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. Which type of medication helps to reduce the workload on the heart by slowing down the heart rate?

• A. Beta-blocker
• B. Calcium channel blocker
• C. Diuretic
• D. ACE inhibitor

Correct answer: A

Rationale: Beta-blockers are medications that work by blocking the action of hormones like adrenaline, thereby reducing the heart rate and the workload on the heart. This makes them effective in managing high blood pressure and various heart conditions. Calcium channel blockers work by relaxing blood vessels and reducing the heart's workload, but they do not primarily slow down the heart rate. Diuretics help the body get rid of excess salt and water by increasing urine production, which can lower blood pressure but not by slowing down the heart rate. ACE inhibitors work by relaxing blood vessels, not by directly affecting heart rate.

3. Which type of medication helps to reduce blood pressure by relaxing the blood vessels?

• A. Calcium channel blocker
• B. ACE inhibitor
• C. Beta-blocker
• D. Diuretic

Correct answer: A

Rationale: The correct answer is A, Calcium channel blocker. Calcium channel blockers work by relaxing the blood vessels, making it easier for the heart to pump blood and reducing blood pressure. Choice B, ACE inhibitor, reduces blood pressure by blocking the production of angiotensin II, a substance that narrows blood vessels. Choice C, Beta-blocker, reduces heart rate and the heart's workload, not directly relaxing blood vessels. Choice D, Diuretic, reduces blood pressure by increasing urine output, reducing the volume of fluid in the blood vessels, rather than directly relaxing them.

4. What is the approximate stroke volume of the heart?

• A. Approximately 60 mL of blood per beat
• B. Approximately 70 mL of blood per beat
• C. Approximately 80 mL of blood per beat
• D. Approximately 90 mL of blood per beat

Correct answer: B

Rationale: The correct answer is B: Approximately 70 mL of blood per beat. The stroke volume of the heart is typically around 70 mL, indicating the volume of blood ejected from the left ventricle with each contraction. Choices A, C, and D are incorrect as they do not represent the standard approximate stroke volume of the heart, which is around 70 mL per beat.

5. The client on digoxin has a potassium level of 2.7 mEq/L. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Increase the dose of digoxin.
• D. Administer potassium supplements.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 2.7 mEq/L is considered low and can increase the risk of digoxin toxicity. Holding the medication and informing the healthcare provider is crucial to prevent adverse effects. Administering the digoxin as ordered (Choice B) would put the client at a higher risk for toxicity. Increasing the dose of digoxin (Choice C) is not appropriate when the client's potassium level is low. Administering potassium supplements (Choice D) may be necessary but is not the priority action in this situation.

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