NCLEX when should I round result in ml in dosage calculation?

[travleur]

I will sit for the NCLEX in 3 days. I am practicing NCLEX questions with the Kaplan Qbank. I had no problem with dosage calculation until I came up with these two questions:

First I came up with this question:

The nurse receives an order to administer phenobarbital (Luminal) gr ii PO to a 3-year-old child. The label on the multidose vial reads 160 mg/5 cc. How many cc of phenobarbital should the nurse administer? Type the correct answer into the blank.

When you do the math, the result is 3.75 cc which is what I answered. But the correct response was 3.8 cc. Si I figured OK I had to round the result.

But then I had this one:

The nurse cares for a client receiving potassium chloride 25 mEq IV piggyback. The potassium chloride is labeled 10 ml = 40 mEq. Record the number of milliliters of potassium chloride that the nurse should add to the IV solution. Type the correct answer into the blank.

correct response: 6.25 (of course I answered 6.3)

The result is not rounded in this example, why? When am I suppose to round cc and when not? What should I do during the NCLEX exam?

[wsuRN09]

NCLEX will tell you when and how they want the answer rounded. Not sure why the Qbank did that to you though:confused: Good Luck!!

[lkwashington]

When you taking the NCLEX it is a perfect world. You never short staff and you always have everything you need to take care of the patient. GOOD LUCK. just a thought.

[elprup, BSN, RN]

I'd call Kaplan and ask them for verification. Actually, email them your exact question above. When I took Kaplan they gave us several email addresses for just these types of questions. Good luck.

[Katie803]

I was taught using dimensional analysis (which I found unusally understandable), but the book taught a different way from the teachers. We were taught to round off to the nearest hundredth, and the book rounded off to the nearest tenth. Also, I think peds rounds up to the nearest hundredth as well. I would think that they would have no problem clarifying this when you went to take the test, but I would do a little research about the newest regulations regarding calculating dosages instead of going in there blind. Maybe even talk with one of your old pharmacology teachers and see what they say as well. But make sure you clarify this! You don't want to be marked incorrectly for something that you could have prevented easily. Good luck!

[travleur]

I've been told that you round to the nearest 100th for result 1ml which makes sense. But I don't understand why it would be different in these 2 examples. It is very frustrating because I always get the dosage calculation right, so yes it would be a shame to get an answer wrong when I have the right result. I can try to contact kaplan but I wonder who would be able to help me... so if anyone can be a little more helpful it would be great.

wsuRN09, are you sure they tell you how they want you to round the numbers during the NCLEX exam? I never heard of it? Is it some king of guidelines they give you ahead, or is it actually mentioned on the question?

Katie, I did my nursing school in France, so my pharmaco teacher probably don't even know what the NCLEX is!

[caliotter3]

If both questions were from the same source, I would suspect an error. I would definitely contact Kaplan on this one.

[jlr820]

I had the very same issue while taking the Kaplan course. In fact I emailed the "Kaplan expert" about it and she basically said that, on the real NCLEX examination the question will specify if/how they want you to round the answer. The Kaplan Qbank was kinda strange sometimes with its answers. Anyway, don't worry about it...on the real test, they will specify how to round (and yes, it is specified in the question). They will give the question, and then it will say something like "Round your answer to the nearest tenth." for example.

[travleur]

I had the very same issue while taking the Kaplan course. In fact I emailed the "Kaplan expert" about it and she basically said that, on the real NCLEX examination the question will specify if/how they want you to round the answer. The Kaplan Qbank was kinda strange sometimes with its answers. Anyway, don't worry about it...on the real test, they will specify how to round (and yes, it is specified in the question). They will give the question, and then it will say something like "Round your answer to the nearest tenth." for example.

thank you very much, now I feel better!

[Katie803]

Wow! You went to Nursing school in France? That's fascinating! How was that experience? Are you from France or did you just have the opportunity to study there?

[nicunewgrad]

I work in a NICU and I also, as NCLEX said WOULD round the first...but NOT the second...not because of any rule I've been taught but simply because it makes sense in practice:

Since the first med is PO and the second is IV, perhaps they have you round in the first one because it's very difficult to get PO meds to the exact hundredths, so rounding up or down to the tenth place makes sense for administration... since the KCL will be on a pump, via IV, you can enter in the exact rate/amount to the hundredths and it will infuse at that exact rate.

I'm not sure if this helps you overall for the NCLEX but it's how I would think about it at work.

[nicunewgrad]

oops, nevermind... I re-read your post and saw that you are, in fact, drawing up the amount you get in your answer for the second problem... I just woke up...a little groggy. Please disregard my previous post! Let us know if you figure it out!!