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. This is a more accurate indicator of tissue perfusion. It represents the cardiac output in terms of liters per minute per square meter of body surface area. Its normal range is 2.4-4 L/min.

• A. Cardiac Index
• B. Stroke volume
• C. Ejection fraction
• D. Cardiac output

Correct answer: A

Rationale: The correct answer is A: Cardiac Index. Cardiac Index is a measure of cardiac output relative to body surface area, providing a more accurate assessment of tissue perfusion. It is calculated by dividing the cardiac output by the body surface area. The normal range for cardiac index is 2.4-4 L/min/m². Choice B, Stroke volume, refers to the amount of blood ejected by the heart in one contraction and is not adjusted for body surface area. Choice C, Ejection fraction, is the percentage of blood pumped out of the heart's ventricles with each contraction, not adjusted for body surface area. Choice D, Cardiac output, is the total volume of blood pumped by the heart per minute, without considering body surface area.

3. The nurse is teaching a client about side effects of ACE inhibitors. What is the most important side effect to monitor?

• A. Cough
• B. Hyperkalemia
• C. Hypotension
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Cough. ACE inhibitors commonly cause a persistent dry cough in patients. This side effect is important to monitor because it can indicate the development of angioedema, a serious adverse reaction that requires immediate medical attention. Hyperkalemia (choice B) is a potential side effect of ACE inhibitors but is not typically the most important one to monitor. Hypotension (choice C) and dizziness (choice D) are also possible side effects of ACE inhibitors, but they are not as critical to monitor as the development of a persistent cough.

4. Which type of lung cancer is strongly associated with exposure to asbestos?

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

Correct answer: A

Rationale: The correct answer is Mesothelioma. This type of lung cancer is indeed strongly associated with exposure to asbestos, affecting the lining of the lungs or abdomen. Adenocarcinoma, Squamous cell carcinoma, and Small cell lung cancer are not primarily linked to asbestos exposure, making them incorrect choices for this question.

5. The nurse is teaching a client about the side effects of beta blockers. What is the most important side effect to monitor?

• A. Hypotension
• B. Bradycardia
• C. Hyperkalemia
• D. Tachycardia

Correct answer: A

Rationale: The most important side effect to monitor when a client is on beta blockers is hypotension. Beta blockers can cause a significant drop in blood pressure, especially at the initiation of therapy. Monitoring for hypotension is crucial to prevent complications such as dizziness, syncope, or falls. While bradycardia can also occur with beta blockers, hypotension takes precedence due to its immediate impact on perfusion. Hyperkalemia is not a common side effect of beta blockers. Tachycardia is actually a condition that beta blockers aim to treat, so it is not a side effect to monitor.

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