The nurse reviews the patient’s chart and advocates for which intervention?

  • Demographics
  • Vital signs
  • Past medical history
  • Medications
  • Assessment
  • Age: 58
    Weight: 245 lb
    Height 5’8”
    Chief complaint: Hypertension

  • Temperature: 37.5°C
    Heart rate: 104 beats per minute
    Respiratory rate: 14 breaths per minute
    Blood Pressure: 128/72 mmHg
    Oxygen saturation: 95%

  • Gastroesophageal reflux disease
    Systemic hypertension
    Seasonal allergies

  • Montelukast sodium 10 mg tab once per day
    Omeprazole 20 mg capsule once per day
    Hydrochlorothiazide 25 mg tab once per day
    Atenolol 50 mg tab once per day

  • HEENT: WNL
    Cardiovascular: Hypertension, well controlled. Otherwise WNL.
    Respiratory: Expiratory wheezes bilaterally. No retractions noted. 
    Genitourinary/Gastrointestinal: GERD, well controlled. Otherwise WNL.
    Musculoskeletal: Lordosis noted.
    Nutrition: Obese with a BMI of 37.3.

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Additional Pharmacological and Parenteral Therapies Questions

The nurse is caring for a patient with pneumonia and fulminant pulmonary arterial hypertension. The patient is intubated and mechanically ventilated receiving inhaled nitric oxide (iNO). Additionally, the patient has a central line with multiple continuous infusions, including norepinephrine, vecuronium, morphine, and propofol. During the shift, the nurse begins to have difficulty breathing, a dry throat, syncope, and chest pain. Which action does the nurse take first?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 10

The patient with well-controlled chronic obstructive pulmonary disorder presents with a 3 day history of increased cough with sputum production, fever, and malaise. Upon assessment, breath sounds are clear after coughing and the patient appears to breathe comfortably with no retractions or nasal flaring. His chest x-ray is clear and his screening complete blood count is largely normal, with exception of a white blood cell count of 16. The nurse anticipates the provider to order which medication(s)? Select all that apply. 

  • Question Type:   Multiple Choice - Select All
  • Difficulty: 9

The 3.2 kg patient with persistent pulmonary hypertension of the newborn (PPHN) has the following order: Infuse norepinephrine 0.05 mcg/kg/min IV and titrate q15 minutes by 0.05 mcg/kg/min to maintain mean arterial pressure between 45 and 55 mm Hg. Overnight, the norepinephrine had been titrated to 0.25 mcg/kg/min for persistent hypotension. At 0900, the MAP rose to 62 mm Hg and the nurse decreased the infusion from 0.25 mcg/kg/min to 0.20 mcg/kg/min. At 0905, the patient’s blood pressure fell to 42 mm Hg. Which action does the nurse take first?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 7

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