Progressive Care RN A: In-Depth Answers with Rationales

1. A patient on a progressive care unit reports sudden severe headache
and vomiting. Blood pressure is 200/120 mmHg. What is the nurse’s
priority?
A. Perform a neurological assessment.
B. Notify the healthcare provider immediately.
C. Administer an IV antihypertensive as prescribed.
D. Place the patient in a semi-Fowler’s position.
Answer and Rationale:
C. Administer an IV antihypertensive as prescribed.
Rationale: This presentation suggests a hypertensive crisis, which
requires immediate blood pressure reduction.


2. A patient is receiving a continuous infusion of dopamine for
hypotension. Which finding indicates that the infusion rate may need to
be decreased?
A. Heart rate 110 bpm
B. Blood pressure 150/90 mmHg
C. Central venous pressure (CVP) 8 mmHg
D. Urine output 40 mL/hour
Answer and Rationale:
B. Blood pressure 150/90 mmHg

,Rationale: An elevated blood pressure suggests that the dopamine dose
is too high, potentially causing excessive vasoconstriction.


3. A patient recovering from a thoracotomy has a respiratory rate of 28
breaths/min and is using accessory muscles to breathe. What is the
nurse’s first action?
A. Increase oxygen delivery.
B. Assess pain level and provide analgesia.
C. Perform a respiratory assessment.
D. Notify the healthcare provider.
Answer and Rationale:
C. Perform a respiratory assessment.
Rationale: Identifying the underlying cause of respiratory distress is
essential before intervening.


4. A patient with type 1 diabetes has a blood glucose of 45 mg/dL and
is alert but shaky. What is the nurse’s priority intervention?
A. Administer 1 mg of glucagon IM.
B. Provide 15 g of fast-acting carbohydrates.
C. Start an IV dextrose infusion.
D. Recheck blood glucose in 15 minutes.
Answer and Rationale:
B. Provide 15 g of fast-acting carbohydrates.

, Rationale: The patient is alert, so oral carbohydrates are the
appropriate and fastest intervention for hypoglycemia.


5. A patient with COPD reports increased shortness of breath. Which
action should the nurse take first?
A. Administer a prescribed bronchodilator.
B. Obtain an arterial blood gas (ABG) sample.
C. Increase oxygen flow.
D. Assess lung sounds and respiratory effort.
Answer and Rationale:
D. Assess lung sounds and respiratory effort.
Rationale: Assessment identifies the cause of the shortness of breath
and guides further interventions.


6. A patient with end-stage renal disease reports severe itching. What
intervention is most appropriate?
A. Administer prescribed antihistamines.
B. Encourage increased water intake.
C. Monitor phosphorus levels.
D. Apply emollients to the skin.
Answer and Rationale:
C. Monitor phosphorus levels.