Nokea
The client who does not respond adequately to fluid replacement has an order for an I.V. infusion of dopamine hydrochloride at 5 µg/kg/minute. To determine that the drug is having the desired effect, the nurse should assess the client for:
- A. Increased renal and mesenteric blood flow.
- B. Increased cardiac output.
- C. Vasoconstriction.
- D. Reduced preload and afterload.
Correct Answer: B
Rationale: Dopamine at 5 µg/kg/minute primarily increases cardiac output by enhancing myocardial contractility and heart rate, improving perfusion in shock. Renal/mesenteric flow occurs at lower doses, vasoconstriction at higher doses, and preload/afterload reduction is not a primary effect.
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Galactorrhea is caused by overproduction of which hormone?
- A. Prolactin.
- B. Adrenocorticotropic hormone (ACTH).
- C. Growth hormone (GH).
- D. Thyroid-stimulating hormone (TSH).
Correct Answer: A
Rationale: Galactorrhea (inappropriate breast milk production) is caused by excess prolactin, often due to a prolactin-secreting pituitary adenoma.
The nurse notices that a client with Parkinson's disease is coughing frequently when eating. Which one of the following interventions should the nurse consider?
- A. Have the client hyperextend the neck when swallowing.
- B. Tell the client to place the chin firmly against the chest when eating.
- C. Thicken all liquids before offering to the client.
- D. Place the client on a clear liquid diet.
Correct Answer: C
Rationale: Thickening liquids reduces aspiration risk in Parkinson's patients with dysphagia, as coughing indicates swallowing difficulty. Hyperextending the neck or a clear liquid diet increases aspiration risk, and chin tuck is less universally effective.
A client post-cystoscopy reports severe pain. The nurse should:
- A. Administer analgesics as prescribed.
- B. Encourage ambulation.
- C. Apply a cold pack.
- D. Notify the physician.
Correct Answer: D
Rationale: Severe pain post-cystoscopy is abnormal and requires physician notification to rule out complications.
A client in hospice care is nearing death. Which of the following is an expected physical change the nurse should prepare the family for?
- A. Increased appetite.
- B. Cool, mottled extremities.
- C. Improved mental clarity.
- D. Regular breathing patterns.
Correct Answer: B
Rationale: Cool, mottled extremities are an expected sign of impending death due to decreased circulation, and preparing the family helps reduce distress.
The nurse is caring for a client diagnosed with Reye's syndrome. The nurse understands that this illness is caused by which medication?
- A. Ibuprofen
- B. Aspirin
- C. Acetaminophen
- D. Diphenhydramine
Correct Answer: B
Rationale: Reye's syndrome is associated with aspirin use, particularly in children with viral infections, leading to liver and brain complications.