How am I supposed to give pills when I have several dosages?

[pepitohonguito87]

I encountered a question stating something like if your order says administer 80 mg of Ativan but then you have 1 pill of 40 mg 2 of 20 mg and several of 10 mg. How many pills would you give?

I would give 1 of 40 mg and 2 of 20 mg and 2 of 10 mg to complete 80 mg. This way the patient won't have 8 pills of 10 mg in his mouth. However, I am not sure if I am correct or not and as usual nursing school never wants you to learn from your mistakes because it's too much work to create new questions. 

What do you think is the right answer? Thanks.

[FiremedicMike, RN, EMT-P]

On 11/23/2022 at 9:59 AM, pepitohonguito87 said:

You are bullying me anyway. You are putting me down and just came to criticize me about a mistake in my math that is not even relevant to the point I am trying to make. Other people answered me and apparently they all thought the same as me. The less amount of pills you use to reach the dosage, the better. They answered me nicely and politely and didn’t try to lecture me so they could feel better because they know they are smart, therefore; they don’t need to put anybody down to feel intelligent.

Nearly all of your posts on this forum revolve around "bullying".

You were not bullied in this thread.

[beachynurse, ASN, BSN]

On 11/22/2022 at 11:45 AM, Pepper The Cat said:

Redo your math.

and I would seriously be questioning 80 mg of Ativan. 

Got that right! Quickly! 

[BostonFNP, APRN]

On 11/22/2022 at 7:49 AM, pepitohonguito87 said:

I encountered a question stating something like if your order says administer 80 mg of Ativan but then you have 1 pill of 40 mg 2 of 20 mg and several of 10 mg. How many pills would you give?

I would give 1 of 40 mg and 2 of 20 mg and 2 of 10 mg to complete 80 mg. This way the patient won't have 8 pills of 10 mg in his mouth. However, I am not sure if I am correct or not and as usual nursing school never wants you to learn from your mistakes because it's too much work to create new questions. 

What do you think is the right answer? Thanks.

I don't follow your logic on this about somehow the nursing school being at fault for you not learning from making a dangerous mistake on a simple math question, not even a med calc question. In real life this mistake could be fatal. 

I know back in the day my program had a mad calc test day 1; anything less than 100% was a fail and out of the program. Nursing schools have too much to teach to have to go back and teach basic MDAS. 

[londonflo]

On 11/24/2022 at 2:57 AM, JKL33 said:

IMO it is full of utterly inane "challenges" like this which are passed off as lessons in critical thinking.

Perhaps the test was designed to evaluate the ability of the student to do basic math?..before moving onto difficult questions? (At the heart of the matter is , not the number of pills, rather the pills needed to meet the dosage.)

If suggesting the OP redo their math is bullying.....I dread the sequelae of the OPs thinking

  At the college level, we obviously don't use questions like "2 + 2 =" but this OPs question needed that to demonstrate the  ability before moving on to more difficult questions. I had students who cannot do basic computational skills, then ask for more questions. They cannot derive the correct answer for questions presented to them already.

[kbrn2002, ADN, RN]

First off, nobody is "bullying you" when asking you to recheck your math. This is by the way, a simple math calculation which in your own question/answer scenario you were incorrect. Your answer provided an excess 20 mg!

Not to mention I would hope any nurse would question an Ativan dose like that before even beginning to figure out how many pills to give. Especially since to my knowledge, which I admit may be wrong but I believe the largest available Ativan dose in table form is 2 mg....so are you really going to give 40 of those bad boys in a single dose?

[JKL33]

57 minutes ago, londonflo said:

Perhaps the test was designed to evaluate the ability of the student to do basic math?..

I personally don't agree with the criticism the OP has received regarding the example they unfortunately posted. I think they were just asking a basic question and they wrote it out quickly, making a mistake that people focused on.

The question stands: If there are four answer choices comprised of different pill combinations that each add up to the ordered dosage, which answer is correct, and why?

I do believe this is a classic "nursing-type" question, which is one where the point is trivial at best, who cares, thousands of questions more test-worthy and important. Yes, this is my personal opinion. I have answered numerous "nursing" questions in my life that, in my personal opinion, fall into this category.

Now I'll take my chances at giving an example for people to pick apart and tell me what "critical" thing I didn't learn:

"What should the nurse do first" questions (implying you're supposed to be prioritizing according to acuity), but the right answer is wrong because it included the nurse doing wrong by speaking directly to the patient instead of the patient's Chinese elder who was also present [which just so happens to be a very stereotypical/idiotic thing to factor into a question] **

?

I would probably fail nursing undergrad, for these reasons, if I had to do it again--proud to say. I just don't have the patience any more.

[JKL33]

Order: [Drug X] 80 mg by mouth once daily

You have on hand:

(2) 40 mg tabs, (8) 10 mg tabs, (4) 20 mg tabs

Answer choices:

A. (8) 10 mg tabs

B. (2) 40 mg tabs

C. (1) 40 mg tab and (2) 20 mg tabs

D. (4) 20 mg tabs

E. (1) 40 mg tab and (4) 10 mg tabs

Some of these might be better choices than others for various reasons, but none are "wrong" or an error of any significance.

But the worst thing about the question is that the likelihood of encountering this scenario is LOW, to say the least.

If you want to know whether nursing students can do math a question with multiple right answers doesn't accomplish that assessment.

[JKL33]

It's like there is some effort to make nursing rigorous....but there is a difference between rigorous and mind numbing foolishness. Surely there are heavier, much more serious issues on which nursing students could spend their time.

I can't put it into words very well but I do think that this phenomenon is a problem within this profession. It contributes to our collective "I don't know what is right unless I ________" [check a policy, ask the doctor, check with manager]. When all along the fact is that if you gave (2) 40s or you gave (1) 80, the patient got what they were supposed to get and the world seriously has bigger problems and you SHOULD be able to make a nursing decision like this without  Mediocre Nancy Nurse giving feedback about why it was wrong.

[chare]

2 minutes ago, JKL33 said:

[...]

If you want to know whether nursing students can do math a question with multiple right answers doesn't accomplish that assessment.

This I agree with.  I have always thought that the problems assigned should reflect actual practice and not involve apothecary units or problems such as the one posted here.  

In my opinion, this, and the lack of feedback from faculty lead to failing to grasp the seriousness of the the subject.

@pepitohonguito87, again it was not my intent to bully you, and if I misread your intent, my apologies.

[londonflo]

17 minutes ago, JKL33 said:

Some of these might be better choices than others for various reasons, but none are "wrong" or an error of any significance.

the original OPs answer was wrong. It was a right or wrong question, independent of how many pills were needed. This was a 6th grade math question.The OP wanted to give an overdose to lessen the number of pills the patient had to take. (Read the first post! the OP changed the answer when the dose was questioned) I understand you want to support fledging nursing students BUT excusing basic 6th grade math answers does not support the health care professional's achievement and practice as a nurse.

[JKL33]

I got that. S/he MADE UP the question and made a mistake in answering the MADE UP example. The mistake is still there for all to see in the OP. The POINT of the post was that there was more than one possible correct answer.

What s/he was ASKING, was if there exists some principle about deciding how many pills to use in that TYPE of scenario. Is giving 10 pills worse than giving 2. Is it WRONG. What is "right," IN SUCH A SCENARIO, and why.

More fun to argue about the great tenets of nursing school and why it is necessary to spend time every day trying to be so tricky--which is supposedly because the people whom THEY LET INTO NURSING SCHOOL can't do elementary level math.

I mean, if people's ability to do very simple math is **the** big important topic of this thread, then I think we should turn our criticisms to the fact that they were allowed into nursing school and the fact that it shouldn't be necessary to teach nursing level math in nursing school AT ALL, because as it turns out "nursing math" it is not some special math, it is just like any other elementary type of math. People should already know how to do it, just like we don't spend our valuable nursing school hours learning "how to tell time in the nursing world," because it is just like telling time in every other situation. And even though we have to use time a LOT, and we sometimes have to do very important things using time, like record for a resuscitation, it is still not a difficult thing and people should know how to do it.

Nursing school is only difficult because of things like this. Because of pettiness laced throughout. It is dangerous and can make your head explode with unprecedented levels of weird pettiness.

[londonflo]

42 minutes ago, JKL33 said:

The POINT of the post was that there was more than one possible correct answer.

Quote

I encountered a question stating something like if your order says administer 80 mg of Ativan but then you have 1 pill of 40 mg 2 of 20 mg and several of 10 mg. How many pills would you give?

I would give 1 of 40 mg and 2 of 20 mg and 2 of 10 mg to complete 80 mg. This way the patient won't have 8 pills of 10 mg in his mouth. However, I am not sure if I am correct or not and as usual nursing school never wants you to learn from your mistakes because it's too much work to create new questions. 

What do you think is the right answer? Thanks.

This is what I read in the original post. No questioning if there was more than one right answer.

 

42 minutes ago, JKL33 said:

What s/he was ASKING, was if there exists some principle about deciding how many pills to use in that TYPE of scenario

No that was not asked by the OP in the original post.

42 minutes ago, JKL33 said:

What s/he was ASKING, was if there exists some principle about deciding how many pills to use in that TYPE of scenario. Is giving 10 pills worse than giving 2.

No that was not asked.

42 minutes ago, JKL33 said:

the great tenets of nursing school and why it is necessary to spend time every day trying to be so tricky-

 in my experience we have enrolled some who have a difficult time in situations where they problem could be solved with common sense....we do not use "tricky 'situations or test questions.

42 minutes ago, JKL33 said:

the fact that they were allowed into nursing school and the fact that it shouldn't be necessary to teach nursing level math in nursing school AT ALL, because as it turns out "nursing math" it is not some special math, it is just like any other elementary type of math

Okay, then let's just let them egregious math errors.

42 minutes ago, JKL33 said:

Nursing school is only difficult because of things like this. Because of pettiness laced throughout. It is dangerous and can make your head explode with unprecedented levels of weird pettiness.

I used to really  value your opinions but you don't seem to have a handle on basic skills that are needed to build on to dosage calculations problems and other elementary communication skills needed in the clinical setting for a beginning students. These are not useless exercises. actually these tests are diagnostic in math skill abilities. We develop math problems that monitor the student's ability to complete a series of calculations starting at the first step.  When the OP was challenged regarding the answer he/she arrived at, "bullying' was used over and over.  This student did not understand the process/rationale  of completing a calculation; rather OP felt those trying  to help were demeaning and took it as a personal affront..