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B) Hypertension C) Depression D) Dehydration Answer: B Feedback: The nurse should assess for hypertension in a client who is being administered dobutamine and beta-adrenergic blocking drugs. Combining dobutamine and beta-adrenergic blocking drugs does not increase the risk of bradycardia, depression, or dehydration. 24. A nurse is teaching a client how to use an auto-injector as treatment for an allergic reaction. Which statement by the client indicates the need for additional teaching? A) ―I should not touch the orange or black tip on the small end.‖ B) ―I should adm inister the dose and then call 9-1- 1 if I'm alone.‖ C) ―I should inject the black tip into my outer thigh.‖ D) ―I need to massage the site after removing the device.‖ Answer: B Feedback: The client should call the emergency number first and then administer the dose if he or she is alone. The client should not touch the orange or black tip on the end. The dose is administered into the outer thigh and the site is massaged for 10 seconds after removing the device. Page 8 25. A client is prescribed norepinephrine IV. Which of the following would be appropriate for the nurse to do? Select all that apply. A) Administer the drug via a gravity infusion. B) Dilute the drug with sterile saline. C) Continuously monitor the client's blood pressure. D) Check the IV insertion site for leakage. E) Assess the client's urinary output hourly. Answer: C, D, E Feedback: When giving norepinephrine IV, the nurse should use an electronic infusion pump, not dilute the norepinephrine solution, continuously monitor the client's blood pressure, check the IV site for leakage or extravasation, restart the IV in another location if extravasation occurs and institute extravasation protocol according to the facility's policy, and assess the client's urine output hourly. 26. While assessing a client, the nurse observes hives and flushing. The client reports itching and a tightness in the throat. The nurse would identify which of the following nursing diagnoses? A) Risk for Allergy Feedback B) Ineffective Tissue Perfusion C) Decreased Cardiac Output D) Risk for Injury Answer: A Feedback: The client is exhibiting signs and symptoms of an allergic reaction. Therefore, Risk for Allergy Feedback would be appropriate. Ineffective Tissue Perfusion and Decreased Cardiac Output would be appropriate if a client is experiencing hypotension and shock. Risk for Injury would be appropriate if the client was experiencing dizziness, weakness, confusion, or disorientation related to the drug therapy. 27. After teaching a group of nursing students about adrenergic drugs and their effects, the instructor

determines that the teaching was successful when the students identify which of the following as an effect of these drugs? A) Decreased myocardial contractility B) Vasodilation C) Increased cardiac output D) Improved airway clearance Answer: C Feedback: Adrenergic drugs improve hemodynamic status by improving myocardial contractility and increasing heart rate, which results in increased cardiac output. Peripheral resistance is increased by vasoconstriction. The drugs do not improve airway clearance. 28. A nurse is reviewing the effects of adrenergic drugs on the body. The nurse demonstrates understanding of this group of drugs by identifying that which of the following would occur if the drug stimulates beta-1 receptors? A) Vasoconstriction of peripheral blood vessels B) Decreased gastrointestinal tract secretions C) Increased force of myocardial contractions D) Bronchodilation Answer: C Feedback: Stimulation of beta-1 receptors leads to an increase in heart rate and an increase in the force of myocardial contraction. Peripheral vasoconstriction occurs when alpha-1 receptors are stimulated. Decreased gastrointestinal motility and secretions occur when alpha-2 receptors are stimulated. Bronchodilation occurs when beta-2 receptors are stimulated. 1. After teaching a group of nursing students about sympatholytic drugs, the instructor determines that the teaching was successful when the students identify which of the following as an example? Select all that apply. A) Angiotensin-converting enzyme inhibitors B) a-adrenergic blockers C) b-adrenergic blockers D) Angiotensin receptor blockers E) Loop diuretics Answer: B, C Feedback: a- and b-adrenergic blockers are classified as sympatholytic drugs. 2. A nurse would administer phentolamine to a client diagnosed with which condition? Select all that apply. A) Pheochromocytoma-induced hypertension B) Benign hypertension C) Preoperative hypertension D) Increased intraocular pressure E) Treatment of dopamine extravasation tissue damage Answer: A, C, E Feedback: Phentolamine is an a-adrenergic blocker used in the treatment of pheochromocytoma-induced hypertension and preoperative hypertension and in the prevention and treatment of tissue damage caused by extravasation of dopamine. 3. A nurse would administer phentolamine cautiously to a client with which condition? Select all that apply. A) Recent MI B) Type 1 diabetes C) Renal failure D) Hepatic failure E) Peripheral artery disease Answer: A, C Feedback: Phentolamine is an a-adrenergic blocker that should be used cautiously in clients who are pregnant or lactating, had a recent MI, or have renal failure or Reynaud's disease.