Nursing Elites

1. Which of the following drugs has a therapeutic effect that increases cardiac output and slows heart rate?

• A. Heparin
• B. Alprazolam
• C. Digoxin
• D. Levothyroxine

Correct answer: C

Rationale: Digoxin is the correct answer. It is a medication known for its positive inotropic effects, which increase cardiac output, and negative chronotropic effects, which slow the heart rate. These effects are achieved by inhibiting the sodium-potassium ATPase pump in myocardial cells. Therefore, Digoxin is commonly prescribed to manage conditions like heart failure and atrial fibrillation, where enhancing cardiac output and reducing heart rate are beneficial. Choices A, B, and D are incorrect because Heparin is an anticoagulant, Alprazolam is a benzodiazepine used for anxiety disorders, and Levothyroxine is a thyroid hormone replacement drug, none of which have the specified therapeutic effects on cardiac function.

2. A client with a UTI and a history of recurrent infections asks why the provider has not yet prescribed an antibiotic. The nurse should explain that the provider has to wait for the results of which of the following laboratory tests to identify which antibiotic to prescribe?

• A. Gram stain
• B. Culture
• C. Sensitivity
• D. Specific gravity

Correct answer: C

Rationale: In the case of a UTI, a sensitivity test is crucial as it identifies the most effective antibiotic to target the specific microorganism causing the infection. This test helps in prescribing the appropriate antibiotic for successful treatment and preventing antibiotic resistance. While a Gram stain and culture are important in diagnosing a UTI, the sensitivity test specifically determines the most suitable antibiotic. Specific gravity, on the other hand, is not related to identifying the appropriate antibiotic for a UTI.

3. A healthcare professional is reviewing the laboratory results of a client taking Warfarin for atrial fibrillation. Which of the following findings should the professional report to the provider immediately?

• A. INR of 4.0
• B. Potassium level of 4.5 mEq/L
• C. Creatinine level of 1.0 mg/dL
• D. BUN of 18 mg/dL

Correct answer: A

Rationale: An INR of 4.0 indicates that the client's blood is clotting too slowly, increasing the risk of bleeding. This level is above the therapeutic range for a client on Warfarin therapy. Therefore, the healthcare professional should notify the provider immediately to prevent potential bleeding complications. The other laboratory values are within normal limits and do not pose an immediate risk to the client's health while on Warfarin therapy.

4. A nurse is evaluating teaching for a client who has Rheumatoid Arthritis and a new prescription for Methotrexate. Which of the following statements by the client indicates understanding of the teaching?

• A. I will be sure to return to the clinic at least once a year to have my blood drawn while I'm taking methotrexate.
• B. I will take this medication on an empty stomach.
• C. I'll let the doctor know if I develop sores in my mouth while taking this medication.
• D. I should stop taking oral contraceptives while I'm taking methotrexate.

Correct answer: C

Rationale: Ulcerations in the mouth, tongue, or throat are often the first signs of methotrexate toxicity and should be reported to the provider immediately.

5. What is the action of Nitroglycerin?

• A. Dilates the Bronchi
• B. Reduces Blood Glucose
• C. Reduces Nausea
• D. Dilates Coronary Arteries

Correct answer: D

Rationale: Nitroglycerin acts by dilating the coronary arteries, leading to increased blood flow and oxygen supply to the heart. This helps in relieving angina symptoms by reducing the heart's workload and improving blood supply to the myocardium. Choices A, B, and C are incorrect because Nitroglycerin's primary action is not related to dilating bronchi, reducing blood glucose, or reducing nausea.

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