Nursing Elites

1. What is a condition where the heart beats with an irregular or abnormal rhythm?

• A. Arrhythmia
• B. Hypertension
• C. Tachycardia
• D. Bradycardia

Correct answer: A

Rationale: Arrhythmia is the correct answer because it refers to an irregular or abnormal heart rhythm, which can cause the heart to beat too fast, too slow, or erratically. Hypertension (choice B) is high blood pressure and not directly related to irregular heart rhythm. Tachycardia (choice C) is a condition where the heart beats too quickly, not necessarily irregularly. Bradycardia (choice D) is a condition where the heart beats too slowly, not necessarily irregularly. Therefore, only arrhythmia (choice A) fits the description provided in the question.

2. The client on nitroglycerin patches reports dizziness when standing up. What is the nurse’s best response?

• A. Advise the client to rise slowly to prevent dizziness.
• B. Instruct the client to discontinue the nitroglycerin patches.
• C. Encourage the client to rest and avoid physical activity.
• D. Suggest the client take an over-the-counter antiemetic.

Correct answer: A

Rationale: The correct answer is to advise the client to rise slowly to prevent dizziness. Dizziness when standing up can be a sign of orthostatic hypotension, a common side effect of nitroglycerin. Rising slowly can help minimize this symptom. Instructing the client to discontinue the nitroglycerin patches (Choice B) is not appropriate without consulting a healthcare provider as sudden discontinuation can lead to adverse effects. Encouraging the client to rest and avoid physical activity (Choice C) does not address the specific issue of orthostatic hypotension. Suggesting the client take an over-the-counter antiemetic (Choice D) is not indicated for dizziness related to orthostatic hypotension.

3. Which condition is characterized by the lungs becoming scarred and stiff, leading to difficulty breathing and inadequate oxygen intake into the bloodstream?

• A. Pulmonary fibrosis
• B. Cystic fibrosis
• C. COPD
• D. Tuberculosis

Correct answer: A

Rationale: The correct answer is A, Pulmonary fibrosis. Pulmonary fibrosis is a lung disease where lung tissue is damaged and scarred, resulting in breathing difficulties and decreased oxygen transfer into the bloodstream. Cystic fibrosis (B) is a genetic disorder primarily affecting the lungs and digestive system, not causing lung scarring. COPD (C) includes conditions like chronic bronchitis and emphysema but doesn't specifically involve lung scarring. Tuberculosis (D) is a bacterial infection that primarily affects the lungs but doesn't cause lung tissue scarring and stiffness as seen in pulmonary fibrosis.

4. The client is on amiodarone. What is the most important side effect to monitor for?

• A. Pulmonary toxicity
• B. Thyroid dysfunction
• C. Liver toxicity
• D. Renal dysfunction

Correct answer: A

Rationale: The correct answer is A: Pulmonary toxicity. Amiodarone is known for causing serious pulmonary toxicity, which can be fatal. Monitoring for pulmonary toxicity is crucial due to its potential severity. Choice B, thyroid dysfunction, is a common side effect of amiodarone but is not as immediately life-threatening as pulmonary toxicity. Choices C and D, liver toxicity and renal dysfunction, are potential side effects of amiodarone but are not as critical or as common as pulmonary toxicity, making them less important to monitor initially.

5. The nurse is administering digoxin to a client with a heart rate of 45 bpm. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Increase the dose of digoxin.
• D. Monitor the client’s heart rate and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A heart rate of 45 bpm is already low, and digoxin can further decrease the heart rate, leading to serious complications like bradycardia or heart block. Administering the medication can exacerbate the bradycardia, hence it should be withheld. Increasing the dose of digoxin is contraindicated due to the client's low heart rate. Monitoring the heart rate alone without taking immediate action to withhold the medication is not the priority when faced with the risk of further lowering the heart rate.

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