Nokea
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 route
- B. Maintaining a fixed rate of administration
- C. Monitoring blood pressure every half hour
- D. Diluting dopamine with sodium bicarbonate
Correct Answer: A
Rationale: Dopamine must be administered intravenously to ensure rapid and controlled delivery, with blood pressure monitored frequently to titrate the dose.
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When describing the autonomic nervous system to a group of nursing students, the instructor determines that the teaching was successful when the students identify which body function as being controlled by this system?
- A. Heart rate
- B. Muscle movement
- C. Blood pressure
- D. Glandular secretions
- E. GI activity
Correct Answer: A,C,D,E
Rationale: The autonomic nervous system regulates involuntary functions such as heart rate, blood pressure, glandular secretions, and gastrointestinal (GI) activity. Muscle movement is primarily controlled by the somatic nervous system.
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 Hg
- B. Temperature reading of 97.6°F
- C. Pulse rate of 60 beats/min
- D. A diastolic blood pressure of 75 mm Hg
Correct Answer: A
Rationale: A systolic blood pressure below 100 mm Hg indicates that epinephrine, which should raise blood pressure, is not effective and requires immediate reporting.
A nurse has administered dopamine to a client taking phenytoin (Dilantin) for a seizure disorder. The nurse would closely monitor the client for which adverse reaction?
- A. Hypotension
- B. Hypoglycemia
- C. Bradycardia
- D. Tachypnea
- E. Seizures
Correct Answer: A,C,E
Rationale: The combination of dopamine and phenytoin increases the risk of seizures, hypotension, and bradycardia due to potential drug interactions affecting cardiovascular and neurological systems.
When describing drugs that block or inhibit the sympathetic nervous system, the nurse includes which of the following?
- A. Antiadrenergic drugs
- B. Adrenergic blocking drugs
- C. Adrenergic stimulating drugs
- D. Adrenergic drugs
- E. Sympatholytics
Correct Answer: A,B,E
Rationale: Antiadrenergic drugs, adrenergic blocking drugs, and sympatholytics are terms used to describe medications that inhibit the sympathetic nervous system by blocking its effects.
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 Response
- B. Ineffective Tissue Perfusion
- C. Decreased Cardiac Output
- D. Risk for Injury
Correct Answer: A
Rationale: Hives, flushing, itching, and throat tightness indicate an allergic reaction, making Risk for Allergy Response the appropriate nursing diagnosis.