Nursing Elites

1. The nurse is monitoring a client on dobutamine. What adverse effect should the nurse watch for?

• A. Tachycardia
• B. Bradycardia
• C. Hypertension
• D. Respiratory distress

Correct answer: A

Rationale: The correct answer is A: Tachycardia. Dobutamine is a medication that stimulates beta-1 adrenergic receptors in the heart, leading to increased heart rate. Therefore, tachycardia is a common adverse effect that the nurse should monitor for. Choices B, C, and D are incorrect because dobutamine typically does not cause bradycardia, hypertension, or respiratory distress as its primary adverse effects.

2. Which type of medication is used to reduce the workload on the heart by slowing down the heart rate and lowering blood pressure?

• A. Beta-blocker
• B. ACE inhibitor
• C. Calcium channel blocker
• D. Diuretic

Correct answer: A

Rationale: The correct answer is A: Beta-blocker. Beta-blockers are medications that reduce the workload on the heart by slowing down the heart rate and lowering blood pressure. They are commonly used in the treatment of heart conditions such as hypertension and heart failure. ACE inhibitors (B) work by dilating blood vessels to reduce blood pressure, calcium channel blockers (C) prevent calcium from entering the heart muscle and blood vessel walls, and diuretics (D) help the body get rid of excess salt and water by increasing urine production.

3. What is the term for inflammation of the bronchial tubes, often leading to a persistent cough and mucus production?

• A. Bronchitis
• B. Asthma
• C. Pneumonia
• D. Cystic fibrosis

Correct answer: A

Rationale: The correct answer is 'Bronchitis.' Bronchitis refers to the inflammation of the bronchial tubes, which can be acute or chronic, leading to symptoms like coughing and increased mucus production. Choice B, 'Asthma,' is a chronic condition characterized by inflammation and narrowing of the airways, often causing wheezing and shortness of breath. Choice C, 'Pneumonia,' is an infection that inflames air sacs in one or both lungs, leading to symptoms like fever, cough, and difficulty breathing. Choice D, 'Cystic fibrosis,' is a genetic disorder that affects the lungs and digestive system, causing mucus buildup and respiratory issues.

4. What is the term that describes the inability of cardiac cells to respond to a new stimulus while they are still in contraction from a previous stimulus?

• A. Refractoriness
• B. Excitability
• C. Contractility
• D. Automaticity

Correct answer: A

Rationale: Refractoriness is the correct term to describe the inability of cardiac cells to respond to a new stimulus while they are still in contraction from a previous stimulus. This period is essential for the heart to complete its contraction and relaxation phases without interference. Excitability refers to the ability of cells to respond to stimuli, not the inability to respond. Contractility is the force of cardiac muscle contraction, and automaticity is the ability of cardiac cells to generate electrical impulses spontaneously, which are not relevant to the described scenario.

5. The client on warfarin has an INR of 3.8. What is the most appropriate action by the nurse?

• A. Administer vitamin K.
• B. Hold the next dose of warfarin.
• C. Increase the dose of warfarin.
• D. Notify the healthcare provider immediately.

Correct answer: A

Rationale: An INR of 3.8 is elevated, indicating an increased risk of bleeding. Administering vitamin K can help reverse the effects of warfarin. Holding the next dose of warfarin would be appropriate if the INR was too high, but not as the first-line action. Increasing the dose of warfarin would worsen the situation by further increasing the INR. Notifying the healthcare provider is important, but immediate action to address the elevated INR is necessary.

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