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Question 1 of 5

When a client is receiving vasoactive therapy IV, such as dopamine (Intropin), and extravasation occurs, the nurse should be prepared to administer which of the following medications directly into the site?

Correct Answer: A

Rationale: Phentolamine is given to counteract the-adrenergic effects that cause ischemia and necrosis of local tissue. Epinephrine is an endogenous catecholamine that produces vasoconstriction and increases heart rate and contractility. Phenylephrine causes constriction of arterioles of skin, mucous membranes, and viscera, which in turn can cause ischemia and necrosis. Sodium bicarbonate is an alkalinizing agent that is incompatible with dopamine.

Question 2 of 5

Which of the following is a characteristic of an ominous periodic change in the fetal heart rate?

Correct Answer: D

Rationale: A recurrent fetal heart rate of 90-100 bpm at the end of contractions (late decelerations) is ominous indicating fetal hypoxia from uteroplacental insufficiency. Normal heart rate (120-130) variability and accelerations are reassuring findings.

Question 3 of 5

Which of the following should be included in discharge teaching for a client with hepatitis C?

Correct Answer: C

Rationale: Alcohol should be avoided as it is detoxified by the liver, which is compromised in hepatitis C. Aspirin is hepatotoxic, blood donation is not allowed, and hepatitis C is not spread orally.

Question 4 of 5

Joint Commission has established protocols for preventing surgical errors. Which steps are parts of that protocol?

Order the Items

Source Container

Circle the surgical site with a marker.
Verify patient information with a designated patient representative.
Designate operative site with a facility designated mark.
Include a copy of the Advanced Directives on the chart before surgery.
Verify patient information three times.
Observe pre-op time out before proceeding with surgery.

Correct Answer: C, E, F

Rationale: Joint Commission protocols include marking the site with a facility-designated mark (
C), verifying patient information multiple times (E), and performing a pre-op time-out (F). Circling the site (
A) is not standard. Patient representative verification (
B) and advance directives (
D) are not part of site verification.

Question 5 of 5

A client with an abdominal aortic aneurysm is admitted in preparation for surgery. Which finding should be reported to the doctor?

Correct Answer: A

Rationale: A WBC of 14,000 cu.mm indicates possible infection or inflammation, which is concerning pre-surgery and should be reported. Abdominal bruit and lower back pain are expected with an abdominal aortic aneurysm, and a platelet count of 175,000 is normal.

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