Nursing Elites

1. A client on an ACE inhibitor reports a persistent cough. What is the nurse’s best response?

• A. Reassure the client that the cough is a common side effect and is usually not serious.
• B. Instruct the client to report the cough to the healthcare provider as it may require discontinuation of the medication.
• C. Advise the client to use a humidifier at night to relieve the cough.
• D. Suggest the client take an over-the-counter cough suppressant.

Correct answer: B

Rationale: The correct answer is B. A persistent cough in a client on an ACE inhibitor may indicate a serious side effect that requires discontinuation of the medication. Instructing the client to report the cough to the healthcare provider is essential for proper evaluation and management. Choice A is incorrect because simply reassuring the client may delay necessary action. Choice C is incorrect as using a humidifier may not address the underlying cause of the cough. Choice D is incorrect because taking a cough suppressant without healthcare provider guidance may mask symptoms without addressing the cause.

2. Which medication is used to prevent blood clots by thinning the blood, reducing the risk of stroke and heart attack?

• A. Anticoagulant
• B. ACE inhibitor
• C. Beta-blocker
• D. Calcium channel blocker

Correct answer: A

Rationale: The correct answer is 'Anticoagulant.' Anticoagulants are medications specifically designed to prevent blood clots by thinning the blood, which effectively reduces the risk of stroke, heart attack, and other cardiovascular events. Choices B, C, and D, which are ACE inhibitors, beta-blockers, and calcium channel blockers, respectively, do not have the primary mechanism of action to prevent blood clot formation. ACE inhibitors, beta-blockers, and calcium channel blockers are commonly used for managing hypertension and other cardiovascular conditions by different mechanisms of action.

3. Which artery supplies the right atrium, right ventricle, a portion of the septum, SA node, AV node, and inferior portion of the left ventricle?

• A. Right coronary artery
• B. Left circumflex artery
• C. Posterior descending artery
• D. Aortic artery

Correct answer: A

Rationale: The correct answer is the right coronary artery. It supplies essential areas of the heart, including the right atrium, right ventricle, a portion of the septum, SA node, AV node, and the inferior portion of the left ventricle. The left circumflex artery primarily supplies the left atrium and lateral wall of the left ventricle, not the mentioned areas. The posterior descending artery supplies the inferior wall of the left ventricle, not the right side. The aortic artery is a general term and does not specifically refer to an artery that supplies the mentioned areas.

4. Which of the following is a chronic lung disease that results in the gradual destruction of the alveoli, causing difficulty breathing and reduced oxygen exchange?

• A. Emphysema
• B. Bronchitis
• C. Pulmonary hypertension
• D. Sarcoidosis

Correct answer: A

Rationale: Emphysema is the correct answer as it is a chronic lung disease characterized by the gradual destruction of the alveoli, which are essential for oxygen exchange. This destruction leads to difficulty breathing and reduced oxygen levels in the blood. Bronchitis is an inflammation of the bronchial tubes, not specifically involving alveoli destruction. Pulmonary hypertension is a condition of high blood pressure in the arteries of the lungs, not directly related to alveoli destruction. Sarcoidosis is a disease characterized by the growth of tiny collections of inflammatory cells in different parts of the body, including the lungs, but it does not primarily involve the destruction of alveoli.

5. The nurse is giving the client digoxin for heart failure and recognizes that the drug has what type of effect on the heart?

• A. Negative inotropic, negative chronotropic effect
• B. Positive inotropic, negative chronotropic effect
• C. Negative inotropic, positive chronotropic effect
• D. Positive inotropic, positive chronotropic effect

Correct answer: B

Rationale: The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin strengthens the heart muscle, providing a positive inotropic effect, which increases the force of contraction. It also decreases the heart rate, having a negative chronotropic effect. Choice A is incorrect because digoxin has a positive inotropic effect, not a negative inotropic effect. Choice C is incorrect as digoxin does not have a positive chronotropic effect but a negative one. Choice D is incorrect because while digoxin has a positive inotropic effect, it does not have a positive chronotropic effect.

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