A priority nursing assessment for a patient who is to receive an alpha- or beta-adrenergic blocking agent would be what?

Correct Answer: D

Rationale: The most serious adverse effect would be severe bradycardia, so the nurse’s priority would be assessing the heart rate. If the patient were identified as having diabetes, then monitoring blood glucose levels would become important because these drugs can aggravate diabetes by blocking sympathetic response including masking the usual signs and symptoms of hypoglycemia and hyperglycemia. Respiratory rate could be impacted if the patient was identified as having a condition causing bronchospasm and diabetes because the combination could worsen both conditions. Measuring urine output should be part of the patient’s care, but it is not the priority assessment.

Correct Answer: A

Rationale: Autonomy refers to the patient's right to make informed decisions about their own healthcare. By expressing a desire to avoid life-prolonging measures and requesting a living will, the patient is exercising his autonomy. Beneficence involves acting in the patient's best interest, justice refers to fairness in healthcare, and veracity involves truth-telling. The patient's statements align most closely with the principle of autonomy, as he is asserting his right to control his medical care.

Correct Answer: D

Rationale: A 25 percent albumin solution contains 25 grams of albumin per 100 milliliters. To administer 1 gram of albumin, the nurse would calculate the volume as follows: 1 gram ÷ 25 grams/100 milliliters = 4 milliliters. Therefore, the nurse will administer 4 milliliters of the 25 percent albumin solution to deliver the ordered dose of 1 gram. Using the entire vial or not using the product at all would be incorrect.

Correct Answer: A

Rationale: Metoclopramide, a D2 antagonist, causes acute dystonia (e.g., oculogyric crisis). Procyclidine, an anticholinergic, rapidly reverses this IV, relaxing muscles, a suitable treatment. Benzhexol (trihexyphenidyl) works orally but is slower. Levodopa and bromocriptine, dopamine agonists, treat Parkinson's, not dystonia from dopamine blockade. Risperidone worsens it. IV procyclidine's speed is critical in acute settings, restoring normal movement effectively.

Correct Answer: D

Rationale: Dobutamine, a β1-selective agonist, can cause arrhythmias, so no arrhythmogenic effect is false. It increases myocardial oxygen consumption by enhancing contractility, not decreases it. It's selective, not non-selective, targeting cardiac β1 receptors. It doesn't act on CNS D2 dopamine receptors but on peripheral β1. It's used in heart failure to boost cardiac output, a true statement, making it valuable in acute settings. This inotropic effect distinguishes it from non-selective agents, critical for managing cardiogenic shock.