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 medication type is used to relax and widen blood vessels, improving blood flow and reducing blood pressure.

• A. Vasodilator
• B. Anticoagulant
• C. Diuretic
• D. Beta-blocker

Correct answer: A

Rationale: The correct answer is A: Vasodilator. Vasodilators are medications that work by relaxing and widening blood vessels, which improves blood flow and reduces blood pressure. They are commonly used in the treatment of heart conditions. Anticoagulants (choice B) are medications that prevent blood clot formation, diuretics (choice C) increase urine production to reduce fluid retention, and beta-blockers (choice D) reduce heart rate and workload on the heart. These mechanisms differ from the action of vasodilators.

3. The nurse is caring for a client on amiodarone who develops a cough. What is the most appropriate action?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect.
• C. Continue the amiodarone and monitor the client’s symptoms.
• D. Discontinue the amiodarone immediately.

Correct answer: A

Rationale: The correct action when a client on amiodarone develops a cough, which can be a sign of pulmonary toxicity, a serious side effect of amiodarone, is to notify the healthcare provider immediately. This is crucial because pulmonary toxicity can lead to severe complications if not addressed promptly. Choices B and C are incorrect as they do not address the potential severity of the situation and may delay necessary intervention. Choice D of discontinuing amiodarone immediately without consulting the healthcare provider can be risky, as sudden discontinuation of the medication may have adverse effects on the client's condition.

4. What is the condition where the blood flow through the coronary arteries is reduced or blocked, leading to chest pain or heart attack?

• A. Coronary artery disease
• B. Atherosclerosis
• C. Pulmonary embolism
• D. Pulmonary hypertension

Correct answer: A

Rationale: The correct answer is A, Coronary artery disease (CAD). CAD occurs when the coronary arteries are narrowed or blocked, reducing blood flow to the heart muscle and increasing the risk of chest pain or heart attack. Choice B, Atherosclerosis, is a condition characterized by the hardening and narrowing of arteries due to the buildup of plaque. Choices C and D, Pulmonary embolism and Pulmonary hypertension, involve issues related to the lungs and not the coronary arteries.

5. 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.

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