Nursing Elites

1. 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.

2. What test uses high-frequency sound waves to create images of the heart, allowing doctors to assess its structure and function?

• A. Echocardiogram
• B. MRI
• C. CT scan
• D. X-ray

Correct answer: A

Rationale: The correct answer is an echocardiogram. An echocardiogram utilizes high-frequency sound waves (ultrasound) to create images of the heart, enabling doctors to evaluate its structure, function, and detect any abnormalities. MRI (Choice B) uses magnetic fields and radio waves to produce detailed images of the body's structures. CT scan (Choice C) combines X-rays and computer technology to create cross-sectional images of the body. X-ray (Choice D) uses electromagnetic radiation to produce images of the internal structures of the body, but it is not the most suitable for assessing the heart's structure and function.

3. What is a condition where the lungs become stiff and scarred, making it difficult to breathe and get enough oxygen into the bloodstream?

• A. Pulmonary fibrosis
• B. Pulmonary edema
• C. Pulmonary embolism
• D. Pulmonary hypertension

Correct answer: A

Rationale: Pulmonary fibrosis is a condition characterized by the stiffening and scarring of the lungs, leading to difficulty breathing and impairing the transfer of oxygen into the bloodstream. Pulmonary edema refers to fluid accumulation in the lungs, causing breathing difficulties due to fluid filling the air sacs. Pulmonary embolism is a blockage in one of the pulmonary arteries in the lungs, often caused by a blood clot. Pulmonary hypertension is high blood pressure in the arteries of the lungs, which can lead to strain on the heart and affect oxygen levels in the blood.

4. A client on a beta blocker has a heart rate of 52 bpm. What is the nurse’s priority action?

• A. Hold the beta blocker and notify the healthcare provider.
• B. Administer the beta blocker as ordered.
• C. Increase the dose of the beta blocker.
• D. Continue to monitor the client and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the beta blocker and notify the healthcare provider. A heart rate of 52 bpm is low, and beta blockers can further decrease the heart rate, potentially causing harm. Therefore, withholding the medication and promptly informing the healthcare provider is crucial for further assessment and possible adjustment of the treatment plan. Administering the beta blocker as ordered (Choice B) can exacerbate the bradycardia. Increasing the dose of the beta blocker (Choice C) would further suppress the heart rate. Continuing to monitor the client and reassessing in 30 minutes (Choice D) might delay necessary interventions and increase the risk of complications in a client with a heart rate of 52 bpm.

5. What is a condition where the heart is unable to relax properly between beats, reducing its ability to fill with blood?

• A. Diastolic heart failure
• B. Systolic heart failure
• C. Hypertrophic cardiomyopathy
• D. Restrictive cardiomyopathy

Correct answer: A

Rationale: The correct answer is A: Diastolic heart failure. In diastolic heart failure, the heart is unable to relax properly between beats, leading to a reduced ability to fill with blood. This condition primarily affects the heart's filling function rather than its pumping function, which is characteristic of systolic heart failure (choice B). Hypertrophic cardiomyopathy (choice C) involves the abnormal thickening of the heart muscle, while restrictive cardiomyopathy (choice D) is characterized by the heart muscle becoming stiff and less compliant. Therefore, choices B, C, and D are incorrect in the context of a heart condition where relaxation between beats is impaired.

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