Nokea
The client is on dobutamine. Adverse effects of Dobutrex (dobutamine) include the following: Select all that apply.
- A. Heart failure
- B. Bradycardia
- C. Tachycardia
- D. Respiratory distress
Correct Answer: C
Rationale: Step-by-step rationale:
1. Dobutamine is a beta-1 adrenergic agonist, which increases heart rate.
2. Tachycardia is a common adverse effect due to increased heart rate.
3. Bradycardia is the opposite effect and not expected with dobutamine.
4. Heart failure is a condition that dobutamine is used to treat, not cause.
5. Respiratory distress is not a typical adverse effect of dobutamine.
Summary:
Choice C (Tachycardia) is correct because dobutamine increases heart rate. Choices A, B, and D are incorrect because dobutamine does not cause heart failure, bradycardia, or respiratory distress.
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A nurse is required to monitor a client with dysrhythmia during the administration of isoproterenol. Which of the following nursing interventions will help to determine the drug response?
- A. Monitor vital signs.
- B. Closely monitor the pulse rate.
- C. Monitor blood pressure.
- D. Monitor fluid intake and output.
Correct Answer: D
Rationale: Monitoring fluid balance helps assess volume status and its impact on heart rate and rhythm during isoproterenol administration.
What test measures the pressure inside the arteries as the heart pumps blood?
- A. Blood pressure test
- B. Pulse oximetry
- C. Echocardiogram
- D. Spirometry
Correct Answer: A
Rationale: The correct answer is A: Blood pressure test. This test measures the pressure inside the arteries during the heart's pumping cycle. It assesses systolic and diastolic pressure, indicating the force exerted by blood on artery walls. Pulse oximetry (B) measures oxygen saturation, not arterial pressure. Echocardiogram (C) is an ultrasound that assesses heart structure and function, not arterial pressure. Spirometry (D) measures lung function, not arterial pressure. Therefore, the blood pressure test is the most relevant choice for assessing arterial pressure.
A patient who underwent a percutaneous, transluminal coronary angioplasty four weeks ago has a subsequent ejection fraction of 30%. The patient returns for a follow-up visit. Examination reveals lungs that are clear on auscultation and slight pedal edema. The patient's medications are digoxin (Lanoxin), furosemide (Lasix), enalapril maleate (Vasotec), and aspirin. The patient reports a 5 lb (2.27 kg) weight gain over the past two days. The cardiac-vascular nurse's initial action is to:
- A. document the weight and reassess the patient at the next session.
- B. inquire about the patient's medication compliance.
- C. notify the patient's physician.
- D. review the patient's most recent nuclear scan.
Correct Answer: B
Rationale: Weight gain and pedal edema suggest fluid retention, so assessing medication compliance is essential.
The nurse is caring for a client on enalapril (Vasotec). What is the most important side effect to monitor?
- A. Cough
- B. Hyperkalemia
- C. Hypotension
- D. Dizziness
Correct Answer: A
Rationale: The correct answer is A: Cough. Enalapril is an ACE inhibitor that can cause a dry, persistent cough as a common side effect. It is important to monitor for this because it can indicate a potentially serious adverse reaction called angioedema. Hyperkalemia (B) is a possible side effect of enalapril but is typically not as urgent to monitor as cough. Hypotension (C) is a common side effect but is usually monitored during the initial dose titration. Dizziness (D) is a less common side effect and is often transient. Monitoring for cough is crucial to detect and manage any potential angioedema promptly.
What test involves the nurse instructing the client to avoid eating or drinking until sensation and the gag reflex return, which may take 1 hour or longer?
- A. Transesophageal echocardiography (TEE)
- B. Magnetic resonance imaging (MRI)
- C. Echocardiography
- D. Cardiac catheterization
Correct Answer: A
Rationale: TEE requires the client to fast until the gag reflex returns to prevent aspiration.