Nursing Elites

1. The nurse is administering a beta blocker to a client with a heart rate of 58 bpm. What is the nurse’s priority action?

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

Correct answer: B

Rationale: The correct answer is B. A heart rate of 58 bpm is considered low, and beta blockers can further decrease the heart rate. Therefore, the nurse's priority action should be to hold the beta blocker and notify the healthcare provider for further assessment. Choice A is incorrect because administering the beta blocker without considering the low heart rate can worsen the condition. Choice C is incorrect as increasing the dose of the beta blocker can lead to further slowing of the heart rate, which is not safe in this situation. Choice D is not the priority action; holding the medication and seeking guidance from the healthcare provider is more crucial.

2. Which condition refers to the heart being unable to pump sufficient blood to meet the body's needs?

• A. Heart failure
• B. Myocardial infarction
• C. Cardiomyopathy
• D. Pericarditis

Correct answer: A

Rationale: The correct answer is A, heart failure. This condition occurs when the heart can't pump enough blood to fulfill the body's requirements. Myocardial infarction (choice B) is the medical term for a heart attack, which is caused by a blockage in the coronary arteries. Cardiomyopathy (choice C) is a disease of the heart muscle that makes it harder for the heart to pump blood. Pericarditis (choice D) is the inflammation of the pericardium, the thin sac-like membrane surrounding the heart, and does not specifically involve the heart's inability to pump sufficient blood.

3. Which of the following is a rare but serious condition where the pulmonary arteries become narrowed, increasing the blood pressure in the lungs?

• A. Pulmonary hypertension
• B. Pulmonary embolism
• C. Pulmonary fibrosis
• D. Aortic stenosis

Correct answer: A

Rationale: The correct answer is A, Pulmonary hypertension. Pulmonary hypertension is a rare but serious condition characterized by high blood pressure in the arteries of the lungs, which can lead to heart failure. Pulmonary embolism (choice B) involves a blockage in one of the pulmonary arteries in the lungs. Pulmonary fibrosis (choice C) is a lung disease that causes lung tissue scarring. Aortic stenosis (choice D) is a condition where the aortic valve narrows, affecting blood flow from the heart.

4. The client on clopidogrel (Plavix) should be monitored for which adverse effect?

• A. Bleeding
• B. Hypertension
• C. Tachycardia
• D. Bradycardia

Correct answer: A

Rationale: Correct! Clopidogrel (Plavix) is an antiplatelet medication that helps prevent blood clots. As a side effect, it can increase the risk of bleeding. Monitoring for signs of bleeding, such as easy bruising, blood in urine or stools, or prolonged bleeding from cuts, is crucial. Choices B, C, and D are incorrect as hypertension, tachycardia, and bradycardia are not typically associated with clopidogrel use.

5. The healthcare provider is administering IV nitroglycerin to a patient for chest pain. What is the most critical parameter to monitor?

• A. Heart rate
• B. Blood pressure
• C. Oxygen saturation
• D. Respiratory rate

Correct answer: B

Rationale: The correct answer is 'Blood pressure.' Nitroglycerin is a vasodilator that can cause a rapid drop in blood pressure, leading to hypotension. Monitoring the blood pressure is crucial to prevent potential complications such as hypotension-induced dizziness, syncope, or organ hypoperfusion. While heart rate, oxygen saturation, and respiratory rate are important parameters to monitor in a clinical setting, the immediate concern with IV nitroglycerin administration is the risk of hypotension, making blood pressure the most critical parameter to assess.

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