Nursing Elites

1. The nurse is caring for a client on enalapril (Vasotec). What is the most important side effect to monitor?

• A. Cough
• B. Hyperkalemia
• C. Hypotension
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Cough. Enalapril is an ACE inhibitor, and cough is a common side effect associated with this class of medication. Monitoring for cough is crucial as it can indicate the development of a potentially serious condition known as angioedema. Hyperkalemia (choice B) is a possible side effect of ACE inhibitors but is not the most important side effect to monitor. Hypotension (choice C) and dizziness (choice D) are also potential side effects of enalapril; however, cough takes precedence due to its association with angioedema, a severe adverse reaction.

2. The nurse is administering enoxaparin (Lovenox) to a client. What is the most important lab value to monitor?

• A. Platelet count
• B. Hemoglobin
• C. White blood cell count
• D. aPTT

Correct answer: A

Rationale: The correct answer is A: Platelet count. When administering enoxaparin, it is crucial to monitor the platelet count because enoxaparin can lead to a rare but serious side effect known as thrombocytopenia, which is a decrease in platelet levels. Monitoring the platelet count helps in detecting this adverse effect early. Choices B, C, and D are incorrect because hemoglobin, white blood cell count, and aPTT are not the most important lab values to monitor specifically for enoxaparin administration.

3. 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.

4. What is a condition where the blood flow to the brain is temporarily blocked, often referred to as a mini-stroke?

• A. Transient ischemic attack (TIA)
• B. Stroke
• C. Aneurysm
• D. Myocardial infarction

Correct answer: A

Rationale: A transient ischemic attack (TIA) is the correct answer. A TIA is often referred to as a mini-stroke because it is caused by a temporary blockage of blood flow to the brain. This blockage resolves on its own, typically within minutes to hours, leading to temporary symptoms similar to a stroke. Option B, 'Stroke,' is incorrect because a stroke involves a more prolonged interruption of blood flow to the brain. Option C, 'Aneurysm,' is incorrect as it is a bulge in a blood vessel that can rupture and cause bleeding, not a temporary blockage of blood flow. Option D, 'Myocardial infarction,' is also incorrect as it refers to a heart attack, not a condition involving the brain's blood flow.

5. Which of the following is a central vasoconstrictor and peripheral vasodilator?

• A. Parasympathetic nervous system
• B. Sympathetic nervous system
• C. Dopamine
• D. Epinephrine

Correct answer: D

Rationale: The correct answer is D, Epinephrine. Epinephrine acts as a central vasoconstrictor and peripheral vasodilator. It increases heart rate and blood flow to muscles, helping to prepare the body for a 'fight or flight' response. Parasympathetic nervous system (choice A) does not cause vasoconstriction but rather vasodilation. The sympathetic nervous system (choice B) is primarily responsible for the fight or flight response, causing vasoconstriction. Dopamine (choice C) primarily acts as a neurotransmitter and hormone, not directly causing central vasoconstriction and peripheral vasodilation.

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