Nursing Elites

1. The client has a prescription for sublingual nitroglycerin. What is the nurse's instruction for how to take this medication during an episode of chest pain?

• A. Take one tablet every 5 minutes, up to three tablets.
• B. Take one tablet every hour until the pain subsides.
• C. Take two tablets immediately if chest pain occurs.
• D. Take one tablet with a full glass of water.

Correct answer: A

Rationale: The correct answer is A. The standard instruction for sublingual nitroglycerin during an episode of chest pain is to take one tablet every 5 minutes, up to three tablets. If the pain persists after taking three tablets, the client should seek emergency help. Choice B is incorrect because taking one tablet every hour is not the appropriate dosing for acute chest pain. Choice C is incorrect as taking two tablets immediately is not in line with the recommended dosing instructions. Choice D is incorrect because sublingual nitroglycerin should be placed under the tongue, not swallowed with water.

2. The client is on enoxaparin (Lovenox) for DVT prophylaxis. What is the most important lab value to monitor?

• A. Platelet count
• B. PT/INR
• C. aPTT
• D. Hemoglobin

Correct answer: A

Rationale: The correct answer is A: Platelet count. When a client is on enoxaparin (Lovenox), monitoring the platelet count is crucial as enoxaparin can lead to a rare but serious side effect known as heparin-induced thrombocytopenia (HIT), causing a decrease in platelet count. Monitoring the platelet count helps detect this adverse reaction early. Choices B, C, and D are incorrect because enoxaparin therapy does not directly affect PT/INR, aPTT, or hemoglobin levels.

3. What is the condition where the blood vessels that supply blood to the legs and feet become narrowed or blocked, causing pain and difficulty walking?

• A. Peripheral artery disease
• B. Raynaud's disease
• C. Varicose veins
• D. Pulmonary embolism

Correct answer: A

Rationale: The correct answer is A, Peripheral artery disease (PAD). PAD is a condition where the blood vessels that supply blood to the legs and feet become narrowed or blocked, leading to decreased blood flow, pain, and difficulty walking, especially during physical activity. Raynaud's disease (choice B) is characterized by vasospasms in the fingers and toes, causing them to turn white or blue. Varicose veins (choice C) are enlarged, twisted veins usually found in the legs. Pulmonary embolism (choice D) is a blockage in one of the pulmonary arteries in the lungs, often caused by a blood clot.

4. What test measures the pressure inside the arteries as the heart pumps blood?

• A. Blood pressure test
• B. Pulse oximetry
• C. Echocardiogram
• D. Spirometry

Correct answer: A

Rationale: The correct answer is A) Blood pressure test. A blood pressure test is specifically designed to measure the pressure inside the arteries as the heart pumps blood. This test is crucial in providing information about cardiovascular health by determining the force of blood against the artery walls. Choice B, Pulse oximetry, measures oxygen saturation in the blood, not blood pressure. Choice C, Echocardiogram, is an ultrasound test that evaluates the structure and function of the heart, not specifically blood pressure. Choice D, Spirometry, is a test used to assess lung function, not blood pressure.

5. Which condition involves the enlargement and weakening of the left ventricle of the heart, leading to reduced pumping ability?

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

Correct answer: A

Rationale: The correct answer is A: Dilated cardiomyopathy. Dilated cardiomyopathy is characterized by the enlargement and weakening of the left ventricle of the heart, which results in a reduced ability to pump blood effectively. Choice B, Hypertrophic cardiomyopathy, involves thickening of the heart muscle, not enlargement. Choice C, Restrictive cardiomyopathy, is characterized by stiffening of the heart muscle, not enlargement. Choice D, Pericarditis, refers to inflammation of the pericardium, the lining surrounding the heart, and does not involve enlargement and weakening of the left ventricle.

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