Nursing Elites

1. In cases of myocardial infarction leading to shock, which medication is appropriate to counteract shock?

• A. Atropine
• B. Dopamine
• C. Digoxin
• D. Adenosine

Correct answer: B

Rationale: In cases of myocardial infarction leading to shock, dopamine is the drug of choice. Dopamine helps increase blood pressure and improve blood flow to vital organs, making it beneficial in managing shock. Atropine is mainly used for symptomatic bradycardia, not for shock. Digoxin is a cardiac glycoside used in heart failure and atrial fibrillation, not for managing shock. Adenosine is typically used for diagnosing and treating supraventricular tachycardias, not for shock associated with myocardial infarction.

2. Which artery supplies the right atrium, right ventricle, a portion of the septum, SA node, AV node, and inferior portion of the left ventricle?

• A. Right coronary artery
• B. Left circumflex artery
• C. Posterior descending artery
• D. Aortic artery

Correct answer: A

Rationale: The correct answer is the right coronary artery. It supplies essential areas of the heart, including the right atrium, right ventricle, a portion of the septum, SA node, AV node, and the inferior portion of the left ventricle. The left circumflex artery primarily supplies the left atrium and lateral wall of the left ventricle, not the mentioned areas. The posterior descending artery supplies the inferior wall of the left ventricle, not the right side. The aortic artery is a general term and does not specifically refer to an artery that supplies the mentioned areas.

3. The client is on enalapril (Vasotec) for hypertension. What side effect is most commonly associated with this medication?

• A. Dry cough
• B. Hypotension
• C. Hyperkalemia
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Dry cough. A dry cough is a common side effect of ACE inhibitors like enalapril. ACE inhibitors can cause the accumulation of bradykinin, leading to irritation of the respiratory tract and resulting in a persistent dry cough. Hypotension (choice B) is a possible side effect of ACE inhibitors but is less common than a dry cough. Hyperkalemia (choice C) is another side effect of ACE inhibitors, but it is not the most commonly associated one. Headache (choice D) is not a common side effect of enalapril compared to a dry cough. Therefore, the most commonly associated side effect with enalapril is a dry cough.

4. A client on a beta blocker has a heart rate of 52 bpm. What is the nurse’s priority action?

• A. Hold the beta blocker and notify the healthcare provider.
• B. Administer the beta blocker as ordered.
• C. Increase the dose of the beta blocker.
• D. Continue to monitor the client and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the beta blocker and notify the healthcare provider. A heart rate of 52 bpm is low, and beta blockers can further decrease the heart rate, potentially causing harm. Therefore, withholding the medication and promptly informing the healthcare provider is crucial for further assessment and possible adjustment of the treatment plan. Administering the beta blocker as ordered (Choice B) can exacerbate the bradycardia. Increasing the dose of the beta blocker (Choice C) would further suppress the heart rate. Continuing to monitor the client and reassessing in 30 minutes (Choice D) might delay necessary interventions and increase the risk of complications in a client with a heart rate of 52 bpm.

5. What is the average cardiac output?

• A. Approximately 4 to 6 L per minute
• B. Approximately 4 to 8 L per minute
• C. Approximately 5 to 8 L per minute
• D. Approximately 3 to 7 L per minute

Correct answer: B

Rationale: The correct answer is B: Approximately 4 to 8 L per minute. Cardiac output is defined as the volume of blood the heart pumps per minute, typically ranging between 4 to 8 liters. Choices A, C, and D provide ranges that are either too narrow or outside the standard average values for cardiac output, making them incorrect.

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