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NABP NAPLEX Exam - Topic 5 Question 118 Discussion

Alteplase is ordered for a 72 YOM who weighs 68kg for Ischemic stroke. The ER physician would like you to dose. As an ER pharmacist you know the dose is 0.9 mg/kg IV (not to exceed 90 mg); give 10% of the total dose as an IV bolus over 1 minute, then give the remaining 90% as an IV infusion over 60 minutes. After reconstitution, the concentration of Altaplace is 1mg/ml. How many ml is needed for the bolus and how many ml is needed for the infusion? Round to the nearest ml.
A) 6ml IV bolus, followed by 55mL IV over 60 minutes
B) 4ml IV bolus, followed by 57mL IV over 60 minutes
C) 3ml IV bolus, followed by 58mL IV over 60 minutes
D) 8ml IV bolus, followed by 52mL IV over 60 minutes
E) 9ml IV bolus, followed by 82mL IV over 60 minutes

NABP NAPLEX Exam - Topic 5 Question 118 Discussion

Actual exam question for NABP's NAPLEX exam
Question #: 118
Topic #: 5
[All NAPLEX Questions]

Alteplase is ordered for a 72 YOM who weighs 68kg for Ischemic stroke. The ER physician would like you to dose. As an ER pharmacist you know the dose is 0.9 mg/kg IV (not to exceed 90 mg); give 10% of the total dose as an IV bolus over 1 minute, then give the remaining 90% as an IV infusion over 60 minutes. After reconstitution, the concentration of Altaplace is 1mg/ml. How many ml is needed for the bolus and how many ml is needed for the infusion? Round to the nearest ml.

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Suggested Answer: A

68kg 0.9mg/kg = 61.2mg dose 1mg/mL = 61.2mL 61.2mg 0.1 = 6mL IV bolus 61.2mg 0.9 = 55mL IV over 60 minutes


by Paola at Apr 12, 2026, 04:58 AM

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Joaquin
10 hours ago
This question is tricky! I think the bolus should be around 6ml.
upvoted 0 times
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Judy
6 days ago
9ml for the bolus? That seems high, right?
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Meghan
11 days ago
I disagree, B seems more accurate to me.
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Jutta
16 days ago
Wait, how do we get 55ml for the infusion?
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Val
2 months ago
I think A is correct, 6ml bolus sounds right!
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Isaiah
2 months ago
The dose is 0.9 mg/kg, so for 68kg that's 61.2 mg total.
upvoted 0 times
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Carlee
3 months ago
I feel like I might be overthinking this. If the max dose is 90 mg, does that change how I calculate the bolus? I need to double-check my notes.
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Weldon
3 months ago
I practiced a similar question where we had to calculate the total dose first. I think for this patient, the total dose would be around 61.2 mg, which makes the bolus about 6 ml.
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Giuseppe
3 months ago
I think the bolus is 10% of the total dose, but I can't recall if I should round before or after calculating the ml needed.
upvoted 0 times
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Krissy
3 months ago
I remember the dosing for alteplase is 0.9 mg/kg, but I'm not sure how to calculate the bolus and infusion volumes correctly.
upvoted 0 times
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