Nursing Elites

1. The client on a beta blocker has a blood pressure of 88/58 mm Hg. What is the nurse’s priority action?

• A. Hold the beta blocker and notify the healthcare provider.
• B. Administer the beta blocker as ordered.
• C. Increase the dose of the beta blocker.
• D. Continue to monitor the client and reassess in 30 minutes.

Correct answer: A

Rationale: The correct action for the nurse to take when a client on a beta blocker presents with a blood pressure of 88/58 mm Hg is to hold the beta blocker and notify the healthcare provider. Beta blockers can further decrease blood pressure, which is already low in this case. Administering the beta blocker as ordered (Choice B) would exacerbate the hypotension. Increasing the dose of the beta blocker (Choice C) would be inappropriate and unsafe given the low blood pressure. Continuing to monitor the client and reassessing in 30 minutes (Choice D) could lead to a delay in necessary intervention. Therefore, the priority is to hold the medication and seek guidance from the healthcare provider.

2. The client is on enalapril (Vasotec) for hypertension. What side effect is most commonly associated with this medication?

• A. Dry cough
• B. Hypotension
• C. Hyperkalemia
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Dry cough. A dry cough is a common side effect of ACE inhibitors like enalapril. ACE inhibitors can cause the accumulation of bradykinin, leading to irritation of the respiratory tract and resulting in a persistent dry cough. Hypotension (choice B) is a possible side effect of ACE inhibitors but is less common than a dry cough. Hyperkalemia (choice C) is another side effect of ACE inhibitors, but it is not the most commonly associated one. Headache (choice D) is not a common side effect of enalapril compared to a dry cough. Therefore, the most commonly associated side effect with enalapril is a dry cough.

3. What is the term used to describe a condition where the blood flow to the brain is temporarily interrupted, often referred to as a 'mini-stroke'?

• A. Transient ischemic attack (TIA)
• B. Stroke
• C. Myocardial infarction
• D. Pulmonary embolism

Correct answer: A

Rationale: The correct answer is A: Transient ischemic attack (TIA). A transient ischemic attack (TIA) is often called a 'mini-stroke' because it is characterized by a temporary interruption of blood flow to the brain, resulting in stroke-like symptoms that typically resolve within a short period. Choice B, 'Stroke,' is incorrect because a stroke involves a more prolonged interruption of blood flow, leading to lasting brain damage. Choices C and D, 'Myocardial infarction' and 'Pulmonary embolism,' are unrelated conditions involving the heart and lungs, respectively, and do not describe a temporary interruption of blood flow to the brain.

4. What is a condition characterized by episodes of severe, acute shortness of breath, often occurring at night?

• A. Paroxysmal nocturnal dyspnea
• B. Sleep apnea
• C. Orthopnea
• D. Dyspnea

Correct answer: A

Rationale: Paroxysmal nocturnal dyspnea is the correct answer. It is characterized by sudden episodes of severe shortness of breath during sleep, often waking the individual. Choice B, Sleep apnea, involves pauses in breathing during sleep but does not usually present with acute shortness of breath. Choice C, Orthopnea, refers to shortness of breath that occurs when lying flat and is relieved by sitting up. Choice D, Dyspnea, is a general term for difficult or labored breathing and does not specifically describe acute episodes at night.

5. Which term describes an abnormal heartbeat that can be either too fast or too slow?

• A. Arrhythmia
• B. Bradycardia
• C. Tachycardia
• D. Conductivity

Correct answer: A

Rationale: The correct answer is A: Arrhythmia. Arrhythmia is a broad term that refers to any irregularity in the heart's rhythm, which can manifest as a heartbeat that is too fast (tachycardia), too slow (bradycardia), or irregular. Choice B, Bradycardia, specifically denotes a slow heart rate, while choice C, Tachycardia, refers to a fast heart rate. Choice D, Conductivity, is not the correct term to describe an abnormal heartbeat characterized by speed irregularities.

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