Nursing Elites

1. The client is on a calcium channel blocker. What is the expected effect on the heart?

• A. Increased heart rate
• B. Decreased heart rate
• C. Increased blood pressure
• D. Decreased blood pressure

Correct answer: D

Rationale: When a client is on a calcium channel blocker, the expected effect on the heart is a decreased heart rate and decreased blood pressure. Calcium channel blockers work by dilating blood vessels and reducing the heart's workload, resulting in decreased blood pressure. Choice A, increased heart rate, is incorrect as calcium channel blockers actually have a negative chronotropic effect, reducing the heart rate. Choice C, increased blood pressure, is also incorrect because these medications are used to lower blood pressure.

2. Which term describes a type of abnormal heart rhythm characterized by rapid and irregular beating of the atria?

• A. Atrial fibrillation
• B. Ventricular fibrillation
• C. Atrial flutter
• D. Sinus tachycardia

Correct answer: A

Rationale: The correct answer is Atrial fibrillation. Atrial fibrillation is indeed a type of abnormal heart rhythm characterized by rapid and irregular beating of the atria. This condition can increase the risk of stroke and heart failure. Choice B, Ventricular fibrillation, is incorrect because it refers to a life-threatening arrhythmia that occurs in the ventricles, not the atria. Choice C, Atrial flutter, is incorrect as it describes a different type of atrial arrhythmia characterized by a regular but fast heartbeat. Choice D, Sinus tachycardia, is incorrect because it is a normal increase in heart rate originating from the sinus node, not an abnormal rhythm.

3. The client on atorvastatin (Lipitor) should be advised to report which of the following symptoms?

• A. Muscle pain
• B. Headache
• C. Nausea
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Muscle pain. Muscle pain can be a sign of rhabdomyolysis, a serious side effect of statins like atorvastatin. Rhabdomyolysis is a condition where muscle fibers break down rapidly and release their contents into the bloodstream, which can lead to kidney damage. Headache, nausea, and dizziness are not commonly associated with atorvastatin use and are less likely to indicate a serious adverse reaction compared to muscle pain.

4. The nurse is caring for a client with atrial fibrillation on dabigatran (Pradaxa). What is the most important instruction to give to the client?

• A. Take the medication with food to prevent stomach upset.
• B. Do not miss a dose and take it at the same time each day.
• C. Avoid consuming alcohol while on this medication.
• D. Monitor for signs of bleeding.

Correct answer: B

Rationale: The most important instruction to give to a client on dabigatran (Pradaxa) is not to miss a dose and take it at the same time each day. This is crucial for maintaining the anticoagulant effect of the medication. Choice A is not necessary as dabigatran does not need to be taken with food. Choice C is important but not as crucial as ensuring proper dosing. Choice D is also important but falls behind in priority compared to maintaining consistent dosing.

5. Which condition is characterized by the lungs becoming scarred and stiff, leading to difficulty breathing and inadequate oxygen intake into the bloodstream?

• A. Pulmonary fibrosis
• B. Cystic fibrosis
• C. COPD
• D. Tuberculosis

Correct answer: A

Rationale: The correct answer is A, Pulmonary fibrosis. Pulmonary fibrosis is a lung disease where lung tissue is damaged and scarred, resulting in breathing difficulties and decreased oxygen transfer into the bloodstream. Cystic fibrosis (B) is a genetic disorder primarily affecting the lungs and digestive system, not causing lung scarring. COPD (C) includes conditions like chronic bronchitis and emphysema but doesn't specifically involve lung scarring. Tuberculosis (D) is a bacterial infection that primarily affects the lungs but doesn't cause lung tissue scarring and stiffness as seen in pulmonary fibrosis.

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