Nursing Elites

1. When administering dobutamine to a client, what is the most important parameter to assess?

• A. Blood pressure
• B. Heart rate
• C. Oxygen saturation
• D. Respiratory rate

Correct answer: A

Rationale: When giving dobutamine, the most critical parameter to assess is blood pressure. Dobutamine is known to cause significant changes in blood pressure, making it essential to closely monitor this parameter to prevent adverse effects. While heart rate is also important to monitor, blood pressure takes precedence due to the potential for hemodynamic instability caused by dobutamine. Oxygen saturation and respiratory rate, although vital signs to monitor, are not typically affected directly by dobutamine administration.

2. What is a condition characterized by an abnormal buildup of fluid between the layers of tissue lining the lungs and chest cavity?

• A. Pleural effusion
• B. Pulmonary edema
• C. Atelectasis
• D. Sarcoidosis

Correct answer: A

Rationale: Pleural effusion is the correct answer as it refers to the accumulation of excess fluid between the layers of the pleura surrounding the lungs and chest cavity. This condition can be caused by various factors such as infections, heart failure, or cancer. Pulmonary edema (choice B) involves fluid accumulation in the lungs' air sacs and is not specific to the pleura. Atelectasis (choice C) is the collapse or closure of a lung leading to airless lung tissue and is not related to fluid buildup. Sarcoidosis (choice D) is a condition characterized by the growth of tiny collections of inflammatory cells in different parts of the body, not specifically involving fluid accumulation in the pleural space.

3. This is a more accurate indicator of tissue perfusion. It represents the cardiac output in terms of liters per minute per square meter of body surface area. Its normal range is 2.4-4 L/min.

• A. Cardiac Index
• B. Stroke volume
• C. Ejection fraction
• D. Cardiac output

Correct answer: A

Rationale: The correct answer is A: Cardiac Index. Cardiac Index is a measure of cardiac output relative to body surface area, providing a more accurate assessment of tissue perfusion. It is calculated by dividing the cardiac output by the body surface area. The normal range for cardiac index is 2.4-4 L/min/m². Choice B, Stroke volume, refers to the amount of blood ejected by the heart in one contraction and is not adjusted for body surface area. Choice C, Ejection fraction, is the percentage of blood pumped out of the heart's ventricles with each contraction, not adjusted for body surface area. Choice D, Cardiac output, is the total volume of blood pumped by the heart per minute, without considering body surface area.

4. Which heart chamber ejects blood into the systemic arterial circulation via the aorta?

• A. Right atrium
• B. Left atrium
• C. Right ventricle
• D. Left ventricle

Correct answer: D

Rationale: The correct answer is D, Left ventricle. The left ventricle pumps oxygenated blood into the systemic circulation via the aorta. This chamber receives oxygen-rich blood from the left atrium and contracts forcefully to propel blood into the aorta, distributing it to the body. The other options, right atrium, left atrium, and right ventricle, do not directly eject blood into the systemic arterial circulation via the aorta. The right atrium receives deoxygenated blood from the body, the left atrium receives oxygenated blood from the lungs, and the right ventricle pumps blood to the lungs for oxygenation.

5. The client is on spironolactone (Aldactone) and has a potassium level of 5.9 mEq/L. What is the nurse’s priority action?

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

Correct answer: A

Rationale: The correct answer is A: Hold the spironolactone and notify the healthcare provider. A potassium level of 5.9 mEq/L is high, indicating hyperkalemia. Spironolactone is a potassium-sparing diuretic that can further increase potassium levels. Therefore, the priority action is to hold the medication to prevent exacerbating hyperkalemia and notify the healthcare provider for further guidance. Choice B is incorrect because administering potassium supplements would worsen hyperkalemia. Choice C is incorrect because continuing spironolactone could lead to a further increase in potassium levels. Choice D is incorrect because increasing the dose of spironolactone would exacerbate the hyperkalemia.

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