2024 NR 341 FINAL EXAM 1 COMPLEX
ADULT HEALTH FINAL EXAM WITH 150
QUESTIONS AND CORRECT ANSWERS
GRADED A+ CHAMBERLAIN UNIVERSITY/
NR 341 FINAL EXAM (LATEST!!)
A client is admitted to the unit with cardiogenic shock from a heart attack. After receiving healthcare provider orders, which intervention medications will the nurse anticipate preparing?Dopamine and Digoxin
(Dopamine improves heart contractility and the choice for hypotensive clients in cardiogenic shock. The goal of treatment of cardiogenic shock would be to restore heart function as well as blood pressure quickly. Digoxin "digs" for a deeper contraction and is a cardiac glycoside.) The emergency department (ED) nurse receives report that a seriously injured patient involved in a motor vehicle crash is being transported to the facility with an estimated arrival in 5 minutes. In preparation for the patient's arrival, the nurse will obtain
- a dopamine infusion.
- lactated Ringer's solution.
- a hypothermia blanket.
- two 16-gauge IV catheters.
Two 16-gauge IV catheters
(A patient with multiple trauma may require fluid resuscitation to prevent or treat hypovolemic shock, so the nurse will anticipate the need for two large-bore IV lines to administer normal saline. Lactated Ringer's solution should be used cautiously and will not be ordered until the patient has been assessed for possible liver abnormalities. Vasopressor infusion is not used as the initial therapy for hypovolemic shock. Patients in shock need to be kept warm, not cool.) 1 / 3
A nurse is assessing a client who is receiving hemodialysis for the first time.Which of the following findings indicates that the client is developing dialysis disequilibrium syndrome?
- Elevated BUN
- Bradycardia
- Headache
- Fever
- Administer IV diuretic medications
- Increase the IV fluid infusion per protocol
- Increase infusion rate of IV vasodilators
- Elevate the head of the bed 45 degrees
- Assess for dysrhythmias.
- Fast flush the arterial line.
- Check the left hand for pallor.
- Re-zero the monitoring equipment. 2 / 3
Headache After surgery for an abdominal aortic aneurysm, a patient's central venous pressure (CVP) monitor indicates low pressures. Which action should the nurse take?
Increase the IV fluid infusion per protocol (A low CVP indicates hypovolemia and a need for an increase in the infusion rate.Diuretic administration will contribute to hypovolemia and elevation of the head or increasing vasodilators may decrease cerebral perfusion.) What action by a new intensive care unit staff nurse would indicate that the nurse educator's teaching about arterial pressure monitoring has been effective?Positions the zero-reference stopcock line level with the phlebostatic axis (For accurate measurement of pressures, the zero-reference level should be at the phlebostatic axis. There is no need to rebalance and recalibrate monitoring equipment every 2 hours.Accurate hemodynamic readings are possible with the patient's head raised to 45 degrees or in the prone position. The anatomic position of the phlebostatic axis does not change when patients are repositioned.) Which action should the nurse take first when the low-pressure alarm sounds for a patient who has an arterial line in the left radial artery?
Assess for dysrhythmias (The low pressure alarm indicates a drop in the patient's blood pressure, which may be caused by dysrhythmias. There is no indication to re-zero the equipment. Pallor of the left hand would be caused by occlusion of the radial artery by the arterial catheter, not by low pressure. There is no indication of a need for flushing the line)
Which nursing action is needed when preparing to assist with the insertion of a pulmonary artery catheter?
- Determine if the cardiac troponin level is elevated.
- Auscultate heart sounds before and during insertion.
- Place the patient on NPO status before the procedure.
- Attach cardiac monitoring leads before the procedure.
Attach cardiac monitoring leads before the procedure
(Dysrhythmias can occur as the catheter is floated through the right atrium and ventricle, and it is important for the nurse to monitor for these during insertion.Pulmonary artery catheter insertion does not require anesthesia, and the patient will not need to be NPO. Changes in cardiac troponin or heart and breath sounds are not expected during pulmonary artery catheter insertion) The nurse is assisting with the placement of a pulmonary artery (PA) catheter.What would the nurse expect to see on the monitor as an indication that the catheter with inflated balloon is placed correctly?
- Typical PA pressure waveform
- Tracing of the systemic arterial pressure
- Tracing of the systemic vascular resistance
- Typical PA wedge pressure (PAWP) tracing
Typical PA wedge pressure (PAWP) tracing
(The purpose of a PA line is to measure PAWP, so the catheter is floated through the pulmonary artery until the dilated balloon wedges in a distal branch of the pulmonary artery, and the PAWP readings are available. After insertion, the balloon is deflated, and the PA waveform will be observed. Systemic arterial pressures are obtained using an arterial line, and the systemic vascular resistance is a calculated value, not a waveform.)
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