Nursing Elites

1. The nurse is giving nitroglycerin sublingually for chest pain. What is the most important instruction to give to the client?

• A. Place the tablet under the tongue and let it dissolve completely.
• B. Swallow the tablet whole with a glass of water.
• C. Chew the tablet and then swallow it.
• D. Take one tablet every 5 minutes until pain is relieved.

Correct answer: A

Rationale: The correct answer is A. The tablet should be placed under the tongue and allowed to dissolve completely to ensure rapid absorption. This route of administration allows the medication to be quickly absorbed into the bloodstream. Choice B is incorrect because nitroglycerin is meant to be absorbed sublingually, not swallowed. Choice C is incorrect as chewing the tablet can cause the medication to be rapidly absorbed, leading to adverse effects like a drop in blood pressure. Choice D is incorrect because the client should take only one tablet every 5 minutes up to a maximum of three tablets for chest pain relief.

2. 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.

3. 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.

4. The client on furosemide (Lasix) is complaining of muscle cramps. What electrolyte imbalance should the nurse suspect?

• A. Hyperkalemia
• B. Hyponatremia
• C. Hypocalcemia
• D. Hypokalemia

Correct answer: D

Rationale: The correct answer is D, Hypokalemia. Muscle cramps are a common symptom of hypokalemia, an electrolyte imbalance characterized by low potassium levels. Furosemide, a loop diuretic like Lasix, can lead to potassium loss in the body, contributing to hypokalemia. Choice A, Hyperkalemia, is incorrect as it refers to high potassium levels. Choice B, Hyponatremia, is incorrect as it pertains to low sodium levels. Choice C, Hypocalcemia, is incorrect as it relates to low calcium levels, not typically associated with muscle cramps in the context of furosemide use.

5. What is a condition where the walls of the arteries in the lungs become thickened and stiff, leading to increased blood pressure in the pulmonary arteries?

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

Correct answer: A

Rationale: Pulmonary hypertension is a condition characterized by the thickening and stiffening of the arteries in the lungs, resulting in elevated blood pressure in the pulmonary arteries. This condition is distinct from the other choices provided. Pulmonary fibrosis involves scarring of lung tissue, pulmonary embolism is a blockage in the pulmonary artery, and pulmonary edema is the accumulation of fluid in the lungs.

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