not deliver the dose immediately after exhalation A or after inhalation D and

Not deliver the dose immediately after exhalation a

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not deliver the dose immediately after exhalation (A) or after inhalation (D), and should deliver no more than two inhalations at a time (C). 38. ANSWER: A RATIONALE: ( A) is the correct calculation: 20,000 units/500 ml = 40 units (the amount of units in one ml of fluid). 40 units/ml x 50 ml/hr = 2,000 units/hour (1,000 units in 1/2 hour). 5.5 x 2,000 = 11,000 (A). OR, multiply 5 x 2,000 and add the 1/2 hour amount of 1,000 to reach the same conclusion = 11,000 units.
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Hesi – Pharmacology 12 39. ANSWER: B RATIONALE: Trough levels are drawn when the blood level is at its lowest, which is typically just before the next dose is given (B). (A, C, and D) do not describe the correct time for obtaining a trough level of an antibiotic. 40. ANSWER: B RATIONALE: (B) is the correct calculation: Dosage on hand/amount on hand = Dosage desired/x amount. 20mg : 2ml = 15mg : x . 20x = 30. x = 30/20; = 1 1/2 or 1.5 ml. 41. ANSWER: B RATIONALE: (B) is the correct calculation: To calculate this problem correctly, remember that the dose of KCl is not used in the calculation. 250 cc/4 hours = 63 cc/hour. 42. ANSWER: C RATIONALE: Dilaudid is an opioid agonist. Stadol is an opioid agonist-antagonist. Use of an agonist- antagonist for the client who has been receiving opioid agonists may result in abrupt withdrawal symptoms, and should be avoided (C). (A, B, and D) do not reflect good nursing practice. 43. ANSWER: B RATIONALE: Angiotensin-converting enzyme (ACE) inhibitors are used in CHF to reduce afterload by reversing vasoconstriction common in heart failure. This vasodilation can cause hypotension and resultant dizziness (B). Weight loss (A) is desired if fluid overload is present, and may occur as the result of effective combination drug therapy such as diuretics with ACE inhibitors. Muscle cramps (C) often indicate hypokalemia in the client receiving diuretics. Excessive diuretic administration may result in fluid volume deficit, manifested by symptoms such as (D). 44. ANSWER: B RATIONALE: When used for a client with pulmonary embolus, the therapeutic goal for warfarin therapy is a PT 1 1/2 - 2 1/2 times greater than the control, or an INR of 2 to 3 (B). A perfusion might be performed to monitor lung function, but not monthly (A). APTT is monitored for the client receiving heparin therapy (C). A blood level for Coumadin cannot be measured (D). 45. ANSWER: C RATIONALE: Hypokalemia (C) can precipitate digitalis toxicity in persons receiving digoxin, which will increase the chance of dangerous dysrhythmias (normal potassium 3.5-5.5 mEq/L). The therapeutic range for digoxin is 0.8 to 2 ng/ml (toxic levels = >2 ng/ml); (A) is within this range. (B) would not warrant the nurse withholding the digoxin. The nurse should withhold the digoxin if the apical pulse is less than 60/min (D). 46. ANSWER: A RATIONALE: Nitroglycerin reduces myocardial oxygen consumption which decreases ischemia and reduces chest pain (A). (B, C, and D) are not expected outcomes of sublingual nitroglycerin.
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