Nursing Elites

1. The client is on hydrochlorothiazide and digoxin. What effect can the nurse expect?

• A. Hydrochlorothiazide increases digoxin levels.
• B. Hydrochlorothiazide decreases digoxin levels.
• C. Hydrochlorothiazide decreases potassium, increasing the risk of digoxin toxicity.
• D. Digoxin can increase the effectiveness of hydrochlorothiazide.

Correct answer: C

Rationale: The correct answer is C. Hydrochlorothiazide is a diuretic that can decrease potassium levels, which in turn can increase the risk of digoxin toxicity. Digoxin typically doesn't impact hydrochlorothiazide levels or effectiveness, making choices A, B, and D incorrect. Choice A stating that hydrochlorothiazide increases digoxin levels is inaccurate. Choice B suggesting that hydrochlorothiazide decreases digoxin levels is also incorrect. Choice D, stating that digoxin can increase the effectiveness of hydrochlorothiazide, is not a typical interaction seen between these medications.

2. The client on nitroglycerin patches reports dizziness when standing up. What is the nurse’s best response?

• A. Advise the client to rise slowly to prevent dizziness.
• B. Instruct the client to discontinue the nitroglycerin patches.
• C. Encourage the client to rest and avoid physical activity.
• D. Suggest the client take an over-the-counter antiemetic.

Correct answer: A

Rationale: The correct answer is to advise the client to rise slowly to prevent dizziness. Dizziness when standing up can be a sign of orthostatic hypotension, a common side effect of nitroglycerin. Rising slowly can help minimize this symptom. Instructing the client to discontinue the nitroglycerin patches (Choice B) is not appropriate without consulting a healthcare provider as sudden discontinuation can lead to adverse effects. Encouraging the client to rest and avoid physical activity (Choice C) does not address the specific issue of orthostatic hypotension. Suggesting the client take an over-the-counter antiemetic (Choice D) is not indicated for dizziness related to orthostatic hypotension.

3. Which type of lung cancer begins in the cells lining the bronchi and bronchioles?

• A. Adenocarcinoma
• B. Small cell lung cancer
• C. Squamous cell carcinoma
• D. Mesothelioma

Correct answer: A

Rationale: Adenocarcinoma is the correct answer because it is a type of lung cancer that originates in the cells lining the bronchi and bronchioles. Adenocarcinoma is one of the most common types of lung cancer, often found in non-smokers and more frequently in women. Small cell lung cancer (Choice B) typically starts in the bronchi, but it is characterized by its rapid growth and tendency to spread quickly. Squamous cell carcinoma (Choice C) usually begins in the squamous cells lining the bronchi and is strongly associated with smoking. Mesothelioma (Choice D) is a cancer that affects the lining of certain organs like the lungs, often caused by asbestos exposure, but it does not specifically start in the cells lining the bronchi and bronchioles.

4. What procedure involves using a balloon to open a narrowed or blocked blood vessel, often followed by the placement of a stent?

• A. Angioplasty
• B. Valve replacement
• C. Coronary artery bypass graft (CABG)
• D. Endarterectomy

Correct answer: A

Rationale: The correct answer is A, Angioplasty. Angioplasty is a procedure that uses a balloon to open a narrowed or blocked blood vessel, often followed by the placement of a stent to maintain vessel patency. Choice B, Valve replacement, involves replacing damaged heart valves, not treating narrowed blood vessels. Choice C, Coronary artery bypass graft (CABG), is a procedure to bypass blocked coronary arteries, not directly open them using a balloon. Choice D, Endarterectomy, is a surgical procedure to remove plaque from the inner lining of an artery, not involving the use of a balloon and stent to open a vessel.

5. Which valve opens during ventricular systole and closes during ventricular diastole?

• A. Aortic valve
• B. Pulmonary valve
• C. Mitral valve
• D. Tricuspid valve

Correct answer: B

Rationale: The correct answer is B: Pulmonary valve. The pulmonary valve opens during ventricular systole to allow blood to flow from the right ventricle into the pulmonary artery. The aortic valve opens during ventricular systole to allow blood to flow from the left ventricle into the aorta. The mitral valve and tricuspid valve are atrioventricular valves that open during ventricular diastole to allow blood to flow from the atria into the ventricles.

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