Nursing Elites

1. What type of heart disease is characterized by the heart muscle becoming enlarged and weakened, reducing its ability to pump blood effectively?

• A. Dilated cardiomyopathy
• B. Hypertrophic cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Myocarditis

Correct answer: A

Rationale: The correct answer is A: Dilated cardiomyopathy. Dilated cardiomyopathy is a type of heart disease where the heart muscle becomes enlarged and weakened, reducing its ability to pump blood effectively, which can lead to heart failure. Hypertrophic cardiomyopathy (B) is characterized by abnormal thickening of the heart muscle, not enlargement. Restrictive cardiomyopathy (C) involves the heart muscle becoming stiff and less flexible, limiting its ability to fill with blood properly. Myocarditis (D) is inflammation of the heart muscle, which can affect the heart's function but is different from dilated cardiomyopathy.

2. The nurse is administering a beta blocker to a client with a heart rate of 58 bpm. What is the nurse’s priority action?

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

Correct answer: B

Rationale: The correct answer is B. A heart rate of 58 bpm is considered low, and beta blockers can further decrease the heart rate. Therefore, the nurse's priority action should be to hold the beta blocker and notify the healthcare provider for further assessment. Choice A is incorrect because administering the beta blocker without considering the low heart rate can worsen the condition. Choice C is incorrect as increasing the dose of the beta blocker can lead to further slowing of the heart rate, which is not safe in this situation. Choice D is not the priority action; holding the medication and seeking guidance from the healthcare provider is more crucial.

3. The client on amiodarone reports shortness of breath. What is the nurse’s best response?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect.
• C. Instruct the client to monitor their symptoms at home.
• D. Suggest the client reduce physical activity.

Correct answer: A

Rationale: When a client on amiodarone reports shortness of breath, it can be indicative of pulmonary toxicity, a severe side effect associated with this medication. The nurse's priority is to notify the healthcare provider immediately to assess the situation and determine the appropriate course of action. Choice B is incorrect because shortness of breath with amiodarone should not be dismissed as a common side effect. Instructing the client to monitor symptoms at home (Choice C) may delay necessary intervention. Suggesting the client reduce physical activity (Choice D) does not address the potential serious nature of the symptom and the need for prompt evaluation.

4. 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.

5. What is a condition where the pulmonary arteries become blocked by a blood clot, leading to chest pain, shortness of breath, and other symptoms?

• A. Pulmonary embolism
• B. Pneumothorax
• C. Pulmonary edema
• D. Pulmonary hypertension

Correct answer: A

Rationale: The correct answer is A, pulmonary embolism. Pulmonary embolism is a condition where a blood clot blocks one of the pulmonary arteries in the lungs, resulting in symptoms like chest pain, shortness of breath, and other related signs. Choices B, C, and D are incorrect because pneumothorax refers to a collapsed lung, pulmonary edema is the build-up of fluid in the lungs, and pulmonary hypertension is high blood pressure in the arteries of the lungs - none of which directly involve a blood clot blocking the pulmonary arteries.

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