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A nurse assesses a client after administering the first dose of a nitrate. The client reports a headache. What action would the nurse take?

Instruct the client to drink water.

Hold the next dose.

Initiate oxygen therapy.

Administer PRN acetaminophen.

Answer and Explanation

The Correct Answer is D

A. Drinking water is not likely to alleviate the headache caused by the nitrate.

B. Holding the next dose is not necessary unless the headache becomes severe or is associated with other symptoms.

C. Initiating oxygen therapy is unnecessary for a headache caused by nitrate use.

D. A headache is a common side effect of nitrate administration due to the vasodilation effect. Administering PRN acetaminophen can help relieve the headache.

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Correct Answer is C

Explanation

A. This is an underestimation due to a miscalculation of the dose rate.

B. This is an overestimation due to a miscalculation of the dose rate.

C. 1. Calculate the desired dose of dobutamine:

Desired dose (mcg/min) = Dose per kg (mcg/kg/min) x Weight (kg)

Desired dose (mcg/min) = 12 mcg/kg/min x 75 kg = 900 mcg/min

2. Convert mcg/min to mg/hr:

900 mcg/min x 60 min/hr = 54,000 mcg/hr

54,000 mcg/hr ÷ 1000 mcg/mg = 54 mg/hr

3. Calculate the concentration of dobutamine in the solution:

Concentration (mg/mL) = Total amount of dobutamine (mg) / Total volume (mL)

Concentration (mg/mL) = 1000 mg (1 g) / 250 mL = 4 mg/mL

4. Calculate the infusion rate (mL/hr):

Infusion rate (mL/hr) = Desired dose (mg/hr) / Concentration (mg/mL)

Infusion rate (mL/hr) = 54 mg/hr / 4 mg/mL = 13.5 mL/hr

5. Round to the nearest whole number:

Infusion rate (mL/hr) = 14 mL/hr

Therefore, the IV pump should be programmed for 14 mL/hr.

D. This is an overestimation due to a miscalculation of the dose rate.

A. Increase 0.9% Normal Saline infusion to 250 ml/hr per protocol. B. Collect blood cultures and start Vancomycin 1gm IV. C. Collect UA for culture and sensitivity. D. Administer Furosemide (Lasix) 20mg IV push.

Correct Answer is D

Explanation

A. Increasing normal saline infusion is appropriate for treating dehydration and hypovolemia.

B. Collecting blood cultures and administering antibiotics is appropriate for treating possible sepsis, given the fever and elevated WBC count.

C. Collecting a urine sample for culture and sensitivity is appropriate to investigate a potential urinary source of infection.

D. Administering furosemide, a diuretic, is inappropriate in a client with signs of dehydration and hypovolemia (e.g., low CVP and PAWP) as it can worsen fluid depletion.

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Test Name	Results	Reference Range
WBC	12, 000	4, 000- 11, 000
Na+	149 mEq/L	135-145 mEq/L
K+	5.0 mEq/L	3.5- 5.0 mEq/L
Cl-	110 mEq/L	96-106 mEq/L
pH	7.34	7.35-7.45
PaCO2	34 mmHg	35- 45 mmHg
PaO2	78 mm Hg	80-100 mmHg
HCO3	21 mEq/L	22- 26 mEq/L

A nurse assesses a client after administering the first dose of a nitrate. The client reports a headache. What action would the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The healthcare provider orders dobutamine at 12 mcg/kg/min. The client weighs 75 kg. The pharmacy provides 250 mL of D5W with 1 g of dobutamine. How many mL/hr should the IV pump be programmed for? (Round to a whole number.)

Correct Answer is C

Explanation

Correct Answer is D

Explanation

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