Pass Your Dose Calc Exam! | Complete Guide for Nursing Students (with PRACTICE PROBLEMS!)

If you're brand new to dose calc and you have absolutely no idea where to start, we're gonna fix that today. I'm gonna give you my simple 6-step process so you can confidently solve dose calc problems on your own, all right, no matter what kind of problem that your nursing school exam throws at you. So just take it from some of our students, this process works. So hit that subscribe button and click the notification bell, and let's dive in. So dose calc is something you're going to see on pretty much every nursing school exam that you you will take. But even more than that, most nursing programs also have a full dose calc exam that you've gotta pass in order to stay in your program. And most of them require that you get a 90% or even a 100% on that exam. And what can be an even bigger problem is that nursing instructors or nursing schools teach dose calc in a lot of different ways, and honestly, so many of them are just so, so confusing. So they'll have you memorize a bunch of random different formulas, and then when you get to your exam, and you don't know which formula to use, or worse, the formula that you memorized, it doesn't even work for the question that they're asking you on the test. So that happens all the time, and it's so, so frustrating trying to memorize random formulas that might work for some super basic dose calc problems. But the problem is, is that it will break as you try to solve more complex dose calc problems like heparin calculations, Pitocin calculations, and problems where you have to use multiple different conversions or steps to get the right answer. So that's going to lead you down a whole spiral of second-guessing yourself and then getting confused about which formula to use and when. And that's the kind of anxiety that we do not want when you take your dose calc exam, right? So that's exactly why I created a simple 6-step process that works every single time, no matter what type of dose calc problem you're solving. There's no formulas to memorize, just follow these steps and you will be golden, my friend. Nursing students rave about this process because it makes dose calc so, so much easier. So the first major thing you've got to know before we get into the steps here is the metric system and the conversions. This is so key because if you don't know these, you will fail your dose calc exam. There is literally just no getting around it. There's no way to get around this. They don't give you these conversions during your exam, so you have to know them ahead of time. So the first big one that you want to know is the metric system. Now, you can't convert units accurately until you know the metric system and how this works. Now, for nursing, the 3 big ones that you've got to know are grams, milligrams, and micrograms. And the magic number here to remember is 1,000. Okay, so 1 gram equals 1,000 milligrams. 1 milligram equals 1,000 micrograms. All right. 1,000. That's your word. And when I say micrograms, think micro, like super small, like microbiology, right? There are 1,000 micrograms in 1 milligram. Then when you see micrograms on your exam, slow down, because those problems are testing really your attention to detail and your decimal placement. So don't rush through those, okay? Micrograms, super small. And then we have the conversion factors. Now these are the absolute must-know conversions for your dose calc exam, my friend. There is no way around it. You have to have these memorized. Please, please, please, your nursing school is not going to give them to you on the test, all right? You will need to have them to solve your problems, and they will not be there for you. You've got to have them memorized. So let's walk through the must-know conversions so you know them, you've got them down solid. Now, of course, I also have a free dose calc cheat sheet with these all written out for you, so just comment dose calc below and I will send that over to you. Now, 1 kilogram equals 2.2 pounds. This is the one that will make or break your pediatric or your critical care calculations. The magic number here, 2.2. Okay, remember 2.2. 1 gram equals 1,000 milligrams, and then 1 milligram equals 1,000 micrograms. We kind of touched on that a little earlier with the metric system. And then 1 liter equals 1,000 milliliters. There's 5 milliliters in 1 teaspoon, And there's 15 mL in 1 tablespoon. Then there's 3 teaspoons in 1 tablespoon. 1 ounce equals 30 mL. And there's 2 tablespoons in 1 ounce. And then of course, 1 grain equals 60 mg. Now this one is tricky. Nursing schools are starting to phase this one out because it's not really used anymore, but I still talk to nursing students quite often whose program still uses it, so I'm going to include it here just in case you need to know it. For your particular nursing program, I recommend that you just learn this one just in case. So here's why this is tricky, is that most medications, 1 grain equals 60 milligrams, but for aspirin, Tylenol, which is acetaminophen, and iron, it's 65 milligrams per grain. So I know that's frustrating, but here's the strategy, okay? If your program doesn't tell you which conversion to use, go with 60. But if it mentions aspirin Tylenol or acetaminophen, or iron, think 65. And then of course, there's 60 minutes in 1 hour. This one seems obvious, but you'll use it constantly for your IV calculation. And then we have IV tubing. So microdrip is always 60 drops per milliliter. If the question says microdrip tubing, you automatically know it's 60 drops per milliliter. Then macrodrip tubing can be 10, 15, or 20 drops per milliliter, so the question will tell you which one to use. Now I know that's a lot of conversions to know, my friend, and that's why I have that free cheat sheet for you with all of that listed. Just comment dose calc below and I will send that over to you. All right, now here's the simple 6-step process that is going to change your life when it comes to dose calc. This is so, so good. Now this process is called dimensional analysis. It's also could be called the railroad track method, and you'll see why in a second, how we're gonna structure it. I'll show you how those kind of railroad tracks work so you can really very visually see how it all is formatted and kind of looks like a railroad track. And it's super, super cool. This is the absolute best way to do dose calc, but it's called dimensional analysis, or the railroad track method is also what you might hear it be called. And if you're a visual learner, this is such a great way to write out dose calc and solve your problems because you can very clearly see how it all lines up and how it all works. I'm going to walk you through a very, very basic dose calc problem here with each step first so that you understand how this works, and then we're going to put it into action. We're going to put it to the test with a bunch of different practice problems. So as we go here, you'll be able to see how these steps work. Super basic problem here, and then we're going to do multiple practice questions together to really make sure that you understand this process. And of course, if you're a NursingSOS member, you already have access to the full step-by-step dose calc course that I have for you inside the NMC, which includes tons of practice problem workbooks so that you can master this process. So be sure to check that out as well inside the NMC. Alright, so our first problem here says: Mr. Gingerbread is a 45-year-old patient admitted to your unit with a bacterial infection. The physician orders 500mg of amoxicillin insulin by mouth. When you head to the med cart, though, you find that you have only 250 mg tablets available. How many tablets will you give to Mr. Gingerbread? Alright, so our step number 1 here is to look at the problem. We're going to figure out what unit we need to end up with at the end. What is the question actually asking you for? So this is step number 1 because you need to find out what you need to end up with at the end so you know what the actual problem is asking you for. So, so often we do a dose-calc problem but we solve for the wrong thing. So it's really important that you do this first or you will end up with the wrong answer at the end. So this is step number 1. So what is this problem asking us for here? What do we need to solve for? So is this problem asking us for milligrams? Is it grams? Is it number of tablets or drops per minute? What is it? Milliliters per hour. So whatever unit the dose calc question wants us to solve for, that's what we're gonna write. We're gonna write this unit on the right-hand side of our paper under NEED. So we're gonna write NEED here, and then we're gonna start with the end in mind. So for this question here, it's asking us for tablets. So tablets. So write tablets on the right-hand side under NEED. Now a pro tip for you here is to actually circle or underline the unit in the question that it's asking you to solve for. So in Just doing it this way, it helps you not to get distracted when you read the question. You'll know exactly what unit you need to end up with at the end, don't have to get distracted with other things. So here we're going to underline tablets. Now step number 2 is to look at the problem again and see what the original order says. So what did the doctor or the prescriber order? So reread the question and look at what the order says, and then write that down on the left-hand side of your paper under order, order. So for this one here, the doctor ordered 500 milligrams, so we write 500 mg, 500 milligrams under order. So now you have your order on the left and what you need on the right, and now we need to get from one to the other. We need to go from one side to the other side. That's where step 3 comes in. Now step number 3 here is where we need to get from what we have ordered to what we need, right? So this is where your conversion factors come into play. So what conversions do we need to use in order to solve the problem? Now this, my friend, is where this process really shines and makes all the difference, so stick with me here. The trick to this is that the units need to cross themselves off. This is how dimensional analysis works. We need to eliminate them, and when we do this, we do this by using conversion factors to cancel out those units. And here's the key: the unit that you want to end up with at the end must be on the top of your railroad tracks, right? Railroad tracks here. All the other units cancel themselves out. So if you have one unit on the top and the same unit on the bottom, those will cancel each other out magically. And what you are left with at the end is only the unit that you need, the one that is not crossed out and the one that— the one in the question that it is asking you for. So if you have this set up correctly, you literally cannot get the wrong answer, my friend. It's just math and it just works, which is so amazing because I don't know about you, but I don't consider myself to be a super great math person. And this method, this, uh, dimensional analysis or the railroad track method, that solves this problem because all you have to do is put the numbers in and put the units in in the right place and you will be able to do it correctly every time. So awesome. So for this question, it tells us that we have 250 milligram tablets available. So our conversion factor here is 1 tablet equals 250 milligrams, right? So we can write this out on our railroad tracks. We need to make sure that our units cancel out. So milligrams needs to be on the bottom so it cancels out with milligrams in our order, right? And tablets needs to be on the top because that's what we need to end up with. So do you see how that works? Milligrams crossed off, it is canceled out. Tablets is on the top. Now here are a couple of tips to help you work through this step because I know it can be a little intimidating at first to do all this, but I promise I'm not going to leave you to figure it out on your own, my friend. So first, go back to the original problem and see if they give you any conversion factors. So reread the question for every dose calc problem you have, and if they give you any conversions, write them in the middle of your paper. That's where we put our conversions in the middle of your paper. Now, second, you can fill in any standard conversions that you need from memory, the ones we just talked about a little while ago, like milligrams to grams or milliliters to liters and things like that. So that's why you need that cheat sheet, right, that I told you about earlier. So definitely comment DoseCalc below and I'll send that over to you. Now, as you keep adding in those conversion factors, keep checking in with what you have ordered and what you need to end up with at the end. So what unit do you have ordered? What unit do you need at the end? And make sure those units cross off so that you get the correct answer. And remember, when you write a unit on both the top and the bottom, they're gonna cancel each other out. It's like they don't exist anymore. It's so beautiful. And don't be afraid to play around with your conversion factors if you need to. You can think of this kind of like a puzzle. So try out a conversion, see if it works, and then erase it if it doesn't. Sometimes you just need to use the good old-fashioned trial and error process with this. So if you're not sure which which conversion factor to use. So don't be afraid to try different ones to see what fits in the equation and to see what works. Now here's another quick tip: if the problem gives you any extra information that you don't need for the math, then cross it off. If your test is on paper, cross it off. If it's on the computer, mentally cross it off in your mind. Some questions are going to throw extra details at you to try to distract you, and the key to getting dose calc right is to stay focused what you need to end up with at the end. What unit do you mean— do you need? Don't get distracted with anything else. Now this is the most important part that students miss and where so many people lose points on their exam. Now the next 3 steps, this is where this all comes together, okay? So let's walk through it here. So now that we have our conversion factor in the middle here under half, and we've got our tablets on the top, we've got milligrams on the bottom, so milligrams will cancel each other out, and then tablets is of course what we need to end up with at the end. So that's on the top, that's perfect. Now we've got to solve the problem. So step number 4 is to multiply straight across the top and multiply straight across the bottom and then divide those two numbers. This is how we solve for this. This is super awesome math, super awesome math trick that does the conversions for you, and it's one of the top reasons that I love writing dose calc out this way, is it makes it so, so easy to get the right answer. So this process, it will not lie, my friend. As long as your units cross each other out, you will get the right answer if you have the correct unit at the top. It's just a math thing and it's awesome. So here we go, we're gonna multiply across the top. So first, so 500 times 1 equals 500, okay? Then the bottom, 1 times 250 is 250. Now we're gonna divide 500 by 250 and that equals 2. All right, 500 250 is 2. And one really important thing to remember here is that you do not round here in step 4, okay? If you need to round, save your rounding for step 5. If you round here in the middle somewhere, your final answer will be off and you'll get the question wrong. So we'll walk through some examples of this in a minute. So just keep that in the back of your mind though, that you're not gonna round until the end, until step number 5. And then in step number 5 is to write the answer appropriately and round. Use the correct rounding rules and the correct use of zeros. And here's a fun memory trick to help you out with this: think nurses are leaders, not followers. So this means that you include leading zeros but not trailing zeros. Okay, so here our answer is 2 tablets. It's a whole number, so we don't have to round anything. We're super good to go on that. But let's say you get an answer and it's 0.5. So that's way too easy for that decimal point to get lost and for someone to think it's 5, right? So instead, you're gonna write 0.5. So that leading zero protects you and the patient. And the same thing if your answer is 5.0, you're not going to include that trailing zero. It would be so easy for someone to miss a decimal and think it's 50. So we write it as 5, not 5.0. And then for rounding, here's the rule: if the number is 5 or greater, round up. If it's 4 or lower, round down. All right, so always make sure at the very end that you are rounding here in step number 5. Do not round when you're plugging in your conversion factors or when you're multiplying in step number 4. You will get the question wrong. Wait to round until step 5. Now there are a couple of specific rounding situations that you want to know. Drops are always rounded to whole numbers. You can't look at a drip chamber, right, and accurately count half a drop. It just doesn't work that way, right? And for an IV pump, then the question should tell you what place to round to. It'll usually either be a whole number or to the tenth, but I have seen some nursing exams that ask for the hundredth. Alright, so just pay attention to what they're asking you for in the problem. And now on to the last step, step number 6 here, and this one can be so easy to skip, but my friend, You really gotta do it, it's gonna save you. You must double-check your math. We want to rework the problem again to make sure that you got it correct, right? So remember what we're calculating here. Dosage calculations are really important to get right. We're talking about medications and someone's life in our hands, right? It's so, so important to double-check yourself, double-check your math, make sure that you got the correct answer. I cannot even tell you how many times I misread a dose calc question on a test because I was so nervous, and I caught myself when I double-checked it. So this is really, really, really important to do, okay? Don't skip it. So does 2 tablets here make sense? While each tablet is 250 milligrams, the original order was 500, so 500 divided by 250 is 2. Check, check, check. We are good to go. All right, so quick recap here of the 6 steps before we jump into the practice problems. We've got step number 1: figure out what you need to end up with at the Step 2: Figure out what the prescriber ordered. Step 3: Decide what conversion factors to use and to make sure your units cancel out. Step 4: Multiply across the top, multiply across the bottom, and divide those 2 numbers. Step 5: Use the correct rounding rules and rules for zeros. Step 6: Double-check your work. This is 6 simple steps and it works every single time. It's so, so great. Now let's walk through several practice problems here so you can see exactly how this 6-step process works with real questions. And don't worry, we're starting with simple, basic problems and then we're going to build up from there. So even if you've never done a dose calc problem in your life, don't worry, my friend, you can do this. We're going to walk through it together. So our first practice problem is: Mrs. Butterscotch is a 66-year-old patient admitted to your unit. With heart failure. The cardiologist orders 0.5 milligrams of her cardiac medication, but when you go to the med room, you find only 250 microgram tablets available. How many tablets will you give Mrs. Butterscotch? So this is so good. So we've gotta walk through the question. First step, is to figure out what we need to end up with. So I always just like to write need on the right-hand side, so we always start with that so we know exactly what we need to end up with, uh, at the end. So what do— what does this question ask us for? What do we need to end up with? So we're going to need here tablets. How many tablets will you give Mrs. Butterscotch tablets? Now step number 2 is what did the doctor order? So what did the order say? So the cardiologist orders 0.5 milligrams of her cardiac medication. So 0.5 milligrams. We want to watch those units. All right, this is milligrams, not micrograms. So milligrams is mg, micrograms is mcg. All right, so milligrams, micrograms. Perfect. So that is what we, uh, the doctor orders. So that's the order, and then we need tablets at the end. Now step number 3 is we have to figure out what conversions we need to use to get from milligrams to tablets. All right, so when we look at the question, we can see that it gives us a conversion. So when we go to the med room, you find only 250 microgram tablets. Okay, ding ding ding, we've got microgram tablets. So let's try to plug this in here. Now when we do this dimensional analysis, we always put our, our order or anything over 1 because that just means like that is that is just over 1. 0.5 milligrams is just what it is. It's not split anyway, so it's 0.5 milligrams. And then also just putting it over 1 just makes it cleaner to see by the time we get to the end. So the conversion that we have here is 250 microgram tablets. So we're gonna put this here. Now the principle to remember here is that any unit that we put on both the top and the bottom crosses out. So those just eliminate each other, they just don't even exist anymore. So let's say we put milligrams at the top, milligrams at the bottom, those two cross each other out. So what we want to do is make sure that whatever unit we need to end up with at the end, that that does not cross out and it's at the top of our railroad track. So let's make sure we do that here. So we have our conversion of 250 microgram tablets. Now, microgram is not currently in our order because it's milligram, but tablets— ding, ding, ding— tablets is what we want to end up with at the end. So we want to put tablets up top. So 1 tablet, 1 tablet is equal to 250 micrograms. You see how that works? Now, 1 tablet is ding, ding, ding, here is the same as this tablet's over here. Perfect! So we don't want that to cross out. So now we're left with milligrams here, ding, ding, and micrograms here. Now here's where we need to know our conversions. So how many micrograms are in 1 milligram? Now there's 1,000 micrograms in 1 milligram. 1,000 micrograms in 1 milligram. And now we need to put micrograms here at the top because it is on the— we need to put it here at the top here because it's on the bottom here. And what is that gonna do? It's gonna cross each other out. And then milligrams we have here at the bottom, and and here again at the top. So these both are gonna cross each other out, which is beautiful because the only unit now that we are left with is tablets. This one right here, tablets. It's perfect. So now in step number 4 is to solve the problem, and all we do here is multiply across the top, multiply across the bottom, and then divide those two numbers. So we have to go 0.5 times 1 times 1,000. So 0.5 times 1 times 1,000 equals 500. All right, and then 1 times 250 times 1. So you see that 1 times 250, we're literally just multiplying across the top of the railroad tracks, across the bottom of the railroad tracks, and then we're gonna divide. So 1 times 250 times 1 is equal to 250, and then we're gonna divide those two. 500 divided by 250 is 2. Ding ding ding! 500 divided by 250 is 2 tablets. So that is how this dimensional analysis and railroad track method works. We structure it this way where any unit that is both on the top and the bottom cancels itself out, that cancels each other out. And then the unit that does not cancel out and that is at the top of the railroad tracks is what we end up with at the end. It's so, so cool. Now, step number 5 here in this process is to round and make sure that we're writing it properly. But it's, it's 2 tablets here, so it's a whole number. There's no rounding needed or anything. And then step number 6 is to double-check. So we just want to double-check all of our math and make sure that we put everything in the right places and that the units cancel out correctly and that we actually did our multiplication and our division correctly. So we know we have tablets here in the question and we put tablets here at the end, perfect. We know that we started with 0.5 micrograms and we actually use the conversion that the problem gave us here, so 250 micrograms per tablet. And then of course there's 1,000 micrograms per milligram. So all of our units cross each other out properly. Then 500 divided by 250 is 2. So we got the question correct. Now let's go on to the next question. So this one says Mr. Pumpernickel is a 154-pound patient in the ICU. His physician orders an antibiotic at 2 milligrams per kilogram. How many total milligrams will you give Mr. Pumpernickel? So of course, step number 1 is starting with the end in mind. What do we need to end up with at the end? So at the end of this problem, we are going to need, at the end, milligrams. How many total milligrams will we give Mr. Pumpernickel. You see that? So milligrams here is what we need to end up with here at the end. Now, what does the order say? This is step number 2, order. What does the order say? Well, this question gives us a lot of erroneous information that we don't need to know. We don't need to know that it's an antibiotic. We don't need to know that he's in the ICU. We don't, we don't need to know any of those things. We're going to ignore the distractors. So the order is 2 milligrams per kilogram. All right, so he is, and he's 154 pounds. All right, so the order is for a 154-pound patient at 2 milligrams per kilogram. So we can put here 2 milligrams per 1 kilogram. Okay, that's the order: 2 milligrams per 1 kilogram. So now step number 3 is figuring out what our conversions are. Alright, so the question gives us a couple of things that we need to know. So we know that Mr. Pumpernickel is a 154-pound patient, so this question is asking us ask us to go from 2 milligrams per 1 kilogram and ask how many milligrams will we give, but we only have his weight in pounds. So how many kilograms are in a pound? We know that 1 kilogram is equal to 2.2 pounds. Alright, 1 kilogram is equal to 2.2 pounds. So we have to put kilogram up here at the top because kilogram is already on the bottom. We want to put it on the top for it to cancel out. So 1 kilogram is equal to 2.2 pounds. Does that make sense? Great. So now we have pounds down at the bottom, but wait, we don't need to end up with pounds over here. We don't want pounds over there. We need to somehow cancel that out because kilograms already cancels out. We want micro— milligrams here, we want milligrams here, but we don't want pounds. So we need to cancel pounds out, and we're gonna do that by putting in his weight. So 2.2 pounds here on the bottom. We know that Mr. Pumpernickel weighs 154 pounds. Lbs. We're gonna put that over 1. So now, ba-da-bum, pounds cancels out. So now we are just left with milligrams at the top and milligrams at the end, and that's beautiful. So we went from milligrams per kilogram to milligrams for his weight, the 154. So now what we have to do is is multiply. In step number 4, we're going to multiply across the top. So 154 times 1 times 2. So all of these, that's all we're doing is just multiplying the whole top row together, is 308. 308 divided by multiplying everything in the bottom row. 1 times 2.2 times 1 is 2.2. 2.2. You see that? Then we're gonna divide. What is 308 divided by 2.2? And we get 140. So 140 milligrams is the answer here. Now step number 5 is we need to make sure that we're rounding correctly and we're using the correct placement of zeros, the correct zeros rule. So because this is a, a whole number, we don't need to round it. So it's 140, not That's it, and there's no zeros. We're not gonna add an extra zero at the end. We're not gonna say like 140.0 or 140.00. No, we're gonna just say 140. So when you're taking your test, just make sure that you write 140. It's not 140.00 or anything like that. It's just 140. And so that's step number 5. Make sure you use the proper rounding rules: 5 and greater, round up; 4 and lower, round down. And then correct use of zeros. Nurses are leaders, not followers. That's your mnemonic. So we use leading zeros, not trailing zeros. All right, so we want to make sure that we're using those correct rounding rules and rules for zeros. And now step number 6 is to double-check your work. So we want to make sure that we plugged in our proper units and that they all cancel out correctly. So he's 154 pounds, we put that there at the top. 2.2 pounds, 1 kilogram, that's perfect. We started with our need, with the milligrams, how many milligrams are we going to give, and we started, um, second step was the order. So 2 milligrams over 1 kilogram was what the doctor actually ordered, so that's perfect. Everything is beautiful here. 154 times 1 times 2 is 308, and then 1 times 2.2 2 times 1 is 2.2, and then 308 divided by 2.2 is 140. So we got the answer correct. All right, now the next question here says Miss Cannoli is a 52-year-old patient recovering from surgery. The physician orders 100 milliliters of IV fluid to infuse over 30 minutes. What milliliter per hour rate will you set the IV pump to for Miss Cannoli? Perfect. So always step number 1, is what do we need to end up with at the end. So when you follow these steps just in order, it helps you focus on like, well, literally what's my next step. Like, we're not gonna get overwhelmed when we read a dose calc question, we're just gonna follow the steps. So step number 1, what do we need to end up with at the end? What unit is the question asking us for? So this question is asking for what milliliter per hour rate will you set the IV pump to for Miss Cannoli? mL per hour. That's what we need to— that is the— what the question is asking us for is the milliliter per hour, so mL per hour. So now you can see that this one, this problem, is asking us for 2 units at the end. We need both milliliters on the top and we need hours on the bottom. Ooh, so we're gonna watch this as we go and I'll show you how this works. So "need" is at the end, of course. We need to figure out what we need to end up with at the end, and we have milliliters per hour. Now what does the order say? What was ordered for her? So the physician ordered 100 mL of IV fluid to infuse over 30 minutes. Alright, so 100 milliliters, milliliters to infuse over 30 minutes. So that's what we got: 100 milliliters of IV fluids to infuse over 30 minutes. So now step number 3 is where we do our conversion. So we have to look at this problem and figure out, okay, how are we going to get from 100 milliliters liters per 30 minutes to milliliters per hour? Well, there's one conversion that we can do. We've got milliliters already at the top here at the need. We've got our milliliters already at the top here in the order, so that's perfect. We don't have to change anything like that. We're not going from milliliters to liters or anything like that. All we need to change is going from minutes 2 hours. That's it. So now we need to figure out how many minutes are in an hour, and we know that that is 60, right? There's 60 minutes in 1 hour. Easily peasily, right? 60 minutes in 1 hour. And this is beautiful because this minutes crosses out because it's on the top and the bottom. So minutes is gone, and now we are left with hours, and we're left with mils, which is exactly what we need at the end. Milliliters on the top, hours on the bottom. Milliliters on the top here in the need, hours on the bottom in the need. Perfect. So now all we have to do here is multiply across the top, multiply across the bottom, and divide those two numbers now in step number 4. So multiply across the top. 100 times 60 is 6,000. 100 times 60 is 6,000. And then 30 times 1 is 30. And then 6,000 divided by 30 is 200. You see how we did that? So we multiply it across the top here, multiply it across the bottom here, and we got 6,000 divided by 30 is 200. So 200 milliliters per hour is our answer. And now since this is a whole number, 200, we don't need to use any rounding rules, nothing for zeros. We're not going to add any zeros at the end or at the beginning or be weird or anything like that. It's just a whole number, is straight 200 milliliters per hour. Now in step number 6, we want to check our work, make sure that we actually solved for the correct thing. So what milliliter per hour rate will you set the IV pump to? So we've got milliliters per hour, that's exactly what the question is asking us for. And then what is our order? Well, our order here was 100 milliliters of fluid over 30 minutes. So we have 100 milliliters of fluid, 30 minutes right there, so that's perfect. And then our conversions here, We did 60 milliliters per— 60 minutes per hour because we needed to get from minutes to hours, and then we got 130 and 60 in one, so we multiplied across the top, across the bottom, and divided, got 200. So we are all good to go. So that's perfect. So 200 milliliters per hour is the answer for this one. All right, now this question says Mr. Sourdough is a 61-year-old patient in your cardiac unit who is experiencing is experiencing dangerous heart arrhythmias. The physician orders lidocaine at 2 milligrams per minute. Pharmacy sends up 1 gram of lidocaine in 250 mL. How many milliliters per hour will you set the IV pump to for Mr. Sourdough? Alright, so always, always, always, always, we start with the end in mind. What do we need to end up with? So we don't want to look at this question and get overwhelmed, right? We're just going to follow the steps one by one, focus on one thing at a time. So what do we need to end up with at the end? Alright, what units is the question asking us for? And right now it's milliliters per hour. How many milliliters per hour will you set the IV pump to? So here on the right-hand side, We're going to write milliliters per hour. Alright, step number 2: What does the order say? So what was actually ordered for our patient? Okay, Mr. Sourdough, he was ordered— the physician orders 2 milligrams per minute. Okay, 2 milligrams per minute, so we're going to put 2 milligrams here. 1 minute there. 2 milligrams per minute. All right, now step number 3 is conversions. What conversions are we going to use right in the middle to go from 2 milligrams per minute to milliliters per hour? Because we need milliliters per hour. Right now we have milligrams per minute. All right, so somehow we've got to go from milligrams to milliliters. In minutes to hours. Okay, so how are we gonna do that? I always like to look at the question first and see if it gives us any conversions. So here in the question, we actually can see pharmacy sends up— ooh— 1 gram in 250 milliliters. Well, there you go. We got 1 gram in 250 milliliters. So milliliters is here at the top in need, so we're gonna write milliliters here at the top. In 250 milliliters, there's 1 gram. Okay, so the pharmacy has 1 gram of lidocaine in 250 mL. So now we have milliliters at the top, and we have milliliters at the top here, which is exactly how we want it. But we have a problem because we have grams right here and we have milligrams here, so those cannot cross themselves out because they're two different units. So somehow now we have to go from milligrams to grams. So how do we do that? We think through our conversion factors, right? So we know that there's 1,000 milligrams in 1 gram, so we're gonna write 1,000 1 gram is equal to 1,000 milligrams. Perfect! Now we have grams here at the top and grams here at the bottom, so we know we can cross those out. We've got milligrams here at the bottom and milligrams here at the top, so we know we can cross those off. So that is perfect. So now we have milliliters here at the top, and that's it. We've got minutes down here at the bottom, and that's it. That's it. So milliliters is already set, but now we have to convert minutes to hours. So how do we get minutes and hours? What's our conversion for that? Well, we know that there are 60 minutes in 1 hour. You see that? 60 minutes in 1 hour. Now we've got hours down here in the need, we've got hours right here in our conversion. So that is right in the correct place that it needs to be. I'll make this a little bit better of an R. There you go. Hour. So that's exactly where they need to be. Milliliters at the top, hours at the bottom, and that's perfect. The minutes here are at the top, minutes here at the bottom, so those both cross off. And you see that we can't put 1 hour to 60 minutes and switch them. We couldn't put 1 hour up here and 60 minutes down here— whoops, 60— because then they wouldn't be able to cross each other out. Then we'd have minutes down here and minutes over there, and we can't do that. They have to be how we had them structured here— minutes here at the top and minutes here at the bottom— so that they could cross each other out. If we had had them switched, it wouldn't work. The multiplication and the division wouldn't work. They actually have to cancel each other out. So that way we have hours at the bottom here, which is what we want here, and then milliliters here, which is exactly what we want there. So now in step number 4, all we're gonna do is multiply across the top, multiply across the bottom, and divide those two numbers. All right, so let's go. So we've got 2 times 250. I know I circled through that, that zero, but it's 250. So 2 times 250 times 1 times 60 is 30,000. All right, and now the bottom is 1 times 1 times 1,000 times 1 is 1,000. All right, now we're gonna divide. 30,000 divided by 1,000 equals 30. All right, so 30 milliliters per hour. So 30 milliliters per hour is our answer. So now in step number 5, we want to make sure we follow the proper rounding rules and the rules for zeros. So this is a whole number, we're not going to change it or round it up or down or anything like that. We're just going to leave it as it is. We're not going to add any zeros or take away any zeros or anything like that, so it's just 30 milliliters per hour. Straight up, that's it. And then step number 6 is to always check your work. You want to make sure that we got the correct answer. So remember to walk through the steps again. The need— what do we need to end up with at the end? What is this question asking us for? It's asking us for milliliters per hour. Okay, so that's there— milliliters per hour. Now what's the order? The order is 2 milligrams per minute, so we've got 2 milligrams here per minute. Then we have our— we want to make sure that we use the proper conversions and that all of our units cancel each other out. So we've got milliliters up here, and we've got milliliters over here in the need, and then we've got— where's our hours? We've got our hours here. And we have our hours down here, which is perfect. So those are left, and then we have milligrams here, those cancel, milligrams here, those cancel, minutes here, that cancels, minutes up here, that cancels, and then grams and grams cancel. Fabulous. And then 2 times 250 times 1 times 60 is 30,000, and then 1 times 1 times 1,000 times 1 is 1,000, and then 30,000 1000 divided by 1000 is 30. So we got it, my friend, we did it! So our answer here is 30 milliliters per hour. Now here are some must-know tips to help you get every question right on your dose calc exam, okay? You can't miss these because if you skip any of these, you could end up getting the question wrong, and we do not want that, right? Tip number 1 is to read the entire question first. This is so important, and it tripped me up up so many times on the dose calc exam. Make sure that you read the entire question first before you start solving anything. Because here's what happens so often: you'll read through the question and you'll assume that you know what it's asking for, and then you'll solve that based on what you thought the question was asking. But then when you go back to check it, you realize that you were solving for the wrong thing, like you had the wrong units or something. It's so easy to just assume that you know what the question is asking you for when it's really asking you for something else. So when you sit down to take your dose calc exam, read the full question first, every single time, even a few times if you need. So this is also why it's the first step in my 6-step dose calc process, is to start with what you need. What units do you need to end up with at the end? You've got to start with that end in mind. To make sure that you're not solving for the wrong thing. We want to make sure we get the right answer and solve for the right thing. And tip number 2 is to circle what the question is asking you for. If your exam is on paper, you can physically circle or underline the specific unit that your question wants you to solve for. Or if you're taking it on a computer, you can just kind of mentally circle it in your mind or like highlight it in your mind, like it needs this, like this is what I'm solving for. I know it sounds like such a small thing, but what happens typically is you're totally stressed on exam day, right? You're so nervous and your brain is going a mile a minute. So really having that like anchor, kind of like that circle on your paper, it's gonna give your brain something to like attach to. So it keeps you locked in on what you actually need to solve for, and it just can help prevent really the number one dose calc mistake, which is doing all the math correctly but then solving for the wrong thing entirely, right? The math works perfect, but if you're solving for milligrams when they want milliliters, that's a problem. So you want to make sure that you're circling it, you know, starting with the end in mind. And then tip number 3 is to use rough mental math to see if you're way off. Okay, before you rework the entire problem or check your work, just do a quick guess. Quick gut check, right? Just ask yourself, does this answer that I got, does it even make sense? If the order is 500 milligrams and the tablets are 250 milligrams, that should be in the ballpark of 2, right? Not 20 or not 0.2. And if you're calculating an IV and you get 50,000 milliliters per hour, right, something went very, very wrong, right? We don't need to do a whole bunch of mental math here. We just want to check, like, does this answer— is it even in the right universe? Like, does this make sense at all? So it's just a quick gut check for you. Then you can go back through, rework the problem, and double-check it. And then tip number 4 is to cross out any extra information that the question gives you that's not applicable. So dose calc questions will typically throw in extra details that you don't need— things like the patient's age or their diagnosis or a medication detail that that has like absolutely nothing to do with the math. This, my friend, it's intentional, right? They are testing you on whether you can kind of eliminate those distractors and filter out the important information and prioritize. So if you're taking your exam on paper, then you can physically cross out that information that doesn't relate to the dose calc question. You can just literally take your pen and cross it out. It can help declutter the problem and keep you focused on what you actually need to do and what matters. Now, especially when you're just starting out and the problems really already feel overwhelming, and getting rid of that extra information in the question, it can make a huge difference. So it's like clearing off the clutter in your house, you know, you just want to make sure everything is free of distractions and it feels manageable. And if your test is on the computer, just really make a mental note in your mind that that info is totally irrelevant, like just cross cross it off in your mind. Like, don't even look at it, it doesn't matter. Now, tip number 5 is to make sure that you do your math setup first before you try to solve it, okay? Don't try to set up your railroad tracks and then do the multiplication at the same time. Treat these as two completely separate phases, all right? That's why I put them in the separate steps in my 6-step dose calc process. You want to get every unit and number in the right place first and verify that all your units cancel out correctly correctly first. All right, we don't want to touch your calculator yet, nothing. Just get this set up right, and then after you know everything cancels out, then you can do the math and you can solve for it. And then tip number 6 is to never do conversions in your head. We don't do that. Your brain will play tricks on you on exam day when you're under pressure, right? That's just how it works. So we want to write every single step out, or you will likely miss something. We don't want that. So even if the conversion seems simple, like, so like even if you think like, oh, I can do that in my head, please don't. All right, write it down because on exam day your stress level is higher than when you're gonna be practicing at home, and that's exactly when that mental math can go wrong. So write it all out so just to make sure you didn't accidentally miss something. Now tip number 7 is to be the unit police. Now write the units out out with every single number and make sure that they cancel correctly. The units— these are the keys to getting the question correct. If your units cancel out properly, your answer will likely be correct. But if they don't, then something's going to be off. So you want to be the unit police. Check them every single time. Tip number 8 is to practice, practice, practice, my friend. This is really the best way to gain confidence confidence in solving dose calc problems. You want to practice it over and over and over again, and then over and over and over again. Do all the practice questions that your school gives you, because the more that you can practice, the more confident you're going to get. If you're a NursingSOS member, make sure to sign into your dashboard and check out the dosage calculation workbooks that I have for you, and the full dose calc course inside the NMC. It's filled with practice problems and those step-by-step videos that I have for you to help this all really, really sink in and walk you through all of it. And if you're not an NMC member yet, you can click the link down in the description below for all the details on that. I'd love to have you inside and to help you pass your dose calc exam and all the rest of your nursing school exams as well. And then tip number 9 is that when you see micrograms, slow down and think. All right, those problems are testing your attention to detail and your attention to decimal placement. These are small numbers. Make sure that your decimal is in the right place and that you're writing your numbers out correctly, because those micrograms can be tricky. And tip number 10 is to remember that weight-based problems are safety questions. So anytime a question is asking you to convert pounds to kilograms or kilograms to pounds or whatever, that is your cue that it is a weight-based question. They're testing you on safety. So for these ones, you'll want to convert pounds to kilograms first before you do anything else so you don't forget. This will make the rest of the problem go so much easier for you. And these often come up as pediatric dose calc safety questions, so they're super, super important to get these right. So remember that 1 kilogram equals 2.2 pounds. That's your golden rule right there for these types of questions. All right, 1 kilogram is 2.2 pounds. And like we talked about before, one of the keys to passing the dose calc exam is knowing the conversion factors, because they are not going to give those to you during the test. So you've really got to know them ahead of time. You've got to have these memorized, and you literally cannot solve any dose calc question without them. So that is a huge deal, my friend. So click on this video right here where I'm going to walk you through all of the must-know conversions and quiz you on them so that you can make sure that you are prepared for your dose calc exam. And if this video helped you, hit that like button and leave a comment below to let me know. All of that helps to tell YouTube to show this video to more nursing students students who need it, and I am on a mission here, my friend, to help as many nursing students pass nursing school as possible. And don't forget to snag your free dose calc cheat sheet that has my whole 6-step process laid out for you. Just comment "dose calc" down below and I'll send that right over to you, or you can click the link in the description below to snag it. And of course, hit that subscribe button and click the notification bell so you never miss a And as always, my friend, go become the nurse that God created only you to be, and I will see you over there in that next video.