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. Which test measures how much and how quickly you can move air out of your lungs?

• A. Spirometry
• B. Peak flow meter
• C. Lung volume test
• D. Arterial blood gas

Correct answer: A

Rationale: The correct answer is A, Spirometry. Spirometry is a common pulmonary function test that measures lung function by assessing the amount (volume) and speed (flow) of air that can be inhaled and exhaled. This test helps in diagnosing conditions like asthma, chronic obstructive pulmonary disease (COPD), and other lung diseases. Peak flow meter (choice B) measures the maximum speed at which a person can exhale air, mainly used in asthma management. Lung volume test (choice C) evaluates the total amount of air the lungs can hold. Arterial blood gas (choice D) measures the levels of oxygen and carbon dioxide in the blood, providing information on how well the lungs are functioning in gas exchange, but it does not specifically measure the amount and speed of air movement in and out of the lungs like spirometry does.

3. The client on spironolactone (Aldactone) has a potassium level of 5.6 mEq/L. What is the nurse’s priority action?

• A. Hold the spironolactone and notify the healthcare provider.
• B. Administer potassium supplements.
• C. Continue the spironolactone as ordered.
• D. Increase the dose of spironolactone.

Correct answer: A

Rationale: The correct answer is A: Hold the spironolactone and notify the healthcare provider. A potassium level of 5.6 mEq/L is high, indicating hyperkalemia. Spironolactone is a potassium-sparing diuretic that can further elevate potassium levels. Therefore, the priority action is to withhold the medication to prevent exacerbating hyperkalemia and notify the healthcare provider for further management. Option B is incorrect because administering potassium supplements would worsen the hyperkalemia. Option C is incorrect as continuing spironolactone can lead to a further increase in potassium levels. Option D is incorrect as increasing the dose of spironolactone would be inappropriate in the presence of elevated potassium levels.

4. What is a condition where the heart's ability to pump blood is reduced because the heart muscle is enlarged, thickened, or stiffened?

• A. Cardiomyopathy
• B. Endocarditis
• C. Myocarditis
• D. Aortic stenosis

Correct answer: A

Rationale: Cardiomyopathy is the correct answer. It is a condition characterized by the enlargement, thickening, or stiffening of the heart muscle, leading to a reduced ability of the heart to pump blood effectively. Endocarditis (Choice B) is the inflammation of the inner lining of the heart chambers and valves, not specifically related to the heart muscle. Myocarditis (Choice C) is inflammation of the heart muscle typically caused by a viral infection, not directly related to the heart muscle's structure. Aortic stenosis (Choice D) is a condition characterized by the narrowing of the aortic valve opening, affecting blood flow from the heart's left ventricle to the aorta, different from the structural changes seen in cardiomyopathy.

5. Which type of medication helps to lower cholesterol levels in the blood?

• A. Statins
• B. Beta-blockers
• C. ACE inhibitors
• D. Diuretics

Correct answer: A

Rationale: Statins are a type of medication specifically designed to lower cholesterol levels in the blood by inhibiting an enzyme involved in cholesterol production. Beta-blockers are mainly used to treat conditions like high blood pressure and heart problems by reducing the heart rate and workload. ACE inhibitors are used to manage conditions like high blood pressure and heart failure by relaxing blood vessels. Diuretics are medications that help the body get rid of excess salt and water by increasing urine production. Therefore, in the context of lowering cholesterol levels, statins are the most appropriate choice.

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