Nursing Elites

1. A client is receiving a low dose of dopamine (Intropin) IV for the treatment of hypotension. Which indicator reflects that the medication is having the desired effect?

• A. Increased heart rate
• B. Increased urinary output
• C. Increased blood pressure
• D. Increased respiratory rate

Correct answer: C

Rationale: Increased blood pressure is the desired effect of administering dopamine (Intropin) to treat hypotension. Dopamine acts by stimulating adrenergic receptors, leading to vasoconstriction and increased cardiac output. This results in an elevation of blood pressure. Choices A, B, and D are incorrect as they do not directly reflect the therapeutic action of dopamine in treating hypotension. Increased heart rate may indicate the body compensating for low blood pressure, increased urinary output is more related to kidney function, and increased respiratory rate is often seen in response to respiratory issues, not the action of dopamine on hypotension.

2. The mother of a 6-year-old anemic boy is taught by the nurse to give iron supplements. Which statement indicates that the mother understands the proper administration of iron?

• A. The iron tablets will be absorbed between meals, on an empty stomach
• B. I should give the iron tablets with his milk and cereal each morning
• C. Iron preparations can be taken with antibiotics if he develops an infection
• D. The iron tablets may cause him to sunburn more easily so he should wear sunscreen

Correct answer: A

Rationale: The correct answer is A because iron supplements are best absorbed on an empty stomach, which maximizes their effectiveness. Giving iron tablets with milk or calcium-rich foods, as mentioned in choice B, should be avoided as they can decrease iron absorption. Choice C is incorrect because iron preparations should not be taken with antibiotics due to potential interactions. Choice D is also incorrect as iron tablets do not cause an increased risk of sunburn, so sunscreen is not necessary specifically due to iron supplementation.

3. In the newborn nursery, the nurse admits a baby from labor and delivery who is suspected of having a congenital heart disease. Which finding helps to confirm this diagnosis?

• A. Pink lips and tongue with cyanotic hands and feet
• B. Respiration rate of 40 and heart rate of 144
• C. Centralized cyanosis and tachycardia when crying
• D. Desquamation from areas of cracked, parchment-like skin

Correct answer: C

Rationale: Centralized cyanosis and tachycardia are classic signs of congenital heart disease. Choice A is incorrect because cyanosis in the hands and feet is not specific to congenital heart disease. Choice B is incorrect as the vital signs provided are not specific indicators of congenital heart disease. Choice D is unrelated to the typical signs of congenital heart disease.

4. A male client with hypertension tells the nurse that he is going to take ginseng to increase his stamina. What information should the nurse provide this client?

• A. Ginseng can decrease the effectiveness of your blood pressure medication
• B. You will need to stop taking ginseng while on blood pressure medication
• C. It is important to monitor your blood pressure regularly while taking ginseng
• D. Ginseng can increase your blood pressure

Correct answer: D

Rationale: The correct answer is D: "Ginseng can increase blood pressure, which is a concern for clients with hypertension." Choice A is incorrect because ginseng does not typically decrease the effectiveness of blood pressure medication. Choice B is incorrect as stopping ginseng while on blood pressure medication may not be necessary. Choice C is not the most direct concern related to ginseng use in a hypertensive client, making it less relevant than the correct answer.

5. A client with type 2 diabetes mellitus is admitted for antibiotic treatment of a leg ulcer. Which signs and symptoms, indicative of hyperosmolar hyperglycemic nonketotic syndrome (HHNS), should the nurse report to the healthcare provider? (Select one that doesn't apply.)

• A. Increased heart rate
• B. Visual disturbances
• C. Presence of uremic frost
• D. Decreased mentation

Correct answer: C

Rationale: The correct answer is C, 'Presence of uremic frost.' Increased heart rate, visual disturbances, and decreased mentation are all signs and symptoms indicative of hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Uremic frost, however, is not associated with HHNS but is a clinical finding seen in severe cases of chronic kidney disease. Therefore, the nurse should report the presence of uremic frost to the healthcare provider as a separate concern from HHNS.

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