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Acknowledgments
Special thanks to:

• Wolters Kluwer editors: Sherry Dickinson, Matt Hauber
• Sister Grace Henke
• Lynn Farmer: Photography
• Ginger Pyron: Editor
• Pharmaceutical companies for supplying labels
• Faith community at Oakhurst Baptist Church for their support and prayers
• Colleagues at Herzing University
• Valerie, Andrew, and Chelsea for their love
• “Unofficial” proofreaders:
Alina-Sarai Gal-Chis
Jocylyn Lundy
Michelle Sugden
Orpha Gehman
Milly Rodriquez
Diane Skwisz
Maritza Cantarero
Ose Martinez
vi
Buchholz9781496302847-fm.indd 6 07/07/15 10:20 AM

Contents
CHAPT E R Arithmetic Needed for Dosage 1

1 Multiplying Whole Numbers 2
Dividing Whole Numbers 2
Fractions 3
Decimals 9
Percents 15
Fractions, Ratio, and Proportion 18
Proficiency Test 1 Arithmetic 21
Answers to Self-Tests 22
CH APT E R Metric and Household Systems of Measurement 31

2 Metric System 32
Household System 39
Liquid Measures 40
Other Conversions 41
Proficiency Test 1 Exercises in Equivalents and Mixed Conversions 44
CH APT E R Drug Abbreviations, Labels, and Packaging 47

3 Interpreting the Language of Prescriptions 47
Time of Administration of Drugs 48
Routes of Administration 52
Metric and SI Abbreviations 54
Household Abbreviations 55
Terms and Abbreviations for Drug Preparations 55
Drug Labels 57
Drug Packaging 59
vii

viii Contents
Equipment to Measure Doses 68

Proficiency Test 1 Abbreviations/Military Time 72
Proficiency Test 2 Reading Prescriptions/Interpreting Written Prescriptions 73
Proficiency Test 3 Labels and Packaging 75
CH AP TER Calculation of Oral Medications—Solids and Liquids 81

4 Oral Solids 82
Converting Order and Supply to the Same Weight Measure 91
Clearing Decimals 93
Special Types of Oral Solid Orders 97
Oral Liquids 98
Special Types of Oral Liquid Orders 107
Oral Solid and Liquid Problems Without Written
Calculations/“Common Sense” Calculations 107
Proficiency Test 1 Calculation of Oral Doses 113
CH AP TER Liquids for Injection 139

5 Syringes and Rounding 139
Special Types of Problems in Injections From a Liquid 153
Injections From Powders 160
Distinctive Features of Injections From Powders 162
Where to Find Information About Reconstitution of Powders 163
Insulin Injections 172
Proficiency Test 1 Calculations of Liquid Injections 187
Proficiency Test 2 Calculations of Liquid Injections
and Injections From Powders 190
Proficiency Test 3 Calculations of Liquid Injections 193
Proficiency Test 4 Mental Drill in Liquids-for-Injection Problems 194
CH AP TER Calculation of Basic IV Drip Rates 213

6 Types of IV Fluids 213
Calculating Basic IV Drip Rates 216
Adding Medications to IVs 224

Contents ix
Medications for Intermittent IV Administration 226

Ambulatory Infusion Device 230
Enteral Nutrition 231
Proficiency Test 1 Basic IV Problems 239
CH APT E R Special Types of IV C

alculations 255
7 Amount of Drug in a Solution 256
Medications Ordered in units/hour or mg/hour 256
Medications Ordered in mcg/minute, mcg/kg/minute,
or milliunits/minute—Calculation of Rate 268
Body Surface Nomogram 276
Patient-Controlled Analgesia 279
Heparin and Insulin Protocols 281
Proficiency Test 1 Special IV Calculations 289
CH APT E R Dosage Problems for Infants and Children 315

8 Dosage Based on mg/kg 316
Administering IV Medications 334
General Guidelines for Continuous IV Medications 347
Proficiency Test 1 Infants and Children Dosage Problems 354
CH APT E R Information Basic to Administering Drugs 367

9 Drug Knowledge 367
Pharmacokinetics 372
Legal Considerations 376
Ethical Principles in Drug Administration 380
Proficiency Test 1 Basic Drug Information 385
CH APT E R Administration Procedures 391

10 Three Checks and Six Rights 391
Standard Precautions Applied to Administration of Medications 400
Routes of Administration 403
Special Considerations 431

x Contents
Proficiency Test 1—Part A, Administration Procedures 437

Proficiency Test 1—Part B, Administration Procedures 441
Appendix A: Proficiency Test Answers 445
Appendix B: Putting It Together Answers 504
Glossary 523
Index 529

1
CHAPTER
Arithmetic Needed
for Dosage
TOPICS COVERED
1. Multiplication and division of whole numbers, fractions, and decimals
2. Addition and subtraction of fractions
3. Reading decimals
4. Changing decimals to fractions
5. Addition, subtraction, multiplication, and division of decimals
6. Clearing and rounding of decimals
7. Percents
8. Solving ratio and proportion
When a medication order differs from the fixed amount at which a drug is supplied, you must calculate
the dose needed. Calculation requires knowledge of the systems of dosage measurements (see Chapter 2)
and the ability to solve arithmetic. This chapter covers the common arithmetic functions needed for the
safe administration of drugs.
Examples that use basic arithmetic functions include problems in dosage calculations such as:
45.5 mL water + 34.75 mL juice = total intake
administer 1.5 mg of a drug; if you have 0.75 mg on hand, how much more of the drug do you need?
administer 3 tablets; if each tablet is 1.5 mg, what is the total dose?
administer 7.5 mg of a drug; if you have 1.25 mg tablets on hand, how many tablets need to be given?
on hand are two ophthalmic solutions: 0.05% and 0.02%. Which solution is strongest?
Beginning students invariably express anxiety that they will miscalculate a dose and cause harm.
lthough everyone is capable of error, no one has to cause an error. The surest way to prevent a mistake is
A
to exercise care in performing basic arithmetic operations and practice basic arithmetic calculations.
For students who believe their arithmetic skills are already satisfactory, this chapter contains self-
tests and a proficiency exam. Once you pass the proficiency exam, you can move on to other chapters
in the book.
Students with math anxiety and those with deficiencies in performing arithmetic will want to work
through this chapter. Examples demonstrate how to perform calculations; the self-tests provide practice
and drill. FINE POINTS boxes explain details about the calculation. After you’ve mastered the content,
take the proficiency exam to verify your readiness to move on.
Since calculators are readily available, why go through all the arithmetic? For one thing, using a cal-
culator still requires that you to know what numbers and functions to enter. In clinical situations you may
encounter some problems that require a calculator’s help, but it’s good to know how to make calculations
Buchholz9781496302847-ch001.indd 1 07/07/15 7:30 PM

2 Henke’s Med-Math: Dosage Calculation, Preparation & Administration
on your own. Solving the arithmetic problems yourself helps you think logically about the amount ordered
and the relative dose needed. And when you can mentally calculate dosage, you increase your speed and
efficiency in preparing medications. Work out the problems in this chapter with and without a calculator.
Multiplying Whole Numbers

If you need a review, study a multiplication table for the numbers 1 through 12, which can be found in a
basic math book or on the internet. (Search for “multiplication table.” One site is http://www.mathisfun.com/
tables). Then do the self-tests, aiming for 100% accuracy.
SELF-TEST 1 Multiplication
Write the answers to these problems. Answers are given at the end of the chapter; aim for 100%.
1. 2 × 6 = 10. 8 × 9 = 19. 4 × 9 =
2. 9 × 7 = 11. 3 × 5 = 20. 3 × 8 =
3. 4 × 8 = 12. 6 × 7 = 21. 12 × 11 =
4. 5 × 9 = 13. 4 × 6 = 22. 9 × 5 =
5. 12 × 9 = 14. 9 × 6 = 23. 9 × 9 =
6. 8 × 3 = 15. 8 × 8 = 24. 7 × 5 =
7. 11 × 10 = 16. 7 × 8 = 25. 12 × 10 =
8. 2 × 7 = 17. 2 × 9 =
9. 8 × 6 = 18. 8 × 11 =
Dividing Whole Numbers

Review division if necessary, using a division table which can be found in a basic math book or on the
internet. Again, aim for 100% accuracy on the self-test.
SELF-TEST 2 Division
Write the answers to the following problems. Answers are given at the end of the chapter.
1. 63 ÷ 7 = 10. 18 ÷ 3 = 19. 36 ÷ 6 =
2. 24 ÷ 6 = 11. 72 ÷ 8 = 20. 18 ÷ 9 =
3. 36 ÷ 12 = 12. 48 ÷ 8 = 21. 21 ÷ 3 =
4. 42 ÷ 6 = 13. 28 ÷ 7 = 22. 48 ÷ 4 =
5. 35 ÷ 5 = 14. 21 ÷ 7 = 23. 144 ÷ 12 =
6. 96 ÷ 12 = 15. 24 ÷ 8 = 24. 56 ÷ 8 =
7. 12 ÷ 3 = 16. 84 ÷ 12 = 25. 60 ÷ 5 =
8. 27 ÷ 9 = 17. 81 ÷ 9 =
9. 49 ÷ 7 = 18. 32 ÷ 8 =

C HAPTE R 1 Arithmetic Needed for Dosage 3
Fractions
A fraction is a portion of a whole number. The top number in a fraction is called the numerator, and
the bottom number is called the denominator. The line between the numerator and the denominator is
a division sign. Therefore, you can read the fraction 14 as “one divided by four.”
EXAMPLE 1 → numerator
4 → denominator
Types of Fractions
In a proper fraction, the numerator is smaller than the denominator.
EXAMPLE 2
5 (Read as “two fifths.”)
In an improper fraction, the numerator is larger than the denominator.
EXAMPLE 5
2
(Read as “five halves.”)
A mixed number has a whole number plus a fraction.
EXAMPLE
1 23 (Read as “one and two thirds.”)
In a complex or common fraction, both the numerator and the denominator are already fractions.
EXAMPLE 1
2
(Read as “one half divided by one fourth.”)
1
4
RULE REDUCING FRACTIONS

Find the largest number that can be divided evenly into the numerator and the denominator.
EXAMPLE EXAMPLE 1:
Reduce 4
12
1
4 1
12
= 3
3
EXAMPLE 2:
Reduce 7
49
FINE POINTS
1 Check to see if the denominator is evenly
7 1
49
= 7 divisible by the numerator. In this exam-
7 ple, the number 7 can be evenly divided
into 49.

Sometimes fractions are more difficult to reduce because the answer is not obvious.
EXAMPLE EXAMPLE 1:
56
Reduce 96 FINE POINTS
1
56 8 ×7 7 In Example 1, note both the numerator
96
= 8 × 12
= 12 and denominator can be evenly divided
1
by 8. In Example 2 both can be evenly
divided by 9.
EXAMPLE 2:
54
Reduce 99
1
54 9×6 6
99
= 9 × 11
= 11
1
When you need to reduce a very large fraction, it may be difficult to determine the largest number that
will divide evenly into both the numerator and the denominator. You may have to reduce the fraction sev-
eral times.
EXAMPLE EXAMPLE 1:
189
Reduce 216 FINE POINTS
63 Prime numbers cannot be reduced any
189 63
Try to divide both by 3 216
= 72 further. Examples are 2, 3, 5, 7, and 11.
72
When reducing, if the last number is even
1
63 9×7 7 or a zero, try 2.
Then use multiples 72
= 9×8
= 8
1 If the last number is a zero or 5, try 5.
If the last number is odd, try 3, 7, or 11.
EXAMPLE 2:
27
Reduce 135
9 1
Try to divide both by 3 27 9 1
135
= 45
= 5
45 5
Then divide by 9.
SELF-TEST 3 Reducing Fractions
Reduce these fractions to their lowest terms. Answers are given at the end of the chapter.
16 8
1. 24 6. 48
36 12
2. 216 7. 30
18 68
3. 96 8. 136
70 55
4. 490 9. 121
18 15
5. 81 10. 60

Adding Fractions
If you need to add two fractions that have the same denominator, first add the two numerators; write that
sum over the denominator and, if necessary, reduce.
1
5
+ 35 = 4
5
If the two fractions have different denominators, the process takes two steps. First convert each frac-
tion, multiplying both of its numbers by their lowest common denominator. After you’ve converted both
fractions, add their two numerators together. If necessary, reduce.
3 32 2
+ += =
5 53 3
3
5
+ 23 35=(( 35×× 33(( ××)) 33=)) 15
=9 15
=9 35= 35
3 ( × 3 )2 ( 2× 95( ×
= )=5=)3510
5 ( × 3 )3 ( 3×15 = 10
= 2= 2
5( × ) 5 ) 15 15 3 3
2 ( × 5 )9 91010 10219 19
= +==3 = or or1 1541 154
3 ( × 5 )15 1+51515 15 15 15
9 10 19
+ = 15 or 1 154
15 15
Subtracting Fractions
To subtract two fractions that have the same denominator, first subtract their numerators and then write
the difference over the denominator. Reduce if necessary.
27
32
− 18
32
= 9
32
= 1
2
If the two fractions have different denominators, first convert each fraction using the lowest common
denominator (just as you did in the adding example above). Then subtract the numerators, and reduce
again if necessary.
7 72 2
− −= =
8 83 3
7 7 ( 7× (3 ×) 3 ) 21 21 7
8
− 23 8=( 8× (3 ×) 3=) 24 = 24
= 8= 7
8
7 ( × 3 )2 ( 2×21
= 8(8( ××)) 88==)) 8716
8 ( × 3 )3 ( 3×24 = 16
= 2=
24 24 3
2
3
2 ( × 8 )21 216 2
= −12416
3 ( × 8 )24 24 −=16 = =5 5
24 243 24 24
21 16 5
24
− 24 = 24
SELF-TEST 4 Adding and Subtracting Fractions
Add and subtract these fractions. Answers are given at the end of the chapter.
15 5
1. 3
7 + 2
7 = 6. 16
− 16 =
3 1 3 2
2. 5
+ 5
= 7. 7 − 7 =
2 1 3 2
3. 4
+ 4
= 8. 5
− 15 =
11 7
4. 2
3
+ 1
6
= 9. 15
− 10 =
1 1 8 5
5. 2
+ 3
= 10. 9
− 12 =

Multiplying Fractions
There are two ways to multiply fractions. Use whichever method is more comfortable for you.
First Way
Multiply the numerators across. Multiply denominators across. Reduce the answer to its lowest terms.
EXAMPLE 2 3 2×3 6
7 ×2 4 =3 7 × 24 ×=3 28 6
× =
726 × 3 4 1 67 × 4 =
2 3 22 × 33 28
7 × 4 =77×× 44 =6 28 =
7 × 423 ×× 32281 3
2 3 21 ×23×283 6= 6 14 ×32×==
1= 2 614 3
76 × 4 3=×672×74 3=34×28 =
7 × 41 28= 14
282 3 ×2
14
= 14 28 == 14 =1
3 ×362×62 14 31
28
26 2 × 22121×263×14
3 33××=
× = =3 =1 28 =
7 =47 4 7 ×28 7 =× 4
14 × 2 1 1414 × 21
28 4 28 14
11
26 6 3=3 ×322××23 3 63
728× =414=14
28 = = 14
×72× 42 14 28
1
11
6 3× 2 3
= 14 × 2 = 14
Second28Way (When You 1
Are Multiplying Several Fractions)
First, reduce each fraction by dividing its numerator evenly into its denominator. Multiply the remaining
numerators across. Multiply the remaining denominators across. Check to see if further reductions are
possible. In Example 1, because of several fractions, you can use any numerator to divide into any of the
denominators.
EXAMPLE EXAMPLE 1: 1 1 1
3 7 5 3 7 5 1
14
× 10 × 12 = 14
× 10
× 12
= 16 FINE POINTS
1 1 12 2 4
2 3 3 7 2 × 53 63 7 5 1 The denominators are
× × = ×
714 4 10 7 ×12 4
= 28
14
× 10
× 12
= 16 14 ÷ 7 = 2
2 2 4 being divided by the
1 1 1 1 10 ÷ 5 = 2
3 7 5 236 3 73 × 22 ×53 3 61 numerators to reduce.
× 10 × 12 = 728××=410= × = = 28
14 14 14 ×72×124 14 16 12 ÷ 3 = 4
2 2 11 4
6 3× 2 3
28
= 14 × 2 = 14
If you’re multiplying
1 mixed numbers, you first need to change each of them into an improper fraction.
The process: For each fraction, multiply the whole number by the denominator; then add that total to the
numerator.
EXAMPLE12: 2
3 4
1 12 × 46 = 2
× 6 = 22 =1
1 2 1 2
2 3 1 2 × 34 36 4 2
7 × =
1 ×
4 27 × 46
= 28
2
× 6
= 2 =1
1 1 2 1 2
26 4 3 33× 22 × 43 3 26
1 12 × × = = × 4 =14 28
728 61 41422×72× 6=
= 2
=1
2 3 3 14 211× 232 6
1 12 × 46 76 ×2 4×3=6× 72=× 42 =
= = 128
3
28
=
1 2
14 × 12
= 14
6 3 × 21 3
28
= 14 × 2 = 14
1 EXAMPLE 3: 4
20
4
5
× 6 23 =4
5
× 3
= 16
3
4 1
2×3 20
2
7 × 43 45= ×7 6× 423 = 46
28
5
× 3
= 16
3
1 4 1
× 627623×==43 345=××722××3=
4 203 3 16
5 = 63
28 14 × 2 4 14 28
1 11
6 3× 2 3
28
= 14 × 2 = 14
1

SELF-TEST 5 Multiplying Fractions
Multiply these fractions. Reduce if necessary. Answers are given at the end of the chapter.
5 3 2
1. 1
6
× 4
5
× 2
= 5. 3 4 × 10 3 = 9. 5 81 × 8 16 × 1
7 =
11 1 2
2. 4
× 3
= 6.
7 2
× 14 = 10. 12
× 4
× 3
=
15 2 20
3. 1 12 × 4 23 = 7. 9
2
× 3
2
=
9
4. 1
× 15
= 8. 6 14 × 7 19 × 5
=
5 45
Dividing Fractions
To divide two fractions, first invert the fraction that is after the division sign, then change the division sign
to a multiplication sign. Reduce to lowest number.
EXAMPLE EXAMPLE 1:
2
150
1
75
1
÷ 150 = 1
× 1
=2 FINE POINTS
75
1
2 Complex fractions such as
1 1 1 150
75
÷ 150 = × 1
=2
75 1
2 1
150 4 1 3
1 1
÷ 150 = 1
× =2 are read as ÷
75 75 1 3 4 8
1 8
The vertical arrangement acts just like a

EXAMPLE 2:
division sign.
1 2
8
4
3 = 1
4
÷ 83 = 1
4
× 3
= 2
3
8 1
1 2
8
4
3 = 1
4
÷ 83 = 1
4
× 3
= 2
3
8 1
1 2
8
4
3 = 1
4
÷ 83 = 1
4
× 3
= 2
3
8 1
1 2
8
4
3 = 1
4
÷ 83 = 1
4
× 3
= 2
3
8 1
EXAMPLE 3:
3
115 6
2 = 65 ÷ 23 = 5
× 3
2
= 9
5
or 1 45
3 1
3
115 6
2 = 65 ÷ 23 = 5
× 3
2
= 9
5
or 1 45
3 1
3
115 6
2 = 65 ÷ 23 = 5
× 3
2
= 9
5
or 1 45
3 1
3
115 6
2 = 65 ÷ 23 = 5
× 3
2
= 9
5
or 1 45
3 1

SELF-TEST 6 Dividing Fractions
Divide these fractions. Answers are given at the end of the chapter.
1 1 7 7
1. 75
÷ 150 = 5. 25
÷ 75 = 9. 5
÷ 1
=
8 3
1
2. 1
8
÷ 1
4
= 6. 2
÷ 14 = 10. 5 12 ÷ 1
=
4
3. 2 23 ÷ 1
2
= 7. 3
4
÷ 83 =
7
4. 75 ÷ 12 12 = 8. 1
60
÷ 10 =
Changing Fractions to Decimals

To change a fraction into a decimal, begin by dividing the numerator by the denominator. Remember that
the line between the numerator and the denominator is a division sign, so 14 can be read as 1 ÷ 4.
In a division problem, each number has a name. The number that’s being divided (your fraction’s
numerator) is the dividend; the one that does the dividing (your fraction’s denominator) is the divisor:
and the answer is the quotient.
40. ← quotient
divisor → 16 640. ← dividend
64
)
0
1
1. Look at the fraction 4
1 ← numerator = dividend
4 ← denominator = divisor
2. Write
41 )
3. Some people find it easier to simply extend the fraction’s straight line to the right, then strike out
the numerator and place that same number down into the “box.”
1 1
=
4
4 1 )
4. Once you’ve set up the structure for your division problem, place a decimal point immediately after
the dividend. Put another decimal point on the quotient line (above), lining up that point exactly
with the decimal point below.
By placing your decimal points carefully, you can avoid serious dosage errors.
1 . ← quotient
)
4 1. ← dividend
FINE POINTS
If the answer does not have a whole
5. Complete the division. number, place a zero before the decimal
1 .25 = 0.25 point: .25 is incorrect; 0.25 is correct.
)
4 1.00
8
This is called a leading zero.
The number of places to carry out the
20 decimal will vary depending on the drug
20 and equipment used. For these exercises,
0 when possible, carry answers to the
thousandths place (three decimal places).

EXAMPLE EXAMPLE 1:
5 5 0.312
=
)
16 = 0.312
16 5.000
4 8
20
16
40
32
8
EXAMPLE 2:
640 640 80. FINE POINTS

)
8
= = 80
8 640. In the answer for Example 2, note the
space between 8 and the decimal point.
When such a space occurs, fill it with a
zero to complete your answer.
EXAMPLE 3:
1 1 0.013
=
)
75 = 0.013
75 1.000
75
250
225
25
SELF-TEST 7 Converting Fractions to Decimals
Divide these fractions to produce decimals. Answers are given at the end of the chapter. Carry
decimal point to three decimal places if necessary. (Do not use rounding rules yet!)
1 1
1. 6
5. 8 9. 5
8
6 1 1
2. 8
6. 7 10. 5
4 1
3. 5
7. 3
9 11
4. 40 8. 12
Decimals
Most medication orders are written in the metric system, which uses decimals.
Reading Decimals and Converting Decimals to Fractions

Start by counting how many places come after the decimal point. One space after the decimal point is the
tenths place. Two spaces is the hundredths place. Three places is the thousandths place, and so on. When
you read the decimal aloud, it sounds like you’re reading a fraction:
0.1 is read as “one tenth” ( 101 ) .

0.01 is read as “one hundredth” ( 1001 ) .

0.001 is read as “one thousandth” ( 1000
1 .
)
Always read the number by its name first, then count off the decimal places. If a whole number precedes
the decimal, read it just as you normally would.
Since decimals are parts of a whole number, you can write them as fractions:
( 100 )
EXAMPLE 56
0.56 = “fifty-six hundredths”
FINE POINTS
0.2 = “two tenths” ( 102 )
Notice the use of the “leading zero.”
0.194 = “one hundred ninety-four This is a zero used before a decimal point
thousandths” 194 ( 1000 ) when writing only a decimal number.
This leading zero is used in dosage
0.31 = “thirty-one hundredths” ( 100
31
) calculations to reduce errors in writing
decimals.
1.6 = “one and six tenths” (1 10
6
)
17.354 = “seventeen and three hundred
fifty-four thousandths” (17 1000
354 .
)
SELF-TEST 8 Reading Decimals
Write these decimals in longhand and as fractions. Do not reduce. Answers are given at the end of
the chapter.
1. 0.25 ________________________________________________________________________
2. 0.004 _______________________________________________________________________
3. 1.7 _________________________________________________________________________
4. 0.5 _________________________________________________________________________
5. 0.334 _______________________________________________________________________
6. 136.75 ______________________________________________________________________
7. 0.1 _________________________________________________________________________
8. 0.15 ________________________________________________________________________
9. 2.25 ________________________________________________________________________
10. 10.325 ______________________________________________________________________
Addition and Subtraction of Decimals

To add decimals, stack them vertically, making sure that all decimal points line up exactly. Starting at the
far right of the stack, add each vertical column of numbers. In your answer, be sure your decimal point
lines up exactly with the points above it.
EXAMPLE 1:
0.8
+ 0.6
1.4

EXAMPLE 2:
10.30
+ 3.28
13.58
To subtract decimals, stack your two decimals as you did for addition, lining up the decimal points as
before. Starting at the far right of the stack, subtract the numbers; again, make sure that the decimal point
in your answer aligns with those above it.
EXAMPLE 1:
2 9 10
13 − 12.54 = 13 .0 0
− 12.54
0.46
EXAMPLE 2:
4 16
14.56 − 0.47 = 14 .56
− 0.47
14.09
SELF-TEST 9 Addition and Subtraction of Decimals
Add and subtract these decimals. Answers are given at the end of the chapter.
1. 0.9 + 0.5 = 6. 98.6 − 66.5 =

2. 5 + 2.999 = 7. 0.45 − 0.38 =
3. 10.56 + 357.5 = 8. 1.724 − 0.684 =
4. 2 + 3.05 + 0.06 = 9. 7.066 − 0.2 =
5. 15 + 0.19 + 21 = 10. 78.56 − 5.77 =
Multiplying Decimals
Line up the numbers on the right. Do not align the decimal points. Starting on the right, multiply each
digit in the top number by each digit in the bottom number, just as you would with whole numbers. Add
the products. Place the decimal point in the answer by starting at the right and moving the point the same
number of places equal to the sum of the decimal places in
both numbers multiplied, count the number of places that
you totaled earlier. If you end up with any blank spaces, fill FINE POINTS
each one with a zero.
Avoid the “trailing zero.” There should
EXAMPLE 1: be no zeroes used to the right of the
decimal point. The use of the trailing zero
2.6 × 0.03 = 2.6 (1 decimal place)
often leads to errors in writing decimals.
× 0.03 ( 2 decimaal places)
0.078 (3 decimal places from the right)
EXAMPLE 2:
FINE POINTS
200 × 0.03 = 200 ( no decimal place)
0.03 ( 2 decimaal places) A quick “double-check” to determine
6.00 ( 2 decimal places from the right) decimal places is to count the number
or of decimal places in each number that is
6 being multiplied. The answer should have
the same number of decimal places.

Dividing Decimals
A reminder: The number being divided is called the dividend; the number doing the dividing is called the
divisor; and the answer is called the quotient.
0.312 → quotient
)
divisor →16 5.000 → dividend
Note: As soon as you write your dividend, place a decimal point immediately after it. Then place another
decimal point directly above it, on the quotient line.
.
)
EXAMPLE 13
16 16 130
Divide.
EXAMPLE 0.812
)
16 13.000
12 8
20
16
40
32
8
Clearing the Divisor of Decimal Points

Before dividing one decimal by another, clear the divisor of decimal points. To do this, move the decimal
point to the far right. Move the decimal point in the dividend the same number of places and, directly
above it, insert another decimal point in the quotient.
EXAMPLE EXAMPLE 1:
) )
0.2 0.004 = 0.: 2 0 .: 0 04
0.02
Hence, 2 00.04)
EXAMPLE 2:
1.262 FINE POINTS
) )
4 .: 3 5.: 4 27 becomes 43. 54.270
43
When you’re dividing, the answer may
not come out even. The dosage calcula-
11 2 tion problems give directions on how
86 many places to carry out your answer.
2 67 In Example 2, the answer is carried out
2 58 to three decimal places.
90
86
4

SELF-TEST 10 Multiplication and Division of Decimals
Do these problems in division of decimals. The answers are given at the end of this chapter. If neces-
sary, carry the answer to three places (unless the answer comes out “even”). (Do not use rounding
rules yet!)
1. 3.14 × 0.02 = 5. 54 × 7.41 =

9. 1.3 40 )
2. 100 × 0.4 = 6. 7.8 140) )
10. 7 18.61
3. 2.76 × 0.004 = )
7. 6 140
4. 6.3 × 7.6 = 8. 0.025 10 )
Rounding Off Decimals

How do you determine the number of places to carry out division? This question seems to continually
confuse students (and teachers sometimes!). The answer depends on the way the drug is dispensed and
the equipment needed to administer the drug. Some tablets can be broken into halves or fourths. Some
liquids are prepared in units of measurement: tenths, hundredths, or thousandths. Some syringes are
marked to the nearest tenth, hundredth, or thousandth place. Intravenous rates are usually rounded to
the nearest whole number or sometimes tenth place. Sometimes, determining when to round is depen-
dent on the clinical setting you work in. Pediatric settings often use dosages in tenths, hundredths, and
thousandths, while in adult settings, often the answer is rounded to the nearest whole number. As you
become familiar with dosage, you’ll learn how far to round off your answers. To practice, first review
the general rule for rounding off decimals.
RULE ROUNDING OFF DECIMALS

To round off a decimal, you simply drop the final number. Exception: If the final number is 5 or higher,
drop it and then increase the adjacent number by 1.
EXAMPLE 0.864 becomes 0.86

1.55 becomes 1.6
0.33 becomes 0.3
4.562 becomes 4.56
2.38 becomes 2.4
To obtain an answer that’s rounded off to the nearest tenth, look at the number in the hundredth place and
follow the above rule for rounding off.

0.667 becomes 0.7
1.46 becomes 1.5

If you want an answer that’s rounded off to the nearest hundredth, look at the number in the thousandth
place and f ollow the above rule for rounding off.

0.148 becomes 0.15
2.375 becomes 2.38
And if you want an answer that’s rounded off to the nearest thousandth, look at the number in the
ten-thousandth place and follow the same rules.

0.0024 becomes 0.002
4.5555 becomes 4.556
SELF-TEST 11 Rounding Decimals
Round off these decimals as indicated. Answers are given at the end of the chapter.
Nearest Tenth Nearest Hundredth Nearest Thousandth
1. 0.25 = ______________ 6. 1.268 = ______________ 11. 1.3254 = ______________
2. 1.84 = ______________ 7. 0.751 = ______________ 12. 0.0025 = ______________
3. 3.27 = ______________ 8. 0.677 = ______________ 13. 0.4521 = ______________
4. 0.05 = ______________ 9. 4.539 = ______________ 14. 0.7259 = ______________
5. 0.63 = ______________ 10. 1.222 = ______________ 15. 0.3482 = ______________
Comparing the Value of Decimals

Understanding which decimal is larger or smaller can help you solve dosage problems. Example: “Will I
need more than one tablet or less than one tablet?”
RULE DETERMINING THE VALUE OF DECIMALS

The decimal with the higher number in the tenth place has the greater value.
EXAMPLE Compare 0.25 with 0.5.

Since 5 is higher than 2, the greater of these two decimals is 0.5.
SELF-TEST 12 Value of Decimals
In each pair, underline the decimal with the greater value. Answers are given at the end of the chapter.
1. 0.125 and 0.25 5. 0.825 and 0.44 9. 0.3 and 0.225

2. 0.04 and 0.1 6. 0.9 and 0.5 10. 0.5 and 0.455
3. 0.5 and 0.125 7. 0.25 and 0.4
4. 0.1 and 0.2 8. 0.7 and 0.35

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“You’ll play, Mrs. Harter,” said Leeds in his affirmative way. “I know
you’re a gambler, right enough. D’you remember that night at the
Club when old Patterson’s crew played whisky poker till the small
hours, and by Jove, d’you remember the cards you picked up? I’ve
never forgotten them. Never saw such cards in my life.”
“I always hold good cards,” said Mrs. Harter indifferently.
And of course one of the Kendals rushed in where ordinarily
intelligent human beings, let alone angels, would have thought twice
about treading.
“Lucky at cards, unlucky in love,” said Aileen, in the self-satisfied
tone of one who is making a consciously apt observation.
The way in which some among us then looked straight at Bill and
Mrs. Harter was only less indecently obvious than the way in which
others among us at once looked away from them.
And Bill and Mrs. Harter just looked at one another, and if we hadn’t,
all of us, known about them before, that look must have told us.
Leeds was the only person who presumably saw nothing, for he
went on to remind Mrs. Harter how badly screwed poor old Patterson
had been that night in Egypt, and didn’t she remember his falling
down the steps backwards?
“Good gracious!” said Dolly Kendal with all the fearful directness of
the Kendals, “you must have known some funny people out there,
Mrs. Harter.”
“Shall we cut for partners?” said Lady Annabel Bending very gently.
Mrs. Kendal does not play bridge, and she came and sat beside me,
no doubt with the kindest intentions of enlivening me, but after
observing three or four times that the picnic had been very well
done, she gradually closed her eyes and ceased to say it. Mumma’s
bulk was partly between me and the rest of the world, and I saw, as
from the shadow of a great rock, what they were all doing, and it
interested me. The people who were playing cards were almost
altogether silent, as good players always are. Claire looked tense
and eager, as she does over everything. It is nothing to her whether
she wins at bridge or not, but it is everything whether she is thought
to excel or not. As a matter of fact, she plays very well. General
Kendal was her partner, and he is a good player, too.
Lady Annabel was playing with Leeds, and every now and then, at
the end of a hand, his voice bellowed out encouragement or
explanation, or even remonstrance.
“I can’t imagine why you didn’t back me up,” he said once. “A hand
that positively screamed for a redouble—positively screamed for it.”
“I acted to the best of my judgment,” said Lady Annabel. “I thought at
the time, and I still think, that I should not have been justified in
redoubling.”
“But it would have given us the game! Listen to me,” commanded
Leeds, most unnecessarily. “I led the spade....”
He proceeded to play the whole hand all over again, card by card.
And at the end of it all Lady Annabel, drooping in a dignified way
over the scattered packs, said that she did not really think she would
have been justified in redoubling.
I suppose it was that spirit which made her the success that she
undoubtedly was, in the days of H. E. Sir Hannabuss Tallboys.
While that was happening, most of the others had disappeared.
Christopher Ambrey and Mrs. Fazackerly were with Sallie and some
of the Kendals, but already the groups were breaking up into twos
and threes.
Only Captain Patch and Mrs. Harter sat quite still, not very far from
where I was, but a good deal removed from the others.
I could just hear the sound of his voice, and hers, as they spoke
together.
Chapter Ten
Of course I thought about Mrs. Harter. She compelled one to think
about her, even then. And I liked young Patch, too, and it seemed to
me that he was heading straight for the rocks.
It was a very hot, still afternoon. Even the shadows of the beech
trees were motionless and unflickering.
The servants had taken away the remains of the feast and the motor
cars had been discreetly manœuvered to some invisible point on the
horizon. By far the most sophisticated things within sight were the
bridge players.
Nancy Fazackerly, coming toward me by herself, blended quite
agreeably into the surrounding green, in her pale green linen frock
with her ash-blonde hair uncovered.
I have known her nearly all her life, and, as one of the very few
young women on earth whose society Claire could tolerate, she had
spent quite a lot of time with us since her return to Cross Loman.
Doubts, however, had for some time been assailing me as to the
security of that state of affairs, and something in her face as she sat
down beside me brought all my misgivings into active life.
“I wish,” said Mrs. Fazackerly gently, “that I knew what to do.”
“When a woman says that, it generally means that her mind is made
up.”
Nancy laughed, but she said, “Mine isn’t.”
I suppose that if one of the Kendals had been there she would
immediately have inquired, “Has he asked you yet?” I have not,
however, been brought up by Mumma, and so these unflinching
methods are beyond me. Moreover, I did not imagine for a minute
that Nancy really wanted advice, any more than anybody else ever
wants it. She only needed someone to whom she could talk more or
less freely.
“You know that my dear father is sometimes a little—peculiar,” she
began in a hesitating way.
“I know—and you know—” said I, “that he treats you disgracefully.
Yes. Let’s come to the point, my dear.”
“Can you imagine that he would ever tolerate the idea of my leaving
him again?”
“If you mean, do I think that he would take it lying down, no, I don’t.
But in your place, I shouldn’t allow him a word in the matter.”
“You are always so brave,” she said wistfully.
“And you are always so cowardly.”
Then I felt rather ashamed of having said that, remembering that,
after all, she had stuck to Fazackerly, from whom most women would
probably have fled at the end of six weeks.
But Nancy only said sadly, “I know I am.”
“Is it Christopher?” I asked, well knowing that it was.
She nodded.
“I know you can’t say you’re glad,” she added hastily.
“But I should be glad, to see you happy.”
“It’s very nice of you.”
We were both thinking of Claire, but our conversation, as is the way
of most conversations, made no mention of that of which we were
thinking.
“I cannot imagine what Father would do, all by himself, although he
does say that I am such a bad housekeeper. And it would be quite
impossible to have anything like a joint establishment.”
I nearly said, “God forbid!” as I thought of old Carey, and his
incessant grumbling, and his stinginess, and his criminology.
“Is your father the only reason why you’re hesitating?”
She gave me a most expressive look.
“Except that it seems far, far too good to be true. I thought my life
was quite over, as far as that sort of thing went, and that I was just
one of those unlucky people who’d made a bad mistake. And then to
find him—so good and dear and nice, and actually caring for me!”
“I fail to see anything so astounding in that last item.”
Nancy Fazackerly shook her head.
“I know what I’m like—what circumstances have made me,” she said
simply. “Father is a very dominant personality, as you know, and I’ve
never been very brave. Sometimes I wonder that I’ve got any
individuality left at all. And then, being so badly off has made me
calculating, and even mean, in tiny little ways that you probably
wouldn’t even understand if I told you about them. You see, I always
knew that the bills would make Father angry, and the thing I’m most
afraid of in the world is that people should be angry with me. Often
and often I’ve said what isn’t true so as not to disagree with other
people. I daresay you won’t believe me....”
I believed her, on the contrary, without any difficulty at all, and I was
touched by her naïveté, and by the pathos of her confession.
“That would be all over if you married Christopher.”
“Yes,” she said. “Of course I suppose everyone, more or less, feels
that if they could be happy they could be good, but if—if anything so
wonderful as that happened to me, it would be the first great chance
that I’d ever had in my life.”
I knew it was true.
“I believe it has come and that you’re going to take it and make the
very most of it. And I’ll back you for all I’m worth, Nancy my dear.”
She thanked me with a gratitude that was disproportionate, and then
asked if I thought that anybody had guessed.
“Because, of course, nothing whatever is settled yet, and in any
case, his sister comes first.”
Nancy looked terribly apprehensive, and I could think of nothing
whatever that would be at once convincing and reassuring, as to
Claire’s reception of the tidings. So, on the principle of the
counterirritant, I asked when she was going to tell her father.
Mrs. Fazackerly’s small face actually and literally became quite pale.
“Chris is going to tell him for me,” she murmured, in a conscience-
stricken whisper. “He says he doesn’t mind. He and Captain Patch
are the only two people I know who are not a little bit overwhelmed
by dear Father’s personality.”
At her mention of Captain Patch, we both glanced round at the little
knoll, at the foot of which he and Mrs. Harter had been sitting, but
the two figures had disappeared. At the same moment the bridge
players rose and came towards us, and the servants apparently
sprang out of the earth and began to collect the cards and markers
and pencils and put them away.
Mrs. Leeds said, “What’s that young man, Patch, done to Mrs.
Harter? I asked her on purpose to keep Hector amused, and she’s
behavin’ like a flapper havin’ her first flirtation. It’s indecent,
considerin’ all we know about the woman.”
“Do tell us what you know about her,” Claire suggested. “I think her
manners are atrocious, myself, and she is victimizing unfortunate
Captain Patch, who used to be quite a nice boy.”
Claire spoke very lightly indeed, and yet one could sense the
bitterness that prompted the words. It was not only personal dislike
of Mrs. Harter—although that certainly existed—it was also
resentment at the central place that Mrs. Harter occupied in an
emotional adventure. On a certain plane, Claire’s perceptions and
intuitions are exceptionally acute, and I think she knew very well that
greater forces were at work than she herself could have coped with,
and the knowledge made her angry. No one likes to feel inadequate,
and, after all, Claire’s speciality was the emotions.
“Do tell us what you know about Mrs. Harter,” she repeated.
“Oh, it doesn’t amount to anythin’ desperate,” said good-natured
Mrs. Leeds. “She was pretty hot stuff out there and her husband
carried on in rather an alarmin’ way, that’s all, when she went a bit
too far. Ghastly little man, Harter—the men all barred him,
absolutely.”
“Why?”
“He wasn’t supposed to be straight, or something—I don’t know,”
said Mrs. Leeds casually. “Never could imagine why the woman
didn’t do a bunk, myself. One or two of the men were mad about her
—God knows why. But nobody had a good word for Harter. He did
some very dirty trick over a deal in polo ponies, I believe, but it was
kept pretty dark, and anyway, we weren’t there very long. The men
all said that Mrs. Harter was straight, whatever they meant by that,
but I never heard of anyone havin’ a good word to say for Harter. I
must say he was an objectionable-lookin’ little bounder, if ever there
was one. No one could imagine why on earth she’d ever married
him.”
“Perhaps she wanted to get away from the plumber’s shop, and
thought that the only opportunity,” Claire suggested. “I suppose, from
what you say, that she must be attractive to men—of a certain sort—
but she isn’t in the least good-looking.”
Mrs. Leeds laughed loudly. I think it crossed her mind vaguely, with
no sort of understanding, that Claire was in some way jealous of
Mrs. Harter, and it amused her.
“It isn’t what I say,” she remarked. “It’s what we could see for
ourselves. That red-headed youth is perfectly besotted. I quite agree
with you that she’s no beauty, but she’s got him on a string all right.”
“It’s a great pity,” said Claire emphatically. “Captain Patch is a nice
young man, really.”
Quite suddenly Mrs. Kendal woke up. She looked round upon us
with rather a blank eye for a moment, but instinct, or her
subconscious self, must have prompted her as to what we had been
talking about, for she joined in almost automatically.
“Captain Patch—yes, indeed. That woman ought to know better.
Why, she must be old enough to be his mother.”
“No.”
That was Mary Ambrey, who is always reasonable, and seldom
emphatic.
“Really, Mrs. Kendal, she isn’t. Not by about eighteen years. Captain
Patch looks very young, I quite agree, but as a matter of fact, he’s
quite old enough to take care of himself.”
“More shame for him,” declared Mumma, not at all viciously, but with
that effortless, relentless implacability of hers that always makes one
think of a tank in action.
“I don’t expect they realize that the way they go about together isn’t
very good form,” said Blanchie Kendal brightly and kindly. She is the
one whom Mumma often speaks of as “our family peacemaker,” but I
doubt if Mrs. Kendal thought it quite fitting that she should
peacemake on the subject of Mrs. Harter and Captain Patch.
“That will do, dear,” she said, and Blanchie desisted from her
charitable attempts at once.
The Kendals are all of them rather large young women, but when
Mumma says, “That will do,” like that, they seem to shrink into a
temporary invisibility.
“I think,” said Mrs. Kendal further, “that we shall have to make a
move. Will you see if you can find Puppa and the others, Blanchie? I
am afraid we ought to make a move.”
“So ought we,” said Claire, and in spite of hospitable protests from
Leeds and Mrs. Leeds, people began to prepare for departure.
Claire, perhaps with a recollection of her tête-à-tête journey with
Leeds in his runabout, at once offered to take Mary and her children
back to the Manor House if they would spend the evening with us,
and Mary agreed.
Christopher had already put Mrs. Fazackerly into his two-seater, and
Mrs. Harter and Captain Patch were nowhere to be seen.
I really felt sorry for Leeds, as I saw the blank expression with which
he offered to drive Lady Annabel Bending home.
“What a bounder that fellow is!” young Martyn observed pleasantly
as the car moved away.
“You’ve eaten his salt,” Claire said gravely. She looked very austere
and high-minded as she said it, but that was probably for the benefit
of Martyn—who seemed in no way impressed—and I saw every
reason to fear that another volcano was claiming Claire’s inward
attention. I knew she would say nothing in front of Sallie and Martyn,
but as soon as we got home they dashed upstairs in search of some
property connected with the play, and Claire and Mary and I
remained together.
Then poor Claire’s features relaxed into an expression of
desperation. These histrionic transformations in her are largely
instinctive, I believe. She herself is never, for an instant, out of her
own line of vision.
“It has come.”
It was useless to ask what had come. I knew and Mary knew.
“Has Christopher said anything to you?” I asked.
“No. Has he to you?”
Claire’s question came like a rapier point, and I was thankful to be
able to say no in reply to it.
“He is going to marry that little third-rate creature.” Claire spoke with
concentrated bitterness.
Claire, theoretically, is a democrat. She is also the champion of
individual freedom, and she believes in the right of every man or
woman to marry for love.
Neither Mary nor I was tactless enough to remind her of all this. In
fact, we said very little. The Claire type of mind cannot be
approached by arguments, being almost as wholly devoid of
sustained reasoning powers as is a young child. It was inevitable
that Claire should be jealous of the woman with whom her brother
fell in love, and the obviousness of poor Mrs. Fazackerly’s
shortcomings made things simpler, in a way. It provided Claire with a
more or less legitimate outlet for her irrational sense of grievance.
“I should never utter one word—I should thank God upon my knees
—if Christopher had found somebody with whom he could go
through life in utter and absolute sympathy—the perfect companion
—” said Claire emotionally, and quite genuinely unaware that her
aspirations on Christopher’s behalf were far beyond any that he
would ever entertain for himself.
I remember, word for word, a curious little interlude that came in,
there, the outcome of that outburst of poor Claire’s.
“The perfect companion of whom you speak has no existence, at
least on this plane,” I said, foolishly enough.
Mary Ambrey looked at me and smiled. “Miles!” She said my name
almost exactly in the half-affectionate, half-amused way in which a
mother admonishes a child when the child is trying to “show off”
before strangers. She wasn’t in the least taken in by my cheap
cynicism, and she wouldn’t allow me to be taken in by it, either.
Dear, beautiful Mary Ambrey! I never, like people in a novel, wonder
whether she has ever guessed. With her fine, clear intelligence, of
course she has guessed—long, long ago.
We had a bad quarter of an hour with Claire. Mary, of course, was far
more successful with her than I was, because she did not exhaust
herself and infuriate Claire by reasoning with her. She just let her talk
—and talk—and talk.
By the time that Sallie came in Claire had got to the stage of knowing
that she was repeating herself and of being secretly glad of an
interruption.
“We were going to have the dress rehearsal next week,” Sallie said.
“Which day, Cousin Miles?”
So we were once more absorbed into the atmosphere of the
theatricals.
“The Bulbul Ameer,” one could not help feeling, was taking shape as
a play in spite of most of the people who were acting in it. Sallie and
Martyn both had talent and a certain amount of amateur experience,
but Alfred Kendal’s sole qualification appeared to be an unlimited
confidence in something which he spoke of, in a very professional
way, as “gag.”
This had a disastrous effect upon Bill Patch, and both of them took to
appealing to Nancy Fazackerly, as part author of the piece.
Her ingenuity was hard put to it, once or twice, and I was touched
when I noticed that she seemed to be making some endeavors in the
direction of truthfulness.
Claire noticed it, too, I feel certain, and the atmosphere that she
managed to diffuse at rehearsal became less violently hostile than it
had been at first.
Everybody else was frankly interested in Christopher and Nancy, and
waited hopefully for them to announce their engagement.
“Is it official, yet?” Lady Annabel asked me one day, and when I said,
“No,” she assured me that she understood perfectly and that I could
rely upon her absolute discretion. The years that she had spent in
the Colonial Service, Lady Annabel said, had trained her.
Several people came to the dress rehearsal. Mrs. Fazackerly’s father
invited himself, to the unspeakable dismay of almost everybody, and
General and Mrs. Kendal, of course, were not to be denied.
“I think that Amy will be far less nervous if she sees me there,” said
Mrs. Kendal, with her kindest smile. “Ahlfred, now, is not nervous—
but Amy is. I think she may be less nervous if she sees me there.
Call it a mother’s fancy if you like, Sir Miles, but I can’t help thinking
that Amy will be far less nervous if she sees me in the front row. So
there I shall be.”
And there, in fact, she was.
Puppa was there, too, although less preoccupied with Amy and
Alfred than with the pair of Hessian boots that he had lent for the
performance. So long as they were on the stage, he never took his
eyes off them.
“Is everyone here?” I asked Nancy.
“Mrs. Harter is coming. Bill went to fetch her.”
She sighed.
“It is all very queer, don’t you think—I mean the way in which they go
about together. Of course, I’m dreadfully sorry for Bill. I think he’s
terribly in love with her.”
I was inclined to think so, too, and I found it quite impossible not to
watch them both when they arrived together.
It was not the first time that Mrs. Harter had come to a rehearsal—it
might have been the second, or at most the third.
Bill took her straight up to Mary Ambrey after she had received
Claire’s very brief greeting and had bowed stiffly in reply to mine.
“Will you come into the green room, Mrs. Harter? They’re all getting
ready.”
“I’m sorry we’re so late,” said Bill. “It was my fault; I started late to
fetch her. I’ll just see the curtain go up and then cut off and get into
my things. I don’t come on till the middle of the scene.”
He marched off to the piano, where Nancy sat already.
I heard her say, “Shall I begin the overture?” and Patch answer,
“Give her ten minutes to get changed. She says it won’t take her
longer than that.”
Mrs. Harter, of course, had to be on the stage before anybody else,
in order to sing “The Bulbul Ameer.”
Bill and Christopher fussed about with the lights, and tested the
curtain and found that it had stuck, as curtains invariably do stick at
all amateur theatricals, and Alfred Kendal said, “Why not have put it
up properly in the first place?” and finally a step ladder was produced
and Patch went up it and dealt adequately with the curtain. It all took
time and created the right atmosphere of dramatic crisis and
masterly presence of mind, and I hope that nobody except myself
heard my neighbor, old Carey, asking what the devil they were all
mucking about like that for.
When the curtain did go up, officially, as Lady Annabel Bending
might have said, the small stage showed a painted background of
palm trees and blue sea, and Mrs. Harter standing in front of it in her
Eastern dress.
The straight lines of the long veil over her head and the circlet of
coins across her forehead suited her very well, although the
swarthiness of her coloring became almost startlingly evident. Her
bare arms were hung with bracelets and she wore long drop earrings
and a girdle of colored stones. The dress, Claire was at pains to
assure us quietly, was entirely incorrect from the point of view of any
known nationality—but it was very effective, all the same.
Sallie, in almost similar clothes, and Amy Kendal, had had their
faces stained with some brown pigment or other and their brows
darkened, but Mary told me that Mrs. Harter had needed scarcely
any make-up at all.
She made no attempt at acting, but simply sang the ridiculous,
mock-pathetic song on which Bill and Nancy had based their play,
right through from beginning to end.
I had forgotten how very good her voice was. At least, I supposed
that I had. Since the day of the dress rehearsal I have sometimes
wondered whether something new had come into it that had not
been there when she sang “The Bluebells of Scotland” at the
concert.
Mrs. Harter looked straight in front of her while she was singing, her
hands behind her back. The silence in the room had a very peculiar
character; it was strangely intent.
Even old Carey, who, after all, was by no means a fool, was perfectly
motionless, and he, like everybody else, was looking at the woman
on the stage.
It was with a perfectly conscious effort that I turned my eyes away
from Mrs. Harter and looked across to where Captain Patch stood.
Bill was leaning against the wall, his back half turned to the stage,
both hands thrust into his pockets. He seemed to be looking fixedly
down at the floor, and he never once raised his eyes or turned round
while the strong sound of Mrs. Harter’s singing vibrated in the room.
There are six verses to the absurd song, and the air is repeated
again and again. For days afterwards we all of us hummed it and
sang it at intervals and execrated it for the persistent way in which it
haunted us.
I can remember every note of it, and no doubt everybody else can,
too, for everybody, now, avoids humming or singing it. Even the least
impressionable people are susceptible to the powers of association
that lie in sound, and the Bulbul Ameer song belongs eternally, so far
as Cross Loman is concerned, to the affair of Mrs. Harter and
Captain Patch.
Mrs. Fazackerly played the final verse slowly and then rattled off the
refrain for the last time with a swing:
“But, of all, the most reckless of life or of limb,
Was Abdul, the Bulbul Ameer—
Was Abdul, the Bulbul Ameer.”
Nancy’s small strong hands crashed out a couple of chords with
astonishing sureness and emphasis.
It was a dress rehearsal, and Bill Patch and I were the only people in
the room who were entitled to speak, just then. I waited for him, but
he only gave me a quick glance and a nod. So I said: “That’s
splendid, Mrs. Harter, thank you very much. Will you go off left,
please? Now then, for the first scene.”
She left the stage and came round to the front. Then Captain Patch
left the wall and walked across the room and went and sat down
beside her.
Chapter Eleven
When the day preceding that of the show arrived, we had all
reached the stage of believing, with entire conviction, that nothing
else in the world mattered but a successful performance. It is this
temporary but complete absence of sense of proportion that puts life
into almost any undertaking, but more especially into one about
which a number of people are engaged.
On the morning of that day Bill tried to hold a final rehearsal, at
which half of the performers failed to appear, because they were
frantically and irrationally mislaying vital pieces of property in
different parts of the house or dashing off in search of substitutes for
other equally vital pieces of property, alleged by them to have been
mislaid by other members of the cast.
“If Alfred Kendal isn’t taken through his bit of dialogue at least half a
dozen times more, he’ll ruin the whole thing,” said Patch, looking
perfectly distraught. “In fact, he’ll probably do that anyhow. For
Heaven’s sake, someone hear him his words.”
“I will,” said Nancy. “Where is Alfred?”
She snatched up a housemaid’s tray that had been loaded with
empty vases for which Claire, her hands full of flowers, had been
vainly inquiring a few moments earlier. “I’ll take this. Where is
Alfred?”
“Always remember, when you’re carrying a loaded tray,” said
General Kendal, “to put the heavy articles in the middle of the tray
and not at the sides.”
“Oh yes, thank you.”
“Let me show you—”
“I’ll leave Alfred to you,” said Bill Patch earnestly, “and if you can get
him to say height and not heighth in the last scene, it’ll make all the
difference.”
“I’ll try, but you know—Oh, General Kendal, thank you very much—
yes, I do quite see. Only I think Lady Flower is in a hurry—”
“Are you looking for Alfred?” said Sallie, dashing past. “He’s trying on
his beard in the dining room. Cousin Claire is looking everywhere for
those drawing-room vases.”
“I know. Thank you so much, Sallie.”
“This fellow is the heaviest, I should say—put him in the middle.
Then these little light bits of glass—”
“Oh thank you, thank you!”
“Wait a minute—that isn’t quite right yet. It always saves time in the
long run,” said the General impressively, “to do things in the right
way.”
“Yes, indeed. Shall I take it now? I know Lady Flower is in a hurry.”
“Did someone say Ahlfred was wanted?” Dolly inquired, also
hurrying and also with her arms full. “Because I heard him say
something about going off on his bicycle to fetch ...” she vanished
through the door, and we only heard faintly the words ... “seems to
have forgotten.”
“Oh, stop him!” cried Nancy. “Do go and stop Alfred, somebody. Wait!
I’ll go myself.”
“Do you want Ahlfred?” said Mrs. Kendal. “Because, if so, he is on
the stage. If you want Ahlfred for anything, I can go and find him for
you.”
“I thought you wanted to take these vase affairs to Lady Flower,” the
General said rather reproachfully to Mrs. Fazackerly. “If you want
Alfred, I can fetch him for you.”
“Oh, thank you,” said Nancy, quite wildly, and she rushed away with
the tray of vases, and Mrs. Kendal went away, too, and presently
reappeared with Alfred, and then, as Nancy was no longer to be
seen, let him go again, whereupon Nancy came in again by another
door and immediately said:
“But where’s Alfred?”
That sort of thing went on all day long, and running all through my
recollection of the whole, chaotic business is a sort of intermittent
duet between Nancy Fazackerly and Alfred Kendal, when at last they
found themselves on the same spot, at the same moment, and she
was hearing him his part.
“Your cue is—‘color of the sea.’”
“Yes, yes. Just give me my cue, will you?”
“—‘color of the sea.’”
“Yes. Color of the sea. Now, what do I say? Funny thing, it’s on the
very tip of my tongue. Don’t tell me—”
“Color of—”
“Don’t tell me.”
“I was only going to give you your cue again ‘Color of the sea’—”
“‘What man can measure the heighth of the mountains? They are—’”
“Didn’t Captain Patch suggest that it really makes the lines run better
to say height?”
“I said height.”
“Oh, did you? I’m so sorry. How stupid of me. Let’s start again ...
‘color of the sea.’”
“‘What man can measure the heighth of the mountains?...’”
Bill passed them once or twice, and each time he heard Alfred he
groaned. By and by Martyn Ambrey, as though he had been the first
person to think of it, came up to me and said:
“You know, this sort of thing really won’t do. If this show is to be any
good at all, we ought to pull ourselves together and have a proper
rehearsal.”
“‘The heighth of the mountains,’” came faintly from the far corner of
the hall.
“If you will collect everyone and bring them here, I’ll keep them
together and send for Patch, and we’ll go through the whole thing,” I
said.
“Right you are. I’ll ring the gong and they’ll think it’s lunch. That’ll
bring them.”
“The young are so cynical nowadays,” I heard Sallie murmur.
“Why not be content with the spirit of the thing, supposing the actual
letter fails me?” Alfred Kendal suggested in the distance. “As a
matter of fact, there’s always a certain amount of gag expected at a
show of this kind.”
“I’m sure you’ll get it in a minute,” said Nancy, with her usual kindly, if
unfounded, optimism. “Let’s just run through it again ... ‘color of the
sea.’”
They crawled through it again.
Martyn’s performance on the gong actually did bring most people
into the hall and I then announced that a final rehearsal was to take
place at once, and everybody said that it was utterly impossible and
adduced important reasons why they should be somewhere else
doing something quite different.
“Very well, then we’ll call a general rehearsal immediately after
lunch. Three o’clock sharp. Does that suit everybody?”
Almost everybody assented, presumably because they were relieved
at having the thing postponed for an hour or two.
“What about Mrs. Harter?” Martyn suddenly inquired.
She was not present.
“If it’s to be the last rehearsal we ought to do the thing properly and
have her song at the beginning and at the end.”
“I can send her down a note,” said Claire.
“I’ll fetch her on my motor bike,” young Martyn volunteered.
He is not always so ready to put himself out on behalf of other
people.
“Does Martyn admire Mrs. Harter?” I had the curiosity to ask his
sister later.
“It’s mostly that he’s so frightfully interested. The whole psychological
situation, you know,” Sallie explained. “I think it’s interesting, too, but
I don’t agree with him altogether that it’s her personality that makes it
so. Bill, in his own way, is quite as well worth watching as she is.”
“You talk as though it were a cinematograph film being shown for
your express benefit.”
“That’s rather a good simile,” said Sallie condescendingly.
“My dear child, bar joking, I wish you’d tell me something. These two
people, I quite agree with you, are out of the ordinary. Are you wholly
and solely curious, and analytical, and interested—or do you ever
feel sorry for them?”
I really wanted to know, and Sallie saw that.
“Honestly, I don’t think I really feel sorry for them, because if the
whole thing came to an end to-morrow—say, she went back to her
husband and he started an affair with somebody else—I should be
disappointed, in a way. I don’t want it all to peter out in some trivial
way. I want to have something worth watching.”
“Quite impersonally?”
“Of course,” said Sallie.
“You don’t know what you’re talking about,” suddenly said Claire
behind me. Neither of us had seen her. “A child of your age has
neither the experience nor the understanding to discuss that sort of
problem.”
From being natural, if patronizing, Sallie instantly became stiffly
arrogant.
“I’ve already been training for some time with a view to making that
or any other sort of problem affecting human beings my work in life.”
“Even a little medical student of two years’ standing doesn’t know
everything, darling.”
Claire saw herself as being gently and subtly satirical as she said
this, and I saw her as being more or less unconsciously jealous of
Sallie’s youth and her cleverness and her opportunities—and above
all resentful of her self-confidence. But Sallie, I suppose, only saw
her as being stupidly “superior” and aggressive.
“I’ll explain the difference between the medical side and the psycho-
analytical side some other time, cousin Claire,” she said, smiling.
“I’m afraid I haven’t time now.”
Of course she knew as well as I did that nothing is less endurable to
Claire than the suggestion that she stands in need of having any
subject under the sun explained to her.
Sallie walked off, cool and triumphant, and Claire turned white with
anger.
She has often said—and it is perfectly true—that she would share
her last penny with Mary’s children did they stand in need of it. But
she cannot allow them to assert themselves.
Claire was not enjoying the theatricals. Bill Patch had diffidently
offered her a part and she had, wisely enough, refused it. But I think
she regretted all the time not holding the center of the stage,
especially when she found that it was Sallie who quite naturally took
that place. Nancy Fazackerly might be one of the authors of the
piece and get all the credit of the musical part of it, but she was
neither as pretty, as young, as clever, nor as self-assertive as Sallie.
Nancy is always ready to let somebody else take the lead, and
moreover, in those days, she seemed to be living in a dream.
Christopher was very devoted to her, and they looked happy. It was
understood that their engagement would not be announced until Mrs.
Fazackerly judged her father’s mood to be a propitious one. Knowing
Nancy’s weakness, and her parent’s force of character, one was
inclined to look upon the case as being adjourned sine die, or at
least until old Carey should be translated into another sphere from
this.
The strain on Claire was a considerable one, and of course she did
nothing whatever to lessen it, but, rather, lay awake at nights and

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Henke’s Med Math: Dosage Calculation,

Preparation, and Administration 8th

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CHAPT E R Arithmetic Needed for Dosage 1

CH APT E R Metric and Household Systems of Measurement 31

CH APT E R Drug Abbreviations, Labels, and Packaging 47

Buchholz9781496302847-fm.indd 7 07/07/15 10:20 AM

Equipment to Measure Doses 68

CH AP TER Calculation of Oral Medications—Solids and Liquids 81

CH AP TER Liquids for Injection 139

CH AP TER Calculation of Basic IV Drip Rates 213

Buchholz9781496302847-fm.indd 8 07/07/15 10:20 AM

Medications for Intermittent IV Administration 226

CH APT E R Special Types of IV C

CH APT E R Dosage Problems for Infants and Children 315

CH APT E R Information Basic to Administering Drugs 367

CH APT E R Administration Procedures 391

Buchholz9781496302847-fm.indd 9 07/07/15 10:20 AM

Proficiency Test 1—Part A, Administration Procedures 437

Appendix A: Proficiency Test Answers 445

Appendix B: Putting It Together Answers 504

Buchholz9781496302847-fm.indd 10 07/07/15 10:20 AM

Buchholz9781496302847-ch001.indd 1 07/07/15 7:30 PM

Multiplying Whole Numbers

Dividing Whole Numbers

Buchholz9781496302847-ch001.indd 2 07/07/15 7:31 PM

In an improper fraction, the numerator is larger than the denominator.

A mixed number has a whole number plus a fraction.

RULE REDUCING FRACTIONS

Buchholz9781496302847-ch001.indd 3 07/07/15 7:31 PM

SELF-TEST 3 Reducing Fractions

Buchholz9781496302847-ch001.indd 4 07/07/15 7:31 PM

SELF-TEST 4 Adding and Subtracting Fractions

Buchholz9781496302847-ch001.indd 5 07/07/15 7:31 PM

Buchholz9781496302847-ch001.indd 6 07/07/15 7:31 PM

SELF-TEST 5 Multiplying Fractions

The vertical arrangement acts just like a

Buchholz9781496302847-ch001.indd 7 07/07/15 7:31 PM

SELF-TEST 6 Dividing Fractions

Changing Fractions to Decimals

Buchholz9781496302847-ch001.indd 8 25/07/15 12:32 PM

640 640 80. FINE POINTS

SELF-TEST 7 Converting Fractions to Decimals

Reading Decimals and Converting Decimals to Fractions

Buchholz9781496302847-ch001.indd 9 07/07/15 7:32 PM

0.01 is read as “one hundredth” ( 1001 ) .

SELF-TEST 8 Reading Decimals

Addition and Subtraction of Decimals

Buchholz9781496302847-ch001.indd 10 07/07/15 7:32 PM

SELF-TEST 9 Addition and Subtraction of Decimals