come
to the ward to prepare and administer a CD with you

3.

A patient has been prescribed Trimethroprim 200mg QDS for an

uncomplicated urine infection. You suspect the frequency of
administration may be incorrect. However the nurse in charge
tells you that she thinks the prescription is correct and you
should give it anyway to prevent any deterioration in the
patients condition. Do you :a) With hold the drug and bleep the pharmacist
b) With hold the drug, look it up in the British National Formulary
(BNF) and contact the prescriber.
c) do as the nurse in charge says ensuring you have
documented your concerns clearly in the patients notes and
asked the prescriber to check it next time he is on the ward

4.

You are doing the 6pm drug round and you have given Mrs Smith
100mgs of Tramadol, you get to the next lady Mrs Brown and
discover that you have given Mrs Smith Mrs Browns Tramadol.
What are you going to do?
a) Carry on with the rest of the drug round but keep a closer eye
on Mrs Smith for the rest of the shift.
b) Tell the nurse in charge who tells you to document in the
medical notes but not to worry.
c) Escalate to the General Manager on call for the evening and
the patients consultant.
d) Check the patient, inform the doctors on call and nurse in

charge, complete an adverse incident form and inform patient

and next of kin.

5.

Question
Mr Jones has been admitted to the ward and when you go
through his medical notes to complete his admission you identify
he is allergic to Codeine. You note on his drug chart that he was
given 15mgs of Dihydrocodeine at 08.00, he is now due another
15 mgs at 12.00. What are you going to do?

Answer

Mark

a) Give the drug as he displayed no sign of allergy earlier and

see what happens.
b) Omit the drug, document reasons for not giving and contact
the prescriber.
c) Give him an alternative analgesic now and discuss your
actions with the doctor later.
6.

Identify the 6 rights or important checks of Drug administration?

7.

In the UK controlled drugs have to be counted daily, while

counting these drugs it has been discovered the count is
incorrect what actions will you take?
a) Lock the drugs away and leave a note for sister on her return
tomorrow.
b) Immediately alert the on call pharmacist, ring the police and
complete an incident form.
c) Check the cupboard thoroughly and all packets inside the
cupboard, double check the CD record book to ensure the
entries are correct, check the ordering and delivery book and
if the count remains incorrect alert the Night Practitioner,
complete incident form and await further instruction.

8.

A patient is due to have Frusemide 80mgs and Metoprolol

25mgs.The most recent observations indicate the BP was
80/60mm/Hg. What will you do?
a) Give the medication and recheck the BP in one hour.
b) Omit tablets, document reasons and inform doctors.
c) Give the tablets and put the patient on a 30 tilt and push oral
fluids.

9.

A patient has been prescribed Fentanyl patch 12mcgs every

72hrs. In the CD cupboard you find Fentanyl patch 25mcgs. The
next dose is now due, what action will you take?
a) Cut the patch in approximately half and place on the patient
b) Order it in the pharmacy book and tell the patient they will
have to wait for it to come from pharmacy in a few hours.
c) Order it in the CD book, call the ward pharmacist and go to
pharmacy to collect as soon as possible.