Nursing Elites

1. The client on nitroglycerin complains of a headache. What is the most appropriate response by the nurse?

• A. Administer acetaminophen as prescribed for the headache.
• B. Hold the next dose of nitroglycerin.
• C. Discontinue the nitroglycerin immediately.
• D. Notify the healthcare provider immediately.

Correct answer: A

Rationale: The correct response is to administer acetaminophen as prescribed for the headache. Headaches are a common side effect of nitroglycerin due to vasodilation. Administering acetaminophen can help relieve the headache. Holding the next dose of nitroglycerin (Choice B) may not address the current headache, and discontinuing nitroglycerin immediately (Choice C) without healthcare provider guidance can be dangerous due to the potential for rebound hypertension. Notifying the healthcare provider immediately (Choice D) is not necessary for a common side effect like a headache, and the nurse can manage this symptom independently.

2. What is a condition where the heart muscle becomes abnormally enlarged, thickened, or stiffened, often leading to heart failure?

• A. Cardiomyopathy
• B. Pericarditis
• C. Aortic stenosis
• D. Mitral valve prolapse

Correct answer: A

Rationale: Cardiomyopathy is the correct answer. It is a condition characterized by the abnormal enlargement, thickening, or stiffening of the heart muscle, which can lead to heart failure. Pericarditis (choice B) is inflammation of the pericardium, the sac surrounding the heart, not directly related to heart muscle enlargement. Aortic stenosis (choice C) is the narrowing of the aortic valve opening, affecting blood flow from the heart, but not directly related to heart muscle enlargement. Mitral valve prolapse (choice D) is a condition where the valve between the left atrium and left ventricle doesn't close properly, causing blood to leak backward, and is not directly related to heart muscle enlargement.

3. For what reason might the nurse be given an order to administer milrinone (Primacor)?

• A. For congestive heart failure
• B. For hypertension
• C. For cardiac arrhythmias
• D. For bradycardia

Correct answer: A

Rationale: Milrinone is commonly prescribed for congestive heart failure to help improve cardiac function and alleviate symptoms. Choices B, C, and D are incorrect as milrinone is not typically used for hypertension, cardiac arrhythmias, or bradycardia. It is specifically indicated for congestive heart failure for short-term management.

4. The nurse is teaching a client about side effects of ACE inhibitors. What is the most important side effect to monitor?

• A. Cough
• B. Hyperkalemia
• C. Hypotension
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Cough. ACE inhibitors commonly cause a persistent dry cough in patients. This side effect is important to monitor because it can indicate the development of angioedema, a serious adverse reaction that requires immediate medical attention. Hyperkalemia (choice B) is a potential side effect of ACE inhibitors but is not typically the most important one to monitor. Hypotension (choice C) and dizziness (choice D) are also possible side effects of ACE inhibitors, but they are not as critical to monitor as the development of a persistent cough.

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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