Nursing Elites

1. The nurse is caring for a client on amiodarone who complains of visual disturbances. What is the nurse’s best response?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect.
• C. Advise the client to monitor their symptoms at home.
• D. Suggest the client reduce physical activity.

Correct answer: A

Rationale: The correct answer is to notify the healthcare provider immediately. Visual disturbances in a client taking amiodarone can indicate amiodarone toxicity, a serious side effect. Notifying the healthcare provider promptly is essential for further assessment and management. Reassuring the client that this is a common side effect (choice B) is incorrect as visual disturbances should not be dismissed without evaluation. Advising the client to monitor their symptoms at home (choice C) may delay necessary intervention. Suggesting the client reduce physical activity (choice D) is unrelated to addressing visual disturbances caused by amiodarone.

2. What procedure involves inserting a needle into the pleural space to remove excess fluid and help the patient breathe more easily?

• A. Thoracentesis
• B. Bronchoscopy
• C. Spirometry
• D. Arterial blood gas (ABG)

Correct answer: A

Rationale: Thoracentesis is the correct answer. It is a procedure where a needle is inserted into the pleural space to remove excess fluid, aiding in easier breathing. Bronchoscopy (Choice B) is a procedure to visualize the airways and diagnose lung problems, not specifically for fluid drainage. Spirometry (Choice C) is a test to measure lung function, not a procedure for fluid removal. Arterial blood gas (ABG) (Choice D) is a blood test to assess oxygen and carbon dioxide levels in the blood, not a procedure for draining fluid from the pleural space.

3. What is the condition where the body's immune system attacks its tissues, causing inflammation and damage?

• A. Autoimmune disease
• B. Infectious disease
• C. Allergic reaction
• D. Degenerative disease

Correct answer: A

Rationale: The correct answer is A: Autoimmune disease. Autoimmune diseases occur when the body's immune system mistakenly attacks its own tissues, leading to inflammation and damage. This is different from infectious diseases (choice B), which are caused by pathogenic microorganisms, allergic reactions (choice C), which involve an exaggerated response of the immune system to harmless substances, and degenerative diseases (choice D), which are characterized by progressive deterioration of tissue or organs due to various factors.

4. What term refers to the degree of myocardial fiber stretch before contraction, related to the volume of blood distending the ventricles at the end of diastole, and determined by the amount of venous return?

• A. Preload
• B. Afterload
• C. Contractility
• D. Ejection fraction

Correct answer: A

Rationale: The correct answer is A: Preload. Preload is the degree of myocardial fiber stretch before contraction, influenced by the volume of blood returning to the heart. This parameter is related to the amount of blood in the ventricles at the end of diastole. Choice B, Afterload, refers to the pressure or resistance that the ventricles must overcome to eject blood. Choice C, Contractility, is the intrinsic ability of the heart muscle to contract. Choice D, Ejection fraction, is the percentage of blood pumped out of the ventricles with each contraction.

5. The nurse is caring for a client on digoxin with a heart rate of 48 bpm. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Administer atropine to increase the heart rate.
• D. Increase the dose of digoxin.

Correct answer: A

Rationale: In this scenario, the nurse's priority action should be to hold the digoxin and notify the healthcare provider. A heart rate of 48 bpm is low, and digoxin, being a medication that can further decrease the heart rate, should be withheld. Administering the digoxin as ordered (Choice B) would not be appropriate in this situation as it can exacerbate bradycardia. Atropine (Choice C) is not the initial treatment for this scenario; holding the digoxin is the first action. Increasing the dose of digoxin (Choice D) would be contraindicated due to the client's bradycardia. Therefore, the correct action is to hold the digoxin and inform the healthcare provider for further guidance.

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