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. What test measures the electrical activity of the heart over a 24- or 48-hour period?

• A. Holter monitor
• B. Electrocardiogram
• C. Stress test
• D. Chest X-ray

Correct answer: A

Rationale: The correct answer is A, Holter monitor. A Holter monitor is a portable device that continuously records the heart's electrical activity over 24 to 48 hours, aiding in the diagnosis of arrhythmias and other heart conditions. Choice B, an Electrocardiogram, provides a snapshot of the heart's electrical activity at a specific point in time, not over an extended period like a Holter monitor. Choice C, a Stress test, measures how the heart responds to physical activity and is not used for continuous monitoring of electrical activity. Choice D, a Chest X-ray, is used to visualize the structures of the chest, not to measure the heart's electrical activity.

3. What type of stroke is caused by a blockage in an artery supplying blood to the brain?

• A. Ischemic stroke
• B. Hemorrhagic stroke
• C. Transient ischemic attack
• D. Embolism

Correct answer: A

Rationale: The correct answer is A: Ischemic stroke. Ischemic stroke occurs when a blood clot blocks an artery supplying blood to the brain, leading to brain damage. Choice B, Hemorrhagic stroke, is caused by bleeding in the brain, not a blockage. Choice C, Transient ischemic attack, is a temporary blockage of blood flow to the brain with symptoms similar to a stroke but typically lasting only a few minutes. Choice D, Embolism, refers to a blood clot or other particle that travels through the bloodstream and blocks a blood vessel.

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

• A. Sympathetic nervous system
• B. Parasympathetic nervous system
• C. Norepinephrine
• D. Acetylcholine

Correct answer: A

Rationale: The correct answer is the Sympathetic nervous system. The sympathetic nervous system is a branch of the autonomic nervous system that is responsible for the fight-or-flight response. It causes vasodilation in central vessels to increase blood flow to vital organs during stress or exercise, while inducing vasoconstriction in peripheral vessels to redirect blood to essential areas. Norepinephrine and acetylcholine are neurotransmitters associated with the sympathetic and parasympathetic nervous systems, respectively, but they are not themselves central vasodilators and peripheral vasoconstrictors.

5. The nurse is giving digoxin to a client. What is the most important parameter to check before administration?

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

Correct answer: A

Rationale: The correct answer is A: Heart rate. Before administering digoxin, it is crucial to check the client's heart rate because digoxin can cause bradycardia, an abnormally slow heart rate. Monitoring the heart rate is essential to prevent potential complications associated with digoxin therapy. Choices B, C, and D are less critical parameters to assess before administering digoxin. While blood pressure is also important to monitor during digoxin therapy, the most crucial parameter to check due to the medication's potential effect on heart rate is the heart rate itself.

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