Nursing Elites

1. A client on a beta blocker has a blood pressure of 90/60 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. Administer a diuretic to reduce blood pressure.
• D. Continue to monitor the client and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the beta blocker and notify the healthcare provider. A blood pressure of 90/60 mm Hg is already low, and beta blockers can further decrease blood pressure. Administering the beta blocker can potentially worsen the situation, leading to complications. Administering a diuretic or continuing to monitor the client without taking immediate action could delay necessary intervention. Therefore, holding the beta blocker and involving the healthcare provider promptly is crucial in this scenario.

2. What test measures the electrical activity of the heart to detect arrhythmias and other heart conditions?

• A. Electrocardiogram (ECG or EKG)
• B. Chest X-ray
• C. Stress test
• D. Arterial blood gas (ABG)

Correct answer: A

Rationale: An electrocardiogram (ECG or EKG) is used to measure the heart's electrical activity, aiding in the detection of arrhythmias and other heart conditions. Choice B, a chest X-ray, is not used to measure electrical activity but to visualize the structures of the chest. Choice C, a stress test, evaluates the heart's response to exertion and is not primarily focused on measuring electrical activity. Choice D, an arterial blood gas (ABG) test, is used to assess oxygen and carbon dioxide levels in the blood, not the heart's electrical activity.

3. The client is on dobutamine. Adverse effects of Dobutrex (dobutamine) include the following: Select all that apply.

• A. Heart failure
• B. Bradycardia
• C. Tachycardia
• D. Respiratory distress

Correct answer: C

Rationale: The correct answer is C: Tachycardia. Dobutamine is a medication that primarily increases heart rate (tachycardia) and blood pressure. Therefore, the adverse effects of dobutamine include tachycardia. Choices A, B, and D are incorrect. Heart failure is not an adverse effect of dobutamine; in fact, it is used to treat heart failure by increasing heart contractility. Bradycardia (slow heart rate) is not an expected adverse effect of dobutamine, as it usually increases heart rate. Respiratory distress is not a common adverse effect of dobutamine.

4. The nurse is administering digoxin to a client with a heart rate of 45 bpm. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Increase the dose of digoxin.
• D. Monitor the client’s heart rate and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A heart rate of 45 bpm is already low, and digoxin can further decrease the heart rate, leading to serious complications like bradycardia or heart block. Administering the medication can exacerbate the bradycardia, hence it should be withheld. Increasing the dose of digoxin is contraindicated due to the client's low heart rate. Monitoring the heart rate alone without taking immediate action to withhold the medication is not the priority when faced with the risk of further lowering the heart rate.

5. What is a condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle?

• A. Coronary artery disease (CAD)
• B. Atherosclerosis
• C. Stroke
• D. Peripheral artery disease

Correct answer: A

Rationale: The correct answer is A, Coronary artery disease (CAD). CAD is a condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle and an increased risk of heart attack. Choice B, Atherosclerosis, is a related condition involving the buildup of fats, cholesterol, and other substances in and on the artery walls, but it is not specific to the coronary arteries. Choices C and D, Stroke and Peripheral artery disease, respectively, involve different arteries and conditions, not directly related to the narrowing or blockage of the coronary arteries.

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