This free Dosage Calculations Practice Test #7 covers IV titration math: turning mcg/kg/min, mcg/min, mg/min and mg/hr orders into pump rates in mL/hr, working backward from the pump to the dose, and calculating each titration step. Work through 10 timed questions, then check every answer with the full rationales below. No sign-up required.
All 10 Questions With Answers & Rationales
Prefer to work at your own pace? Every question from the timed quiz above is listed here in full. Choose your answer, then tap Show Answer & Rationale to check it.
Question 1: mcg/kg/min to mL/hr
Dobutamine is prescribed at 5 mcg/kg/min. The bag contains dobutamine 500 mg in 250 mL. The client weighs 80 kg. At what rate in mL/hr should the nurse set the pump?
- A. 6 mL/hr
- B. 12 mL/hr
- C. 24 mL/hr
- D. 120 mL/hr
Show Answer & Rationale
Answer: B. 12 mL/hr
Rationale: Step 1, concentration: 500 mg ÷ 250 mL = 2 mg/mL = 2,000 mcg/mL. Step 2, dose per minute: 5 mcg/kg/min × 80 kg = 400 mcg/min. Step 3, dose per hour: 400 mcg/min × 60 = 24,000 mcg/hr. Step 4, rate: 24,000 mcg/hr ÷ 2,000 mcg/mL = 12 mL/hr. 24 mL/hr is what you get if you forget to convert mg to mcg correctly and use 1,000 mcg/mL. Always use the concentration printed on your bag, because premixed concentrations vary between facilities.
Question 2: mL/hr back to mcg/kg/min
A client weighing 60 kg has dopamine 800 mg in 500 mL infusing at 15 mL/hr. What dose is the client receiving in mcg/kg/min? (Round to the nearest tenth.)
- A. 4 mcg/kg/min
- B. 5.5 mcg/kg/min
- C. 10 mcg/kg/min
- D. 6.7 mcg/kg/min
Show Answer & Rationale
Answer: D. 6.7 mcg/kg/min
Rationale: Work backward from the pump. Concentration: 800 mg ÷ 500 mL = 1.6 mg/mL = 1,600 mcg/mL. Dose per hour: 15 mL/hr × 1,600 mcg/mL = 24,000 mcg/hr. Dose per minute: 24,000 ÷ 60 = 400 mcg/min. Per kilogram: 400 mcg/min ÷ 60 kg = 6.67, rounded to 6.7 mcg/kg/min. Checking the actual dose against the order at every handoff and every bag change is how pump programming errors are caught.
Question 3: mg/min to mL/hr
Amiodarone is prescribed at 0.5 mg/min. The bag contains amiodarone 900 mg in 500 mL of D5W. At what rate in mL/hr should the nurse set the pump? (Round to the nearest tenth.)
- A. 16.7 mL/hr
- B. 27.8 mL/hr
- C. 33.3 mL/hr
- D. 8.3 mL/hr
Show Answer & Rationale
Answer: A. 16.7 mL/hr
Rationale: Concentration: 900 mg ÷ 500 mL = 1.8 mg/mL. Dose per hour: 0.5 mg/min × 60 = 30 mg/hr. Rate: 30 mg/hr ÷ 1.8 mg/mL = 16.67, rounded to 16.7 mL/hr. The most common mistake with mg/min orders is skipping the × 60 step, which gives a rate 60 times too low. Amiodarone loading and maintenance regimens vary, so always follow the prescription and your facility protocol.
Question 4: Titration step (mcg/min)
Nitroglycerin 50 mg in 250 mL is infusing at 3 mL/hr for chest pain. The prescription allows the nurse to increase the dose by 10 mcg/min if chest pain continues and blood pressure stays within the ordered limits. The criteria are met. What is the new pump rate?
- A. 4.5 mL/hr
- B. 3.3 mL/hr
- C. 6 mL/hr
- D. 13 mL/hr
Show Answer & Rationale
Answer: C. 6 mL/hr
Rationale: First find the current dose. Concentration: 50 mg ÷ 250 mL = 0.2 mg/mL = 200 mcg/mL. Current dose: 3 mL/hr × 200 mcg/mL = 600 mcg/hr ÷ 60 = 10 mcg/min. New dose: 10 + 10 = 20 mcg/min. New rate: 20 mcg/min × 60 = 1,200 mcg/hr ÷ 200 mcg/mL = 6 mL/hr. 13 mL/hr is the error of adding 10 to the pump rate instead of to the dose. Titrate the dose, then convert it to a rate. Titration limits and blood pressure parameters come from the prescription, not from a fixed rule.
Question 5: Two titration steps (mg/hr)
Nicardipine 25 mg in 250 mL is started at 5 mg/hr. The prescription says to increase by 2.5 mg/hr every 15 minutes until the blood pressure goal is reached. After two increases the goal has not been reached. What rate in mL/hr is now running?
- A. 100 mL/hr
- B. 75 mL/hr
- C. 10 mL/hr
- D. 50 mL/hr
Show Answer & Rationale
Answer: A. 100 mL/hr
Rationale: Concentration: 25 mg ÷ 250 mL = 0.1 mg/mL. Dose after two increases: 5 + 2.5 + 2.5 = 10 mg/hr. Rate: 10 mg/hr ÷ 0.1 mg/mL = 100 mL/hr. 75 mL/hr is the rate after only one increase (7.5 mg/hr). Note how much fluid a dilute bag delivers at higher doses. This is one reason many facilities use more concentrated premixed bags, so always check the concentration you actually have.
Question 6: Sedation in mcg/kg/min
Propofol 10 mg/mL is prescribed at 25 mcg/kg/min for a mechanically ventilated client who weighs 90 kg. At what rate in mL/hr should the nurse set the pump?
- A. 1.35 mL/hr
- B. 22.5 mL/hr
- C. 135 mL/hr
- D. 13.5 mL/hr
Show Answer & Rationale
Answer: D. 13.5 mL/hr
Rationale: Dose per minute: 25 mcg/kg/min × 90 kg = 2,250 mcg/min. Dose per hour: 2,250 × 60 = 135,000 mcg/hr = 135 mg/hr. Rate: 135 mg/hr ÷ 10 mg/mL = 13.5 mL/hr. 135 mL/hr is the result of using 1 mg/mL instead of 10 mg/mL, and 1.35 mL/hr comes from a misplaced decimal. Sedation targets and titration steps are set by the prescription and the unit's sedation protocol.
Question 7: Beta blocker in mcg/kg/min
Esmolol 2,500 mg in 250 mL is prescribed at 50 mcg/kg/min. The client weighs 75 kg. At what rate in mL/hr should the nurse set the pump?
- A. 2.25 mL/hr
- B. 37.5 mL/hr
- C. 22.5 mL/hr
- D. 225 mL/hr
Show Answer & Rationale
Answer: C. 22.5 mL/hr
Rationale: Concentration: 2,500 mg ÷ 250 mL = 10 mg/mL = 10,000 mcg/mL. Dose per minute: 50 mcg/kg/min × 75 kg = 3,750 mcg/min. Dose per hour: 3,750 × 60 = 225,000 mcg/hr. Rate: 225,000 ÷ 10,000 = 22.5 mL/hr. Answers of 2.25 and 225 are decimal-place errors, which is why a quick estimate (about 4 mg/min, or 225 mg/hr, from a 10 mg/mL bag) is a useful check before you start the pump.
Question 8: mL/hr back to mg/hr
Nicardipine 40 mg in 200 mL is infusing at 37.5 mL/hr. How many mg/hr is the client receiving?
- A. 3.75 mg/hr
- B. 7.5 mg/hr
- C. 15 mg/hr
- D. 187.5 mg/hr
Show Answer & Rationale
Answer: B. 7.5 mg/hr
Rationale: Concentration: 40 mg ÷ 200 mL = 0.2 mg/mL. Dose: 37.5 mL/hr × 0.2 mg/mL = 7.5 mg/hr. 187.5 is what you get if you divide instead of multiply (37.5 ÷ 0.2). Rate (mL/hr) × concentration (mg/mL) = dose (mg/hr): the mL units cancel, which is a quick way to confirm you set the problem up correctly.
Question 9: Vasopressor in mcg/min
Norepinephrine is prescribed at 8 mcg/min. The bag contains norepinephrine 4 mg in 250 mL. At what rate in mL/hr should the nurse set the pump?
- A. 3 mL/hr
- B. 50 mL/hr
- C. 7.5 mL/hr
- D. 30 mL/hr
Show Answer & Rationale
Answer: D. 30 mL/hr
Rationale: Concentration: 4 mg ÷ 250 mL = 0.016 mg/mL = 16 mcg/mL. Dose per hour: 8 mcg/min × 60 = 480 mcg/hr. Rate: 480 mcg/hr ÷ 16 mcg/mL = 30 mL/hr. Writing the units out (mcg/min × 60 min/hr ÷ mcg/mL) lets them cancel to mL/hr, which catches a setup error before it reaches the pump. Some facilities order norepinephrine in mcg/min and others in mcg/kg/min, and bag concentrations differ, so read the order and the label every time.
Question 10: Find the dose, then titrate
Nitroprusside 50 mg in 250 mL is infusing at 21 mL/hr for a client who weighs 70 kg. The prescription says to increase by 0.5 mcg/kg/min to reach the blood pressure goal. The goal has not been reached. What is the new pump rate?
- A. 31.5 mL/hr
- B. 26.3 mL/hr
- C. 42 mL/hr
- D. 10.5 mL/hr
Show Answer & Rationale
Answer: A. 31.5 mL/hr
Rationale: Concentration: 50 mg ÷ 250 mL = 0.2 mg/mL = 200 mcg/mL. Current dose: 21 mL/hr × 200 = 4,200 mcg/hr ÷ 60 = 70 mcg/min ÷ 70 kg = 1 mcg/kg/min. New dose: 1 + 0.5 = 1.5 mcg/kg/min. New rate: 1.5 × 70 kg = 105 mcg/min × 60 = 6,300 mcg/hr ÷ 200 = 31.5 mL/hr. Shortcut: each 0.5 mcg/kg/min equals 10.5 mL/hr in this bag, so 21 + 10.5 = 31.5 mL/hr. Maximum doses and goals come from the prescription and your facility protocol.
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