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 artery supplies the right atrium, right ventricle, a portion of the septum, SA node, AV node, and inferior portion of the left ventricle?

• A. Right coronary artery
• B. Left circumflex artery
• C. Posterior descending artery
• D. Aortic artery

Correct answer: A

Rationale: The correct answer is the right coronary artery. It supplies essential areas of the heart, including the right atrium, right ventricle, a portion of the septum, SA node, AV node, and the inferior portion of the left ventricle. The left circumflex artery primarily supplies the left atrium and lateral wall of the left ventricle, not the mentioned areas. The posterior descending artery supplies the inferior wall of the left ventricle, not the right side. The aortic artery is a general term and does not specifically refer to an artery that supplies the mentioned areas.

3. The client is being taught about the use of warfarin. What is the most important dietary instruction?

• A. Avoid foods high in vitamin K.
• B. Increase the intake of vitamin K-rich foods.
• C. Avoid foods high in protein.
• D. Increase the intake of foods high in calcium.

Correct answer: A

Rationale: The correct answer is A: Avoid foods high in vitamin K. Warfarin is a medication that works by decreasing the activity of vitamin K in the body to prevent blood clotting. Therefore, consuming foods high in vitamin K like green leafy vegetables can interfere with the medication's effectiveness. Choices B, C, and D are incorrect. Increasing the intake of vitamin K-rich foods would counteract the effects of warfarin. Avoiding foods high in protein or increasing the intake of foods high in calcium are not specifically related to the use of warfarin.

4. What is a type of pneumonia that is contracted by inhaling contaminated water droplets?

• A. Legionnaires' disease
• B. Tuberculosis
• C. Asbestosis
• D. Histoplasmosis

Correct answer: A

Rationale: The correct answer is Legionnaires' disease. Legionnaires' disease is a severe form of pneumonia caused by inhaling water droplets contaminated with Legionella bacteria. This bacterium thrives in water systems such as air conditioning units, hot tubs, and water fountains. Choices B, C, and D are incorrect because Tuberculosis is caused by Mycobacterium tuberculosis, Asbestosis is caused by asbestos fibers, and Histoplasmosis is caused by a fungus found in bird and bat droppings.

5. The client is on digoxin and has severe digoxin toxicity. What is the nursing priority action?

• A. Check the potassium level.
• B. Give Digibind as an antidote.
• C. Change the dosing of digoxin to every other day.
• D. Administer a potassium supplement to decrease digoxin toxicity.

Correct answer: B

Rationale: The correct answer is to give Digibind as an antidote in cases of severe digoxin toxicity. Digibind works by binding to digoxin and preventing it from causing further harm. Checking the potassium level (choice A) is important but not the priority when the client has severe toxicity. Changing the dosing to every other day (choice C) is not appropriate in the setting of severe toxicity where immediate action is required. Giving a potassium supplement (choice D) may be needed eventually, but the priority is to administer Digibind to counteract the toxic effects of digoxin.

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