Progressive Care RN Guide with Expert Answers and Rationale

1. A patient on digoxin presents with nausea, blurred vision, and a
heart rate of 48 bpm. What is the most appropriate nursing action?
A. Administer atropine.
B. Check digoxin levels.
C. Hold the next dose of digoxin.
D. Notify the healthcare provider.
Answer and Rationale:
B. Check digoxin levels.
Rationale: Symptoms suggest digoxin toxicity. Verifying serum levels
confirms the diagnosis and guides treatment.


2. A patient receiving total parenteral nutrition (TPN) has a glucose
level of 250 mg/dL. What is the nurse’s priority intervention?
A. Notify the healthcare provider.
B. Administer insulin as prescribed.
C. Slow the TPN infusion rate.
D. Recheck the glucose level in 1 hour.
Answer and Rationale:
B. Administer insulin as prescribed.
Rationale: Hyperglycemia is a common complication of TPN and
should be managed with insulin to maintain glucose control.

,3. A patient on warfarin therapy has an INR of 4.5. What is the nurse’s
priority intervention?
A. Notify the healthcare provider.
B. Administer vitamin K as prescribed.
C. Hold the next dose of warfarin.
D. Assess the patient for signs of bleeding.
Answer and Rationale:
D. Assess the patient for signs of bleeding.
Rationale: An elevated INR increases the risk of bleeding, and
assessment ensures early detection of complications.


4. A patient is admitted with a suspected pulmonary embolism. Which
diagnostic test does the nurse anticipate?
A. Chest X-ray
B. D-dimer
C. CT pulmonary angiography
D. Arterial blood gas (ABG)
Answer and Rationale:
C. CT pulmonary angiography
Rationale: This is the gold standard for diagnosing pulmonary
embolism.

, 5. 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.


6. A patient develops ventricular tachycardia on the monitor. What is
the nurse’s first action?
A. Administer amiodarone IV as prescribed.
B. Assess the patient’s pulse and consciousness.
C. Prepare for defibrillation.
D. Notify the healthcare provider immediately.
Answer and Rationale:
B. Assess the patient’s pulse and consciousness.
Rationale: Determining whether the VT is pulseless or stable guides
further management.