Nursing Elites

1. The client on furosemide (Lasix) is complaining of muscle cramps. What electrolyte imbalance should the nurse suspect?

• A. Hyperkalemia
• B. Hyponatremia
• C. Hypocalcemia
• D. Hypokalemia

Correct answer: D

Rationale: The correct answer is D, Hypokalemia. Muscle cramps are a common symptom of hypokalemia, an electrolyte imbalance characterized by low potassium levels. Furosemide, a loop diuretic like Lasix, can lead to potassium loss in the body, contributing to hypokalemia. Choice A, Hyperkalemia, is incorrect as it refers to high potassium levels. Choice B, Hyponatremia, is incorrect as it pertains to low sodium levels. Choice C, Hypocalcemia, is incorrect as it relates to low calcium levels, not typically associated with muscle cramps in the context of furosemide use.

2. The nurse is administering a beta blocker to a client with a heart rate of 50 bpm. What is the priority action?

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

Correct answer: A

Rationale: The correct action is to hold the beta blocker and notify the healthcare provider. A heart rate of 50 bpm is already low, and beta blockers can further decrease the heart rate, potentially causing adverse effects like bradycardia or heart block. Administering the beta blocker as ordered (Choice B) can exacerbate the low heart rate. Decreasing the dose of the beta blocker (Choice C) may not be sufficient to address the potential harm. Monitoring the client’s heart rate and reassessing in 30 minutes (Choice D) may delay necessary interventions if the heart rate drops further. Therefore, the priority is to hold the medication and seek guidance from the healthcare provider.

3. This is a more accurate indicator of tissue perfusion. It represents the cardiac output in terms of liters per minute per square meter of body surface area. Its normal range is 2.4-4 L/min.

• A. Cardiac Index
• B. Stroke volume
• C. Ejection fraction
• D. Cardiac output

Correct answer: A

Rationale: The correct answer is A: Cardiac Index. Cardiac Index is a measure of cardiac output relative to body surface area, providing a more accurate assessment of tissue perfusion. It is calculated by dividing the cardiac output by the body surface area. The normal range for cardiac index is 2.4-4 L/min/m². Choice B, Stroke volume, refers to the amount of blood ejected by the heart in one contraction and is not adjusted for body surface area. Choice C, Ejection fraction, is the percentage of blood pumped out of the heart's ventricles with each contraction, not adjusted for body surface area. Choice D, Cardiac output, is the total volume of blood pumped by the heart per minute, without considering body surface area.

4. What is the average cardiac output?

• A. Approximately 4 to 6 L per minute
• B. Approximately 4 to 8 L per minute
• C. Approximately 5 to 8 L per minute
• D. Approximately 3 to 7 L per minute

Correct answer: B

Rationale: The correct answer is B: Approximately 4 to 8 L per minute. Cardiac output is defined as the volume of blood the heart pumps per minute, typically ranging between 4 to 8 liters. Choices A, C, and D provide ranges that are either too narrow or outside the standard average values for cardiac output, making them incorrect.

5. The client on amiodarone reports shortness of breath. What is the nurse’s best response?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect.
• C. Instruct the client to monitor their symptoms at home.
• D. Suggest the client reduce physical activity.

Correct answer: A

Rationale: When a client on amiodarone reports shortness of breath, it can be indicative of pulmonary toxicity, a severe side effect associated with this medication. The nurse's priority is to notify the healthcare provider immediately to assess the situation and determine the appropriate course of action. Choice B is incorrect because shortness of breath with amiodarone should not be dismissed as a common side effect. Instructing the client to monitor symptoms at home (Choice C) may delay necessary intervention. Suggesting the client reduce physical activity (Choice D) does not address the potential serious nature of the symptom and the need for prompt evaluation.

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