3121 Pharm 2 Exam 3 Summer 2026
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Free 3121 Pharm 2 Exam 3 Summer 2026 Questions
Cefazolin 500mg is ordered. Cefazolin is supplied as a powder in a vial. Directions on the vial state "add 10mL of sterile water for injection for a concentration of 100mg/mL." How many mL needed?
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5 mL
Explanation
Correct Answer:
5 mL
Formula:
Volume (mL)=Concentration (mg/mL)/Dose Ordered (mg)
Calculation:
Volume=500 mg/100 mg/mL=5 mL
Since the reconstituted vial provides a concentration of 100 mg per every 1 mL, dividing the ordered dose (500 mg) by the concentration (100 mg/mL) gives the volume needed to deliver exactly 500 mg. The 10 mL of sterile water used for reconstitution is the diluent volume added to the powder — it's what creates the 100 mg/mL concentration, not the answer itself, so it doesn't directly factor into the final calculation beyond establishing that concentration.
45% sodium chloride (half-normal saline) has a lower solute concentration than plasma, making it a hypotonic solution. This causes water to shift out of the vascular space and into the cells, which can be useful for treating cellular dehydration but requires careful monitoring for fluid shift complications.
Why Other Options are Incorrect:
- A patient receiving IV fluids suddenly develops dyspnea, anxiety, crackles, and distended neck veins. What is the nurse's priority action?
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0.45% sodium chloride is hypotonic, not hypertonic; hypertonic solutions have a higher solute concentration than plasma and would draw fluid into, not out of, the bloodstream.
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0.45% sodium chloride is not isotonic; isotonic solutions like 0.9% normal saline remain in the vascular space and expand plasma volume without causing fluid shifts into cells.
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0.45% sodium chloride is a crystalloid solution, not a colloid; colloids contain larger molecules that increase oncotic pressure, which is not the mechanism of this hypotonic crystalloid solution.
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Encourage oral fluids.
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Increase the infusion rate.
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Stop or slow the IV infusion and notify the healthcare provider.
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Place the patient flat in bed.
Explanation
Correct Answer: (C) Stop or slow the IV infusion and notify the healthcare provider.
This presentation (dyspnea, anxiety, crackles, distended neck veins) indicates fluid overload, a potentially serious complication of IV fluid therapy. The priority action is to stop or slow the infusion immediately to prevent further fluid accumulation, and notify the provider so further treatment (such as diuretics) can be initiated.
Why the other options are incorrect:
A. Encouraging additional oral fluids would worsen the fluid overload and is contraindicated in this situation.
B. Increasing the infusion rate would significantly worsen the fluid overload and could lead to serious complications like pulmonary edema or cardiac decompensation.
D. Placing the patient flat would worsen respiratory distress in a fluid-overloaded patient; the patient should instead be positioned upright (high Fowler's) to ease breathing.
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