Nursing Elites

1. What is a condition where the right side of the heart fails due to increased pressure in the pulmonary arteries, often caused by chronic lung disease?

• A. Cor pulmonale
• B. Heart failure
• C. Pulmonary embolism
• D. Myocarditis

Correct answer: A

Rationale: Cor pulmonale is the correct answer. It is a condition where the right side of the heart fails due to increased pressure in the pulmonary arteries, often caused by chronic lung disease such as COPD. Pulmonary embolism (choice C) is a blockage in one of the pulmonary arteries in your lungs. Myocarditis (choice D) is inflammation of the heart muscle. While heart failure (choice B) is a broad term that can involve the failure of either the right or left side of the heart.

2. The client is on hydrochlorothiazide and digoxin. What effect can the nurse expect?

• A. Hydrochlorothiazide increases digoxin levels.
• B. Hydrochlorothiazide decreases digoxin levels.
• C. Hydrochlorothiazide decreases potassium, increasing the risk of digoxin toxicity.
• D. Digoxin can increase the effectiveness of hydrochlorothiazide.

Correct answer: C

Rationale: The correct answer is C. Hydrochlorothiazide is a diuretic that can decrease potassium levels, which in turn can increase the risk of digoxin toxicity. Digoxin typically doesn't impact hydrochlorothiazide levels or effectiveness, making choices A, B, and D incorrect. Choice A stating that hydrochlorothiazide increases digoxin levels is inaccurate. Choice B suggesting that hydrochlorothiazide decreases digoxin levels is also incorrect. Choice D, stating that digoxin can increase the effectiveness of hydrochlorothiazide, is not a typical interaction seen between these medications.

3. The client is on nitroglycerin and reports chest pain. What is the nurse’s priority action?

• A. Administer nitroglycerin as ordered.
• B. Administer morphine as ordered.
• C. Administer aspirin as ordered.
• D. Notify the healthcare provider immediately.

Correct answer: D

Rationale: The correct answer is D: Notify the healthcare provider immediately. If a client on nitroglycerin reports chest pain, the priority action is to notify the healthcare provider immediately. This is crucial to ensure prompt reassessment of the client's condition and treatment plan. Administering nitroglycerin, morphine, or aspirin without consulting the healthcare provider first can be risky as the chest pain may indicate a need for a change in treatment or further evaluation. Administering medications without proper assessment and guidance can lead to complications and is not recommended in this scenario.

4. What is the condition where the pericardium, the sac surrounding the heart, becomes inflamed, leading to chest pain and other symptoms?

• A. Pericarditis
• B. Myocarditis
• C. Endocarditis
• D. Pulmonary hypertension

Correct answer: A

Rationale: Pericarditis is the correct answer. It is the inflammation of the pericardium, the sac surrounding the heart, which can lead to chest pain and other symptoms. Myocarditis (choice B) is inflammation of the heart muscle, not the pericardium. Endocarditis (choice C) is inflammation of the inner lining of the heart chambers and valves, not the pericardium. Pulmonary hypertension (choice D) is high blood pressure in the arteries of the lungs, not related to pericardial inflammation.

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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