Nursing Elites

1. The client is on dobutamine. Adverse effects of Dobutrex (dobutamine) include the following: Select all that apply.

• A. Heart failure
• B. Bradycardia
• C. Tachycardia
• D. Respiratory distress

Correct answer: C

Rationale: The correct answer is C: Tachycardia. Dobutamine is a medication that primarily increases heart rate (tachycardia) and blood pressure. Therefore, the adverse effects of dobutamine include tachycardia. Choices A, B, and D are incorrect. Heart failure is not an adverse effect of dobutamine; in fact, it is used to treat heart failure by increasing heart contractility. Bradycardia (slow heart rate) is not an expected adverse effect of dobutamine, as it usually increases heart rate. Respiratory distress is not a common adverse effect of dobutamine.

2. What is a condition where the heart muscle is weakened and unable to pump blood effectively, often leading to heart failure?

• A. Cardiomyopathy
• B. Myocarditis
• C. Endocarditis
• D. Pericarditis

Correct answer: A

Rationale: Cardiomyopathy is the correct answer. In cardiomyopathy, the heart muscle becomes weak and cannot pump blood effectively, which can lead to heart failure. Myocarditis (choice B) is inflammation of the heart muscle, not specifically causing muscle weakness. Endocarditis (choice C) is an infection of the inner lining of the heart chambers and valves. Pericarditis (choice D) is inflammation of the pericardium, the outer lining of the heart.

3. The nurse is caring for a heart client on digoxin and notes a potassium level of 2.5. What is the appropriate priority nursing intervention?

• A. Do nothing as this is a normal potassium level.
• B. The potassium level is low so the nurse asks for an order for potassium.
• C. The nurse asks to check the digoxin level as low potassium can increase digoxin toxicity.
• D. The nurse stops the digoxin.

Correct answer: C

Rationale: The correct answer is C. When caring for a client on digoxin with a low potassium level, the priority nursing intervention is to check the digoxin level. Low potassium can increase the risk of digoxin toxicity. Checking the digoxin level will help determine if any adjustments to the medication regimen are needed to prevent potential harm. Choice A is incorrect as a potassium level of 2.5 is low, not normal. Choice B is not the priority as simply giving potassium may not address the underlying issue of potential digoxin toxicity. Choice D is not the initial action to take without assessing the digoxin level first.

4. What is the term that describes the inability of cardiac cells to respond to a new stimulus while they are still in contraction from a previous stimulus?

• A. Refractoriness
• B. Excitability
• C. Contractility
• D. Automaticity

Correct answer: A

Rationale: Refractoriness is the correct term to describe the inability of cardiac cells to respond to a new stimulus while they are still in contraction from a previous stimulus. This period is essential for the heart to complete its contraction and relaxation phases without interference. Excitability refers to the ability of cells to respond to stimuli, not the inability to respond. Contractility is the force of cardiac muscle contraction, and automaticity is the ability of cardiac cells to generate electrical impulses spontaneously, which are not relevant to the described scenario.

5. The client asks about side effects of taking digoxin. How does the nurse respond?

• A. Anorexia can be a side effect of digoxin.
• B. Tachycardia can be a side effect of digoxin.
• C. Constipation can be a side effect of digoxin.
• D. Urinary retention can be a side effect of digoxin.

Correct answer: A

Rationale: The correct answer is A: 'Anorexia can be a side effect of digoxin.' Anorexia, nausea, vomiting, and diarrhea are commonly known side effects of digoxin. Choice B, 'Tachycardia can be a side effect of digoxin,' is incorrect as digoxin is used to treat tachycardia, not cause it. Choice C, 'Constipation can be a side effect of digoxin,' is incorrect as constipation is not a typical side effect of digoxin. Choice D, 'Urinary retention can be a side effect of digoxin,' is also incorrect as urinary retention is not a common side effect associated with digoxin use.

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