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. Which of the following is a genetic disorder that causes thick, sticky mucus to build up in the lungs and digestive system, leading to severe respiratory and digestive problems?

• A. Cystic fibrosis
• B. Pulmonary fibrosis
• C. Pulmonary edema
• D. Bronchiectasis

Correct answer: A

Rationale: The correct answer is A, cystic fibrosis. Cystic fibrosis is a genetic disorder characterized by the buildup of thick, sticky mucus in the lungs and digestive system, resulting in severe respiratory and digestive issues. Choice B, pulmonary fibrosis, involves scarring and thickening of lung tissue, not excessive mucus production. Choice C, pulmonary edema, refers to fluid accumulation in the lungs, not mucus buildup. Choice D, bronchiectasis, is a condition where the airways in the lungs are damaged and widened, leading to chronic cough and sputum production, but it does not specifically involve the thick, sticky mucus characteristic of cystic fibrosis.

3. What is the condition where the body's immune system attacks its tissues, causing inflammation and damage?

• A. Autoimmune disease
• B. Infectious disease
• C. Allergic reaction
• D. Degenerative disease

Correct answer: A

Rationale: The correct answer is A: Autoimmune disease. Autoimmune diseases occur when the body's immune system mistakenly attacks its own tissues, leading to inflammation and damage. This is different from infectious diseases (choice B), which are caused by pathogenic microorganisms, allergic reactions (choice C), which involve an exaggerated response of the immune system to harmless substances, and degenerative diseases (choice D), which are characterized by progressive deterioration of tissue or organs due to various factors.

4. Which artery supplies the right atrium, right ventricle, a portion of the septum, SA node, AV node, and inferior portion of the left ventricle?

• A. Right coronary artery
• B. Left circumflex artery
• C. Posterior descending artery
• D. Aortic artery

Correct answer: A

Rationale: The correct answer is the right coronary artery. It supplies essential areas of the heart, including the right atrium, right ventricle, a portion of the septum, SA node, AV node, and the inferior portion of the left ventricle. The left circumflex artery primarily supplies the left atrium and lateral wall of the left ventricle, not the mentioned areas. The posterior descending artery supplies the inferior wall of the left ventricle, not the right side. The aortic artery is a general term and does not specifically refer to an artery that supplies the mentioned areas.

5. The client is receiving digoxin and has a potassium level of 2.8 mEq/L. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Increase the dose of digoxin.
• C. Continue the current dose of digoxin.
• D. Administer potassium supplements.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 2.8 mEq/L indicates hypokalemia, which can increase the risk of digoxin toxicity. Holding the medication and informing the healthcare provider is crucial to prevent adverse effects. Choice B is incorrect because increasing the dose of digoxin would further raise the risk of toxicity. Choice C is incorrect as continuing the current dose could exacerbate the toxicity risk. Choice D is incorrect because administering potassium supplements alone is not sufficient to address the potential digoxin toxicity; the first step should be to hold the digoxin and seek further guidance.

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