A nurse in the emergency department is monitoring a client who is receiving dopamine to treat hypovolemic shock. Which of the following findings should the nurse identify as an indication for increasing the client's dopamine dosage?

Heart rate 60/min

Oxygen saturation 95%

Blood pressure 90/50 mm Hg

Respiratory rate 14/min

Answer and Explanation

The Correct Answer is C

Choice A reason: A heart rate of 60/min is within the normal range for an adult, and while it may be considered on the lower end, it is not in itself an indication to increase dopamine dosage. Dopamine is used to increase heart rate and cardiac output, but a rate of 60/min does not typically warrant an increase in dosage unless accompanied by other signs of inadequate perfusion.

Choice B reason: An oxygen saturation of 95% is within the normal range for arterial blood gases and is not an indication to increase dopamine dosage. Oxygen saturation reflects the percentage of hemoglobin binding sites in the bloodstream occupied by oxygen.

Choice C reason: A blood pressure of 90/50 mm Hg is considered low and can be an indication for increasing the dopamine dosage in a client with hypovolemic shock. Dopamine increases blood pressure by vasoconstriction and increasing cardiac output, which is critical in managing shock.

Choice D reason: A respiratory rate of 14/min is within the normal range for adults and is not an indication to increase dopamine dosage. The respiratory rate should be monitored for changes that could indicate worsening of the client's condition, but on its own, it does not dictate adjustments to dopamine therapy.

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Correct Answer is B

Explanation

Choice A reason: Droplet precautions are used for diseases that are transmitted through large respiratory droplets produced by coughing, sneezing, or talking. AIDS, caused by the Human Immunodeficiency Virus (HIV), is not transmitted through respiratory droplets, so droplet precautions are not necessary for a client with AIDS.

Choice B reason: Standard precautions are the primary strategy for the prevention of infection transmission and apply to all patients receiving care in hospitals, regardless of their diagnosis or presumed infection status. These precautions include hand hygiene, the use of personal protective equipment (PPE) like gloves and gowns, and safe injection practices. Since HIV/AIDS can be transmitted through blood and certain body fluids, standard precautions are essential when caring for clients with AIDS.

Choice C reason: Airborne precautions are used for diseases that are transmitted by small droplet nuclei that remain suspended in the air and can be widely dispersed by air currents within a room or over a long distance. HIV/AIDS is not transmitted through the airborne route, so airborne precautions are not indicated for clients with AIDS.

Choice D reason: Contact precautions are used for infections that are spread by direct contact with the patient or indirect contact with surfaces or patient care items. While HIV can be present in body fluids, it is not easily transmitted through casual contact. Therefore, contact precautions are not specifically required for clients with AIDS unless they have other conditions that warrant such precautions.

A. "I take my other pills at least 30 minutes after my alendronate." B. "I take my alendronate on the same day every week with an 8-ounce glass of milk." C. "I sit up and read the morning paper after taking my alendronate." D. "I will need to have a bone density test occasionally while taking this medication."

Correct Answer is B

Explanation

Choice A reason: This statement does not indicate a need for further instruction. It is recommended to take other medications at least 30 minutes after alendronate to ensure proper absorption of the drug.

Choice B reason: This statement indicates a need for further instruction. Alendronate should be taken with plain water, not milk. The calcium in milk can interfere with the absorption of alendronate.

Choice C reason: This statement is correct and does not indicate a need for further instruction. Patients are advised to stay upright for at least 30 minutes after taking alendronate to prevent esophageal irritation or reflux.

Choice D reason: This statement is correct and does not indicate a need for further instruction. Periodic bone density tests are necessary to monitor the effectiveness of alendronate therapy in treating osteoporosis.

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A nurse in the emergency department is monitoring a client who is receiving dopamine to treat hypovolemic shock. Which of the following findings should the nurse identify as an indication for increasing the client's dopamine dosage?

Nursing Test Bank

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