Nursing Elites

1. The client is on nitroglycerin and reports chest pain. What is the nurse’s priority action?

• A. Administer nitroglycerin as ordered.
• B. Administer morphine as ordered.
• C. Administer aspirin as ordered.
• D. Notify the healthcare provider immediately.

Correct answer: D

Rationale: The correct answer is D: Notify the healthcare provider immediately. If a client on nitroglycerin reports chest pain, the priority action is to notify the healthcare provider immediately. This is crucial to ensure prompt reassessment of the client's condition and treatment plan. Administering nitroglycerin, morphine, or aspirin without consulting the healthcare provider first can be risky as the chest pain may indicate a need for a change in treatment or further evaluation. Administering medications without proper assessment and guidance can lead to complications and is not recommended in this scenario.

2. Which test measures the electrical activity of the heart and can detect arrhythmias and other heart conditions?

• A. Electrocardiogram (ECG or EKG)
• B. Chest X-ray
• C. MRI
• D. CT scan

Correct answer: A

Rationale: The correct answer is A: Electrocardiogram (ECG or EKG). An electrocardiogram is a test that measures the electrical activity of the heart and can detect arrhythmias and other heart conditions by recording the heart's electrical impulses. Choices B, C, and D are incorrect because a chest X-ray is used to visualize the structures in the chest, an MRI (Magnetic Resonance Imaging) is used to provide detailed images of organs and tissues, and a CT scan (Computed Tomography) is a type of imaging that uses X-rays to create detailed cross-sectional images of the body.

3. The client on a beta blocker has a blood pressure of 88/58 mm Hg. 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 action for the nurse to take when a client on a beta blocker presents with a blood pressure of 88/58 mm Hg is to hold the beta blocker and notify the healthcare provider. Beta blockers can further decrease blood pressure, which is already low in this case. Administering the beta blocker as ordered (Choice B) would exacerbate the hypotension. Increasing the dose of the beta blocker (Choice C) would be inappropriate and unsafe given the low blood pressure. Continuing to monitor the client and reassessing in 30 minutes (Choice D) could lead to a delay in necessary intervention. Therefore, the priority is to hold the medication and seek guidance from the healthcare provider.

4. What is an infection that causes inflammation in the air sacs of one or both lungs, which may fill with fluid or pus?

• A. Pneumonia
• B. Tuberculosis
• C. Pleurisy
• D. Pulmonary edema

Correct answer: A

Rationale: The correct answer is A, Pneumonia. Pneumonia is an infection that inflames the air sacs in one or both lungs, which may fill with fluid or pus, causing symptoms like cough, fever, chills, and difficulty breathing. Tuberculosis (B) is a bacterial infection that primarily affects the lungs but is caused by a different bacterium. Pleurisy (C) is inflammation of the tissues that line the lungs and chest cavity, not the air sacs. Pulmonary edema (D) is a condition where fluid accumulates in the lungs' air sacs but is often due to heart problems rather than an infection.

5. What is the condition where the lungs become filled with fluid, often due to heart failure, making it difficult to breathe?

• A. Pulmonary edema
• B. Pleural effusion
• C. Pulmonary hypertension
• D. Pneumothorax

Correct answer: A

Rationale: Pulmonary edema is the correct answer. It occurs when fluid fills the lungs, usually due to heart failure, leading to breathing difficulties. Pleural effusion is the accumulation of fluid around the lungs, not inside. Pulmonary hypertension is high blood pressure in the arteries of the lungs, and pneumothorax is the presence of air between the lung and chest wall.

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