# A 42 kg adult has an order for acetaminophen injection 1000 mg every 6 hours. Which action should the nurse take?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=513956&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A 42 kg adult has an order for acetaminophen injection 1000 mg every 6 hours. Which action should the nurse take?

## Option

1. Administer the full 100 mL bag because the client is an adult.
2. Hold the dose and clarify the order because clients under 50 kg require weight-based limits. **✔ Correct answer**
3. Administer 1000 mL because the solution contains 10 mg/mL.
4. Give the dose and ignore acetaminophen from combination products.

**Correct answer: 2**

## Explanation

Adults under 50 kg require weight-based dosing; the labeled maximum single dose is 15 mg/kg, so 1000 mg exceeds the 630 mg limit for 42 kg.

## In-depth explanation

Quick answer
Hold and clarify the 1000 mg order.

Why this is correct
The injection contains 10 mg/mL, but dose safety is based on milligrams and body weight. For 42 kg, 15 mg/kg equals 630 mg, below the ordered 1000 mg.

Easy analogy or mental picture
The bag size is the container, not the client-specific dose.

Memory hook
Under 50 kg: calculate mg/kg and count every acetaminophen source.

NCLEX decision rule
Check weight, milligrams, milliliters, pump programming, and total daily exposure before administration.

Why the other choices are wrong
Adult status does not override the under-50-kg rule. A 1000 mL dose is a unit error, and combination products still count toward the daily total.References
1DailyMed: Acetaminophen InjectionWeight-based dosing under 50 kg and mg/mL error prevention

## Clinical scenario

Dose-unit check
Verify weight, mg/kg limit, concentration in mg/mL, volume to infuse, interval, and all acetaminophen sources.

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