A nurse is caring for an older adult client who is prescribed isoproterenol. After administering the drug, the nurse would immediately report which of the following changes to the primary health care provider?A) Blood glucose levelB) AppetiteC) TemperatureD) Pulse rate
Ans: D Feedback: The nurse should report any changes observed in pulse rate or rhythm immediately. Changes in glucose level, appetite, or temperature need not be reported immediately to the primary care provider unless they are severe.
A client is to receive midodrine. Which of the following would the nurse include in the plan of care to ensure that the client doesn't develop supine hypertension?A) Administer midodrine during the day.B) Ensure that the client is lying in a supine position.C) Instruct the client to regularly shift positions.D) Assist the client when moving out of bed.
Ans: A Feedback: The nurse can minimize the risk of supine hypertension by administering the drug during the daytime. The nurse should ensure that the client is in an upright, not supine, position. Instructing the client to regularly shift positions or assisting the client when moving out of bed will not significantly reduce the risk of supine hypertension.
A nurse is preparing to administer a prescribed adrenergic agent to a client who is in shock. Before administering the drug, the nurse would assess for and document which of the following as a sign of shock?A) Increased temperatureB) Reddish/pinkish skinC) Dry, dehydrated skinD) Changes in consciousness
Ans: D Feedback: Symptoms of shock, such as a change in the level of consciousness, should be recorded by the nurse as part of the preadministration assessment. Cool skin, not elevated temperature, is another symptom of shock. The nurse also needs to record signs of diaphoresis and cyanosis, not reddish/pinkish or dry, dehydrated skin.
A client is prescribed dopamine. Which of the following would the nurse include in the client's plan of care?A) Administering dopamine only via IV routeB) Maintaining a fixed rate of administrationC) Monitoring blood pressure every half hourD) Diluting dopamine with sodium bicarbonate
Ans: A Feedback: The nurse should ensure that dopamine is administered intravenously. The rate of administration of the drug should be adjusted according to the client's blood pressure, and it should not be fixed at any particular rate. The nurse should monitor blood pressure every 2 minutes, not every half hour, from the beginning of therapy until the desired blood pressure is achieved.
After administering dobutamine to a client, the nurse would assess the client closely for which adverse reaction?A) Cardiac arrhythmiasB) Urinary retentionC) Elevated temperatureD) Sleeplessness
Ans: A Feedback: The nurse should monitor for cardiac arrhythmias (bradycardia and tachycardia) because they are common adverse reactions observed in clients receiving dobutamine HCL. Dobutamine HCL does not cause urinary retention, elevated temperature, or sleeplessness.
A nurse is monitoring the vital signs of a client who has received epinephrine. The nurse would report which of the following assessment findings?A) Systolic blood pressure below 100 mm HgB) Temperatures reading of 97.6∞FC) Pulse rate of 60 beats/minD) A diastolic blood pressure of 75 mm Hg
Ans: A Feedback: The nurse must immediately report a fall in systolic blood pressure below 100 mm Hg. Epinephrine should raise the blood pressure, so a continued low systolic pressure indicates the medication has not been effective. A diastolic blood pressure of 75 mm Hg, a pulse rate of 60 beats/min, and a temperature reading of 97.6∞F are normal and need not be reported immediately.
A client has been administered dobutamine. The client is also receiving a beta-adrenergic blocking drug. The nurse would monitor the client for the development of which of the following resulting from the use of these two drugs?A) BradycardiaB) HypertensionC) DepressionD) Dehydration
Ans: B Feedback: The nurse should assess for hypertension in a client who is being administered dobutamine and beta-adrenergic blocking drugs. Combining dobutamine and beta-adrenergic blocking drugs does not increase the risk of bradycardia, depression, or dehydration.
A nurse is teaching a client how to use an auto-injector as treatment for an allergic reaction. Which statement by the client indicates the need for additional teaching?A) I should not touch the orange or black tip on the small end.B) I should administer the dose and then call 9-1-1 if I'm alone.C) I should inject the black tip into my outer thigh.D) I need to massage the site after removing the device.
Ans: B Feedback: The client should call the emergency number first and then administer the dose if he or she is alone. The client should not touch the orange or black tip on the end. The dose is administered into the outer thigh and the site is massaged for 10 seconds after removing the device.
While assessing a client, the nurse observes hives and flushing. The client reports itching and a tightness in the throat. The nurse would identify which of the following nursing diagnoses?A) Risk for Allergy ResponseB) Ineffective Tissue PerfusionC) Decreased Cardiac OutputD) Risk for Injury
Ans: A Feedback: The client is exhibiting signs and symptoms of an allergic reaction. Therefore, Risk for Allergy Response would be appropriate. Ineffective Tissue Perfusion and Decreased Cardiac Output would be appropriate if a client is experiencing hypotension and shock. Risk for Injury would be appropriate if the client was experiencing dizziness, weakness, confusion, or disorientation related to the drug therapy.
After teaching a group of nursing students about adrenergic drugs and their effects, the instructor determines that the teaching was successful when the students identify which of the following as an effect of these drugs?A) Decreased myocardial contractilityB) VasodilationC) Increased cardiac outputD) Improved airway clearance
Ans: C Feedback: Adrenergic drugs improve hemodynamic status by improving myocardial contractility and increasing heart rate, which results in increased cardiac output. Peripheral resistance is increased by vasoconstriction. The drugs do not improve airway clearance.
A nurse is reviewing the effects of adrenergic drugs on the body. The nurse demonstrates understanding of this group of drugs by identifying that which of the following would occur if the drug stimulates beta-1 receptors?A) Vasoconstriction of peripheral blood vesselsB) Decreased gastrointestinal tract secretionsC) Increased force of myocardial contractionsD) Bronchodilation
Ans: C Feedback: Stimulation of beta-1 receptors leads to an increase in heart rate and an increase in the force of myocardial contraction. Peripheral vasoconstriction occurs when alpha-1 receptors are stimulated. Decreased gastrointestinal motility and secretions occur when alpha-2 receptors are stimulated. Bronchodilation occurs when beta-2 receptors are stimulated.