Nursing Elites

1. A client on a beta blocker has a heart rate of 52 bpm. 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 answer is to hold the beta blocker and notify the healthcare provider. A heart rate of 52 bpm is low, and beta blockers can further decrease the heart rate, potentially causing harm. Therefore, withholding the medication and promptly informing the healthcare provider is crucial for further assessment and possible adjustment of the treatment plan. Administering the beta blocker as ordered (Choice B) can exacerbate the bradycardia. Increasing the dose of the beta blocker (Choice C) would further suppress the heart rate. Continuing to monitor the client and reassessing in 30 minutes (Choice D) might delay necessary interventions and increase the risk of complications in a client with a heart rate of 52 bpm.

2. The client is prescribed warfarin. What should the client be taught about this medication?

• A. Avoid foods high in vitamin K.
• B. Take the medication with food to prevent stomach upset.
• C. Take the medication at the same time every day.
• D. Increase the dose if a dose is missed.

Correct answer: A

Rationale: The correct answer is A: Avoid foods high in vitamin K. Warfarin is an anticoagulant medication, and vitamin K can counteract its effects. Therefore, it is important for clients taking warfarin to avoid foods high in vitamin K to maintain the medication's effectiveness. Choice B is incorrect because warfarin should be taken consistently as prescribed, regardless of food intake. Choice C is incorrect because while consistency in timing is important, it is not specific to the effectiveness of warfarin. Choice D is incorrect because clients should never increase the dose of warfarin on their own, especially to make up for a missed dose, as it can lead to serious bleeding risks.

3. What is a condition where the heart's electrical impulses are blocked or delayed, leading to a slower or irregular heartbeat?

• A. Heart block
• B. Atrial fibrillation
• C. Tachycardia
• D. Bradycardia

Correct answer: A

Rationale: Heart block is the correct answer. It is a condition where the electrical impulses in the heart are blocked or delayed, resulting in a slower or irregular heartbeat. This can lead to symptoms like dizziness, fainting, or other issues. Atrial fibrillation (B) is characterized by rapid, irregular heartbeats. Tachycardia (C) is a condition where the heart rate is too fast. Bradycardia (D) is the opposite of tachycardia, where the heart rate is too slow.

4. 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.

5. What is a condition where the lung's alveoli are permanently enlarged and damaged, leading to shortness of breath?

• A. Emphysema
• B. Bronchitis
• C. Atelectasis
• D. Pulmonary fibrosis

Correct answer: A

Rationale: Emphysema is the correct answer. It is a chronic lung condition characterized by the permanent enlargement and damage of the alveoli, leading to shortness of breath and impaired oxygen exchange. Bronchitis is the inflammation of the bronchial tubes, not specifically related to alveolar damage. Atelectasis is the collapse of lung tissue, not enlargement. Pulmonary fibrosis involves scarring and thickening of lung tissue, different from the alveolar damage seen in emphysema.

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