The nurse reviewed all nursing note entries and notified the physician

Cardiovascular Pharmacology NCLEX RN

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Question 1 of 5.

Extract:The following scenario applies to the next 1 items The nurse in the emergency department (ED) is caring for a client with septic shock Item 1 of 1 Nurses' Notes 1400: Follow-up assessment after the infusion of 30 mL/kg of 0.9% saline bolus (1850 mL total) was infused. Vital signs: T 103.4Â° F (39.7Â° C), P 104, RR 22, BP 90/61, pulse oximetry reading 95% on room air. 1410: The physician was notified of the vital signs, and a verbal order for a dopamine drip was received for 5 mcg/kg/minute to titrate to a MAP of 65 mm Hg. The order was read back and verified. 1415: Dopamine infusion started in the client's right antecubital peripheral vascular access device. 1445: The client reports 'stinging' pain at the vascular access site. The site had erythema, swelling, and tenderness when touched. The infusion was stopped.

The nurse reviewed all nursing note entries and notified the physician of the vascular access device assessment findings. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two (2) actions the nurse should take to address that condition, and two (2) parameters the nurse should monitor to assess the client's progress

Action To take

A.Obtain a prescription for phentolamine
B. Flush the vascular access device
C. Aspirate any residual medication
D. Restart the infusion at a lower rate.

Potential Condition

A.Extravasation
B. Hematoma
C. Infiltration
D. Phlebitis.

Parameter to Monitor

A.Urinary output
B. Neurovascular status of affected extremity
C. Drainage at vascular access site
D. Pain level.

Explanation: The client is experiencing extravasation (B) due to dopamine causing stinging, erythema, and swelling. Actions include obtaining phentolamine (A, an antidote for vasopressor extravasation) and aspirating residual medication (A). Monitor neurovascular status (C) and pain level (C) to assess progress.

Question 2 of 5.

Extract:Cardiovascular Pharmacology NCLEX RN

The nurse is caring for a client newly diagnosed with an abdominal aortic aneurysm. The nurse should anticipate a prescription for which of the following medications?

A. naproxen

B. digoxin

C. prednisone

D. atenolol

Explanation: Atenolol, a beta-blocker, is often prescribed to manage blood pressure and reduce stress on the aortic wall in clients with an abdominal aortic aneurysm to prevent rupture. Naproxen (an NSAID), digoxin (a cardiac glycoside), and prednisone (a corticosteroid) are not typically used for this condition.

Question 3 of 5.

The nurse is caring for a client with the following clinical data. Based on the vital signs, which medications would the nurse clarify with the primary healthcare provider (PHCP) prior to administration? See the exhibit. Select all that apply.

A. Atenolol 50 mg PO Daily

B. Spironolactone 50 mg PO Daily

C. Albuterol 2.5 mg via nebulizer Daily

D. Fentanyl 50 mcg IV Push q 6 hours PRN Pain

E. Modafinil 100 mg PO Daily

Explanation: Without specific vital signs provided, atenolol (a beta-blocker) may need clarification if the client has low heart rate (bradycardia) or low blood pressure, as it can exacerbate these conditions. Spironolactone, albuterol, fentanyl, and modafinil are less likely to require clarification based solely on vital signs unless specific contraindications (e.g., severe hypotension or respiratory distress) are present.

Question 4 of 5.

The nurse has taught a client who has been prescribed clonidine via a transdermal patch. Which of the following statements by the client would indicate a need for further teaching?

A. I can wear this patch while I shower.

B. I should keep this patch on for five days.

C. This medication may make me drowsy.

D. If I ever have to have a magnetic resonance imaging (MRI), I will need to remove the patch before the test.

Explanation: Clonidine transdermal patches are typically changed every 7 days, not 5 days, so the statement about keeping the patch on for five days indicates a need for further teaching. The other statements are correct: clonidine patches are water-resistant, can cause drowsiness, and must be removed before an MRI due to potential metal content.

Question 5 of 5.

The nurse has taught a client who has been prescribed nitroglycerin transdermal. Which of the following statements by the client would indicate a correct understanding of the teaching?

A. It is okay for me to apply this patch to the area that has been shaven.

B. This patch should be removed for 4 to 6 hours to avoid me developing a tolerance.

C. It is okay for me to wear this patch while I shower.

D. I should apply this patch below my knee to lessen my chance of getting a headache.

Explanation: Applying a nitroglycerin transdermal patch to a shaved area ensures good adhesion and absorption, indicating correct understanding. Nitroglycerin patches are typically removed for 10-12 hours to prevent tolerance, not 4-6 hours. While water-resistant, applying below the knee is not standard and does not reduce headache risk.