Emergency Nursing 2024 Exam Questions and Correct Answers

The nurse is preparing to administer dopamine, a beta and alpha agonist, to a client in cardiogenic shock. Which intervention should the nurse implement? 1. Ensure the client is on a cardiac monitor 2. Monitor the blood pressure every 15 minutes 3. Evaluate the intake and output every hour 4. Instruct the client to report burning at the intravenous site 5. Assess the client's neurological status every hour Ans--1. Clients must be connected to a cardiac monitor prior to and during the infusion of cardiotonic drugs. The client in cardiogenic shock will be in the intensive care department. The client in hypovolemic shock is receiving dextran, a non blood colloid. Which assessment data warrants immediate intervention by the nurse? 1. The client's blood pressure is 102/78 2. The client's pulse oximeter reading is 95% 3. The client's lung sounds reveal bilateral crackles 4. The client's urine output is 120mL in 3 hours. Ans--3. Because of the ability of all colloids, including dextran, to pull fluid into the vascular space, circulatory overload is a serious adverse outcome. Crackles in the lungs reflect pulmonary congestion, a sign of fluid-volume overload. The nurse is preparing to administer a nitroglycerin (Tridil) drip to a client in cardiogenic shock. The client has total parenteral nutrition (TPN) running through a triple lumen catheter. Which intervention should the nurse implement? 1. Mix the nitroglycerin in 500mL of lactated Ringer's 2. Initiate the drip in its own line 3. Use regular intravenous tubing when administering Tridil 4. Ensure that the client's nitroglycerin patch is in a nondairy area Ans--2. There are compatibility issues with many medications. The medication is best running through its own lumen. No medication not in the TPN bag should be administered through the TPN line. The nurse is caring for the client in septic shock. The nurse administered the twice-a-day, intravenous, broad-spectrum antibiotic ceftriaxone (Rocephin) at 0900. At 1100 the health-care provider prescribed daily intravenous vancomycin, an aminoglycoside antibiotic. Which intervention should the nurse implement? 1. Administer the vancomycin within 2 hours 2. Notify the HCP and question the antibiotic order 3. Schedule the vancomycin to be administered at 2100 4. Assess the client's white blood cell count Ans--1. Septic shock is secondary to an infection of the blood and a broadspectrum antibiotic (such as Rocephin) is prescribed until cultures and sensitivity results are obtained. The antibiotic that is specific to the bacteria causing the septic shock--in this case, vancomycin--should be administered as soon as possible