Nursing Elites

1. What is the primary action of digoxin when prescribed to a patient with heart failure?

• A. Increase heart rate
• B. Decrease cardiac output
• C. Strengthen cardiac contractions
• D. Lower blood pressure

Correct answer: C

Rationale: Digoxin, when prescribed to a patient with heart failure, primarily acts by strengthening cardiac contractions. This leads to an improvement in cardiac output, making it an essential medication in managing heart failure. By enhancing the force of contractions, digoxin helps the heart pump more effectively and efficiently, leading to better circulation and symptom control in patients with compromised cardiac function.

2. A client with chronic kidney disease (CKD) is scheduled for hemodialysis. Which pre-dialysis assessment finding should the nurse report to the healthcare provider?

• A. Serum potassium of 5.5 mEq/L.
• B. Blood pressure of 180/90 mm Hg.
• C. Heart rate of 80 beats per minute.
• D. Serum sodium of 140 mEq/L.

Correct answer: B

Rationale: The correct answer is B. A blood pressure of 180/90 mm Hg is elevated and should be reported to the healthcare provider before hemodialysis. Hypertension can have a significant impact on the effectiveness and safety of the dialysis treatment. Controlling blood pressure before the procedure is crucial to prevent complications during the dialysis session.

3. The healthcare provider formulates a nursing diagnosis of 'High risk for ineffective airway clearance' for a client with myasthenia gravis. What is the most likely cause for this nursing diagnosis?

• A. Pain during coughing.
• B. Diminished cough effort.
• C. Thick, dry secretions.
• D. Excessive inflammation.

Correct answer: B

Rationale: Clients with myasthenia gravis commonly experience muscle weakness, including in the muscles used for coughing. This diminished cough effort can lead to ineffective airway clearance, increasing the risk of respiratory complications. Therefore, the most likely cause for the nursing diagnosis 'High risk for ineffective airway clearance' in a client with myasthenia gravis is the diminished cough effort due to muscle weakness.

4. A patient with peptic ulcer disease is prescribed omeprazole. When should the patient take this medication for optimal effectiveness?

• A. With meals
• B. At bedtime
• C. Before meals
• D. After meals

Correct answer: C

Rationale: Omeprazole should be taken before meals to reduce stomach acid production and promote healing of the ulcer. Taking it before meals ensures that the medication can inhibit acid secretion when the stomach is most active in producing acid, thereby maximizing its effectiveness in treating peptic ulcer disease.

5. For a patient with asthma, what is the primary purpose of prescribing montelukast?

• A. Relieve acute bronchospasm
• B. Prevent asthma attacks
• C. Thin respiratory secretions
• D. Suppress cough

Correct answer: B

Rationale: Montelukast, a leukotriene receptor antagonist, is primarily prescribed to prevent asthma attacks. It works by reducing inflammation and bronchoconstriction in the airways, thereby helping to control asthma symptoms and prevent exacerbations.

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