Nursing Elites

1. The nurse is caring for a client on amiodarone. What adverse effect is the nurse most concerned about?

• A. Pulmonary toxicity
• B. Liver toxicity
• C. Thyroid dysfunction
• D. Renal dysfunction

Correct answer: A

Rationale: The correct answer is A, Pulmonary toxicity. Amiodarone is known to cause pulmonary toxicity, which can be serious and even fatal in some cases. This adverse effect includes interstitial pneumonitis, pulmonary fibrosis, and acute respiratory distress syndrome. Monitoring for symptoms such as cough, dyspnea, and fever is crucial. Choices B, Liver toxicity, C, Thyroid dysfunction, and D, Renal dysfunction, are incorrect because while amiodarone can also affect the liver, thyroid, and kidneys, the most concerning adverse effect that requires immediate attention and monitoring is pulmonary toxicity.

2. 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.

3. What is a condition where the airways become inflamed and narrow, making breathing difficult?

• A. Asthma
• B. Bronchitis
• C. Pleurisy
• D. Tuberculosis

Correct answer: A

Rationale: Asthma is the correct answer. It is a condition characterized by inflammation, narrowing, and swelling of the airways, leading to symptoms like wheezing, shortness of breath, and coughing. Bronchitis is the inflammation of the bronchial tubes; Pleurisy is inflammation of the tissues that line the lungs and chest cavity; Tuberculosis is a bacterial infection that mainly affects the lungs.

4. The client on warfarin has an INR of 5.5. What is the priority nursing action?

• A. Administer vitamin K as an antidote.
• B. Hold the next dose of warfarin.
• C. Increase the dose of warfarin.
• D. Administer fresh frozen plasma.

Correct answer: A

Rationale: An INR of 5.5 is significantly elevated, indicating an increased risk of bleeding. The priority nursing action in this situation is to administer vitamin K as an antidote to reverse the effects of warfarin and lower the INR. Holding the next dose of warfarin (choice B) is important but not as immediate as administering vitamin K. Increasing the dose of warfarin (choice C) would further elevate the INR, worsening the bleeding risk. Administering fresh frozen plasma (choice D) is not the first-line treatment for high INR due to warfarin.

5. What is a condition where the heart beats too fast, reducing its ability to pump blood effectively?

• A. Tachycardia
• B. Bradycardia
• C. Arrhythmia
• D. Ventricular fibrillation

Correct answer: A

Rationale: Tachycardia is the correct answer because it is a condition characterized by a fast heart rate, which can decrease the heart's efficiency in pumping blood. Bradycardia, on the other hand, refers to a slow heart rate, which is the opposite of what is described in the question. Arrhythmia is a general term for any irregularity in the heart's rhythm, not necessarily specifically related to a fast heart rate. Ventricular fibrillation is a life-threatening arrhythmia where the heart's lower chambers quiver instead of pumping blood effectively, but it is not specifically characterized by a fast heart rate.

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