Calculations II

Question 1

Using the Harris-Benedict equation below, calculate the resting non-protein caloric requirement
(BEE) for a major trauma patient (stress factor 1.8). The patient is a 58 year old male who
weighs 190 pounds and measures 5'11" in height. Activity factor is 1.2. (Answer must be
numeric; no units or commas; round final answer to the nearest WHOLE number.)

BEE (males): 66.47 + 13.75(weight in kg) + 5.0(height in cm) - 6.76(age in years)

BEE (females): 655.1 + 9.6(weight in kg) + 1.85(height in cm) - 4.68(age in years)

Question 2

You are asked to prepare one liter of 10% sodium bicarbonate solution. You only have a 1%
solution and a 20% solution in stock. How many milliliters of the 1% solution will be required to
compound this prescription? (Answer must be numeric; no units or commas; round final answer
to the nearest WHOLE number.)

Question 3

Oral potassium chloride 10% solution contains 20 mEq of potassium per 15 mL of solution. A
patient is prescribed 22 mEq of potassium daily. How many milliliters of potassium chloride
10% will the patient receive each day? (Answer must be numeric; no units or commas.)

Question 4

How many milliliters (mL) of Mylanta suspension are contained in each dose of prescription
below? Round to the nearest WHOLE number.

Belladonna Tincture 20 mL
Phenobarbital 80 mL
Mylanta susp. qs. ad 150 mL
Sig 15 mL TID

Answer

A 2.5 mL Mylanta per dose

B 5 mL Mylanta per dose
C 10 mL Mylanta per dose
D 15 mL Mylanta per dose
E 45 mL Mylanta per dose
Question 5

Greg is a 66 yo male admitted the hospital for cellulitis. What is his CrCl using the Cockcroft-
Gault equation? Use ideal body weight. (Answer must be numeric; no units or commas; round
final answer to the nearest WHOLE number.)

Physical Exam / Vitals:

Height: 73 inches Weight: 187 pounds
BP: 167/82 mmHg HR: 79 BPM
RR: 14 BPM Temp: 101.9°F Pain: 4/10
Extremities: Mild-moderate right lower extremity cellulitis extending to mid-calf. No open
lesions.

Labs:
Na (mEq/L) = 146 (135 – 145)
K (mEq/L) = 5.2 (3.5 – 5)
Cl (mEq/L) = 99 (95 – 103)
HCO3 (mEq/L) = 28 (24 – 30)
BUN (mg/dL) = 22 (7 – 20)
SCr (mg/dL) = 1.7 (0.6 – 1.3)
Glucose (mg/dL) = 137 (100 – 125)
Ca (mg/dL) = 9.5 (8.5 – 10.5)
Mg (mEq/L) = 1.9 (1.3 – 2.1)
PO4 (mg/dL) = 3.0 (2.3 – 4.7)

Question 6

The pharmacy receives a prescription for 100 grams of 5% hydrocortisone ointment. You have a
10% hydrocortisone ointment and a 2.5% hydrocortisone ointment available. Using only these
products, how many grams of the 2.5% ointment should be used to compound this
prescription? (Answer must be numeric; no units or commas; include a leading zero when
answer is less than 1; round final answer to the nearest TENTH.)

Question 7

The pharmacist has an order for heparin 25,000 units in 250 mL D5W to infuse at 2,000
units/hour. How many hours will be needed to infuse the entire bag? (Answer must be numeric;
no units or commas.)

Question 8

A 10 gram packet of potassium chloride provides 20 mEq of potassium. How many grams of
powder would provide 9 mEq of potassium? (Answer must be numeric; no units or commas.)
Question 9

Polly is 62 inches tall and weighs 225 lbs. What is her adjusted body weight? (Answer must be
numeric; no units or commas; round final answer to the nearest WHOLE number.)

Question 10

Choose the correct indications for parenteral nutrition (PN) therapy. (Select ALL that apply.)

Answer

A Severe gut dysfunction due to various conditions, such as Crohn's disease, ulcerative colitis,
obstruction and short bowel syndrome from surgery.
B Patients requiring long-term supplemental nutrition because they are unable to receive daily
requirements through oral or enteral feedings.
C A patient who will be NPO for three full days secondary to surgery.
D All patients in the ICU.
E A patient with mild acute pancreatitis.

Question 11

A babysitter brings a 9-year-old girl to the Emergency Department. She is unarousable. Labs are
ordered and an ABG is drawn. The ABG results are as follows: 7.49/42/85/39/96. What acid
base disorder does the child have?
Answer

A Metabolic acidosis
B Metabolic alkalosis
C Respiratory acidosis
D Respiratory alkalosis

Question 12

Choose the correct statement concerning parenteral nutrition (PN) therapy:

Answer

A Dextrose in PN provides 1.1 kcal/gram

B Amino acids provide 4 kcal/gram
C Dextrose in PN provides 4 kcal/gram
D 20% fat emulsion provides 2.2 kcal/gram
E 10% fat emulsion provides 2.2 kcal/gram

Question 13
If 500 mL of a 28% (v/v) solution of methyl salicylate are diluted to a 2 liter solution, what will
be the percentage strength (v/v)? (Answer must be numeric; no units or commas.)

Question 14

A patient has a blood urea nitrogen (BUN) of 38 and a serum creatinine of 2.4. Is the patient
dehydrated?

Answer

A It is not possible to estimate dehydration with these lab parameters.

B Yes, a BUN:SCr ratio less than 20:1 indicates dehydration.
C No, not until the BUN:SCr ratio is greater than 20:1.
D No, not until the ratio is greater than 40:1.
E No, not until the ratio is greater than 80:1.

Question 15

A nurse is hanging a 2% lidocaine solution for a patient. If the dose is 4 mg/min, how many
hours will a 100 mL bag last? (Answer must be numeric; no units or commas; round final answer
to the nearest WHOLE number.)

Question 16

Danielle is a 22 year old female (154 pounds) in the ICU after a motor vehicle accident. She is
going to be started on PN today. The prescriber has ordered 25 kcal/kg/day to be provided as a 2-
in-1 PN solution with standard electrolytes. The pharmacist has several bags of 2-in-1 PN with
standard electrolytes that were ordered for a different patient whose PN was actually
discontinued yesterday. The PN bags are labeled D20% (w/v) and amino acid 7% (w/v). How
many milliliters of this PN would be required to provide the daily caloric intake ordered for
Danielle? (Answer must be numeric; no units or commas; round final answer to the nearest
WHOLE number.)

Question 17

An order is written for cyclosporine 5 mg/kg IV. How many milliliters of a 50 mL bag
containing 100 mg of cyclosporine per milliliter should be administered to a 165 pound liver
transplant patient? (Answer must be numeric; no units or commas.

Question 18
A pharmacist adds 250 mg of drug A to 500 mL of 0.9% Sodium Chloride. If the solution is
administered at 1.6 mL per minute, how many milligrams of drug A will the patient receive in 1
hour? (Answer must be numeric; no units or commas.)

Question 19

If 1 gallon of a 15% (w/v) solution is evaporated to a solution with a 40% (w/v) strength, what
will be the new volume (in milliliters)? Use 1 gallon = 3,785 mL. (Answer must be numeric; no
units or commas; round final answer to the nearest WHOLE number.)

Question 20

Calculate the anion gap for a patient with the following lab values: (Answer must be numeric; no
units or commas.)

Labs:
Na (mEq/L) = 130 (135 – 145)
K (mEq/L) = 4.0 (3.5 – 5)
Cl (mEq/L) = 105 (95 – 103)
HCO3 (mEq/L) = 22 (24 – 30)
BUN (mg/dL) = 22 (7 – 20)
SCr (mg/dL) = 1.6 (0.6 – 1.3)
Glucose (mg/dL) = 98 (100 – 125)
Ca (mg/dL) = 10.1 (8.5 – 10.5)
Mg (mEq/L) = 1.9 (1.3 – 2.1)
PO4 (mg/dL) = 3.4 (2.3 – 4.7)
WBC (cells/mm3) =
3.1 (4 – 11 x 10^3)
Hgb (g/dL) =
14.5 (13.5 – 18 male)
Hct (%) =
43.4 (38 – 50 male)
Plt (cells/mm3) =
342 (150 – 450 x 10^3)
Segs = 32%
Bands = 7%

Question 21

Gretta is a 42 yo female who weighs 185 pounds and is 65 inches tall. Her Scr is 1.8. What is her
CrCl using the Cockcroft-Gault equation? (Answer must be numeric; no units or commas; round
final answer to the nearest WHOLE number.)

Question 22
Using 10 grams of a 15% boric acid ointment, the pharmacist will manufacture a 12% ointment.
How many milligrams of diluent is required? (Answer must be numeric; no units or commas;
round final answer to the nearest WHOLE number.)

Question 23

A patient has the following differential:

WBC = 6,200 cells/mm3

Segs = 14%
Bands = 7%

Calculate the ANC. (Answer must be numeric; no units or commas.)

Question 24

Pete is 71 inches tall and weighs 392 pounds. What is his adjusted body weight in kilograms?
(Answer must be numeric; no units or commas; round final answer to the nearest WHOLE
number.)

Question 25

Calculate the corrected calcium for a patient with the following lab values. (Answer must be
numeric; no units or commas; round final answer to the nearest TENTH.)

Labs:
WBC (cells/mm3) =
10.2 (4 – 11 x 10^3)
Hgb (g/dL) =
13.3 (13.5 – 18 male)
Hct (%) =
38.2 (38 – 50 male)
Plt (cells/mm3) =
342 (150 – 450 x 10^3)
Albumin (g/dL) = 1.7 (3.5 – 5)
AST (IU/L) = 56 (10 – 40)
ALT (IU/L) = 42 (10 – 40)
A1C (%) = 8.5
Na (mEq/L) = 142 (135 – 145)
K (mEq/L) = 3.5 (3.5 – 5)
Cl (mEq/L) = 101 (95 – 103)
HCO3 (mEq/L) = 25 (24 – 30)
BUN (mg/dL) = 13 (7 – 20)
SCr (mg/dL) = 1.5 (0.6 – 1.3)
Glucose (mg/dL) = 129 (100 – 125)
Ca (mg/dL) = 8.1 (8.5 – 10.5)
Mg (mEq/L) = 1.1 (1.3 – 2.1)
PO4 (mg/dL) = 4.8 (2.3 – 4.7

Question 26

A pharmacist receives an order for voriconazole 6 mg/kg IVPB Q12H for 24 hours for a patient
weighing 150 lbs. How many total milligrams (mg) of voriconazole will the patient
receive? (Answer must be numeric; no units or commas; round final answer to the nearest
WHOLE number.)

Question 27

Using 10 grams of a 15% boric acid ointment, the pharmacist will manufacture an 8% ointment.
How many grams of diluent is required? (Answer must be numeric; no units or commas; round
final answer to the nearest TENTH.)

Question 28

An obese female patient is to receive 4.6 mg/kg/d of theophylline, dosed on IBW. The patient is
5'4" and weighs 245 pounds. Calculate the patient's daily dose of theophylline. (Answer must be
numeric; no units or commas; round final answer to the nearest TEN milligrams.)

Question 29

The pharmacist has an order for heparin 25,000 units in 250 mL D5W to infuse at 2,000
units/hour. How many units of heparin will the patient receive in 10 hours? (Answer must be
numeric; no units or commas.)

Question 30

How many milliequivalents of sodium are in 1 mL of 8.4% sodium bicarbonate? (M.W. =

84) (Answer must be numeric; no units or commas.)

Question 31

A 10 mL vial is labeled potassium chloride (2 mEq/mL). How many grams of potassium chloride
are present? (M.W. of KCl = 74.5) (Answer must be numeric; no units or commas; include a
leading zero if answer is less than 1.)

Question 32

Calculate the corrected calcium for a patient with the following lab values. (Answer must be
numeric; no units or commas; round final answer to the nearest TENTH.)
Labs:
Na (mEq/L) = 135 (135 – 145)
K (mEq/L) = 3.6 (3.5 – 5)
Cl (mEq/L) = 101 (95 – 103)
HCO3 (mEq/L) = 25 (24 – 30)
BUN (mg/dL) = 13 (7 – 20)
SCr (mg/dL) = 1.0 (0.6 – 1.3)
Glucose (mg/dL) = 95 (100 – 125)
Ca (mg/dL) = 7.8 (8.5 – 10.5)
Mg (mEq/L) = 1.5 (1.3 – 2.1)
PO4 (mg/dL) = 2.3 (2.3 – 4.7)
WBC (cells/mm3) =
6.2 (4 – 11 x 10^3)
Hgb (g/dL) =
14.5 (12 – 16 female)
Hct (%) =
43.4 (36 – 46 female)
Plt (cells/mm3) =
342 (150 – 450 x 10^3)
Albumin (g/dL) = 2.2 (3.5 – 5)
AST (IU/L) = 25 (10 – 40)
ALT (IU/L) = 12 (10 – 40)

Question 33

The pharmacist has an order for heparin 25,000 units in 250 mL D5W to infuse at 2,000
units/hour. What is the infusion rate in mL/hour? (Answer must be numeric; no units or
commas.)

Question 34

Phosphate and calcium can precipitate in a PN bag and cause a pulmonary embolus. Which of
the following methods can help reduce this risk?

Answer

A Keeping the pH above 6

B Choosing calcium chloride over calcium gluconate
C The calcium and phosphate added together should not exceed 45 mEq/L
D Keeping the calcium:phosphorus ratio less than 1:2
E Infusing the PN within four days of preparation

Question 35

A patient has the following differential:

WBC = 2.2 X 10^3 cells/mm3
Segs = 18%
Bands = 20%

Calculate the ANC. (Answer must be numeric; no units or commas.)

Question 36

JM is a patient in the ICU (6’1” and 256 pounds). He is currently receiving a 3-in-1 PN at 115
mL/hr. The PN is 12.1% w/v dextrose and 4.7% w/v protein.

The prescriber wants the patient’s protein intake from the PN to be 1.2 g/kg IBW per day. By
how many grams will the current protein content need to be reduced to achieve this? (Answer
must be numeric; no units or commas; round final answer to the nearest WHOLE number.)

Question 37

A patient has been receiving 500 mL of an enteral mixture that contains 645 mOsm/L. The
pharmacist will reduce the contents to 480 mOsm/L. How many milliliters of bacteriostatic water
should be added to the bag? Round to the nearest WHOLE number.

Answer

A 150 mL
B 172 mL
C 500 mL
D 645 mL
E 672 mL

Question 38

The pharmacist has an order for heparin 25,000 units in 250 mL D5W to infuse at 2,000
units/hour. The infusion set delivers 60 drops per milliliter. How many drops does the patient
receive in one hour? (Answer must be numeric; no units or commas.)

Question 39

A parent brings a 6-year-old boy to the Emergency Department. Labs are ordered and an ABG is
drawn. The ABG results are as follows: 7.24/53/99/26/98. What acid base disorder does the child
have?

Answer

A Metabolic acidosis
B Metabolic alkalosis
C Respiratory acidosis
D Respiratory alkalosis

Question 40

A patient weighing 120 kg is to receive 0.3 mg/kg per day of amphotericin B (reconstituted and
diluted to a concentration of 0.1 mg/mL) by IV infusion. What volume of solution is required to
deliver the daily dose? (Answer must be numeric; no units or commas.)

Question 41

Calculate the body mass index (BMI) for a male who is 6'4" tall and weighs 225 pounds.
(Answer must be numeric; no units or commas; round final answer to the nearest TENTH.)

Question 42

A 51 year-old male (height 5'9" and weight 175 lbs) is hospitalized after a motor vehicle
accident. He develops a Pseudomonas aeruginosa infection. The physician orders tobramycin
1.5 mg/kg IV Q8H. Calculate the tobramycin dose that will be given every 8 hours. Use the
patient's IBW. (Answer must be numeric; no units or commas; round final answer to the nearest
TEN milligrams.)

Question 43

A patient is taking 2 calcium citrate tablets once daily. Each weighs 1,500 mg total (non-
elemental) weight. She wishes to trade her calcium tablets for the carbonate form. How many
800 mg carbonate tablets (by weight) will she need to provide the same daily dose? (Answer
must be numeric; no units or commas; round final answer to the nearest WHOLE tablet.)

Question 44

A 31 year old female is recovering in the surgical intensive care unit post major surgery. The
medical team wants to start PN. She is 116 pounds, 5' 6" with some mild renal impairment.
Calculate her BEE using the Harris-Benedict equation provided. (stress factor = 1.7 and activity
factor =1.2). (Answer must be numeric; no units or commas; round final answer to the nearest
WHOLE number.)

BEE (males): 66.47 + 13.75(weight in kg) + 5.0(height in cm) - 6.76(age in years)

BEE (females): 655.1 + 9.6(weight in kg) + 1.85(height in cm) - 4.68(age in years)

Question 45
Janine is a 73 yo female who weighs 102 pounds and is 63 inches tall. Her SCr is 1.5. What is
her CrCl using the Cockcroft-Gault equation? Use actual weight. (Answer must be numeric; no
units or commas; round final answer to the nearest WHOLE number.)

Question 46

Calculate the body mass index (BMI) for a female who is 5'4" tall and weighs 180
pounds. (Answer must be numeric; no units or commas; round final answer to the nearest
WHOLE number.)

Question 47

Which of the following represent additional items that may be added to a patient's total
parenteral nutrition? (Select ALL that apply.)

Answer

A Multivitamins
B Trace elements
C Insulin
D Electolytes
E Dopamine

Question 48

A pharmacist has an order for parenteral nutrition that includes 1000 mL of D70%. The
pharmacist checks the supplies and finds the closest strength available is D50%. How many mL
of D50% will provide an equivalent energy requirement? Round to the nearest WHOLE
number.

Answer

A 500 mL
B 1000 mL
C 1400 mL
D 1500 mL
E 1700 mL

Question 49

Calculate the anion gap for a patient with the following lab values: (Answer must be numeric; no
units or commas.)
Labs:
WBC (cells/mm3) =
2.3 (4 – 11 x 10^3)
Hgb (g/dL) =
14.5 (12 – 16 female)
Hct (%) =
43.4 (36 – 46 female)
Plt (cells/mm3) =
342 (150 – 450 x 10^3)
PMNs = 32%
Bands = 5%
Na (mEq/L) = 132 (135 – 145)
K (mEq/L) = 4.0 (3.5 – 5)
Cl (mEq/L) = 100 (95 – 103)
HCO3 (mEq/L) = 18 (24 – 30)
BUN (mg/dL) = 18 (7 – 20)
SCr (mg/dL) = 1.4 (0.6 – 1.3)
Glucose (mg/dL) = 276 (100 – 125)
Ca (mg/dL) = 9.8 (8.5 – 10.5)
Mg (mEq/L) = 1.3 (1.3 – 2.1)
PO4 (mg/dL) = 4.2 (2.3 – 4.7)

Question 50

You are asked to prepare one liter of 10% NaCl solution for irrigation. You only have a 0.9%
solution and a 23.4% solution in stock. Using both the high and the low concentration, how
many milliliters of the 23.4% solution will be required to compound this prescription? (Answer
must be numeric; no units or commas; round final answer to the nearest WHOLE number.)
Answers
1) 1764
2) 526
3) 16.5
4) B
5) 48
6) 66.7
7) 12.5
8) 4.5
9) 71
10) A, B
11) B
12) B
13) 7
14) C
15) 8
16) 1823
17) 3.75
18) 48
19) 1419
20) 3
21) 44
22) 2500
23) 1302
24) 116
25) 9.9
26) 818
27) 8.8
28) 250
29) 20,000
30) 1
31) 1.49
32) 9.2
33) 20
34) C
35) 836
36) 34
37) B
38) 1200
39) C
40) 360
41) 27.4
42) 110
43) 2
44) 1326
45) 24
46) 31
47) A, B, C, D
48) C
49) 14
50) 404