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. What is a condition where the blood flow to the brain is temporarily blocked, often referred to as a mini-stroke?

• A. Transient ischemic attack (TIA)
• B. Stroke
• C. Aneurysm
• D. Myocardial infarction

Correct answer: A

Rationale: A transient ischemic attack (TIA) is the correct answer. A TIA is often referred to as a mini-stroke because it is caused by a temporary blockage of blood flow to the brain. This blockage resolves on its own, typically within minutes to hours, leading to temporary symptoms similar to a stroke. Option B, 'Stroke,' is incorrect because a stroke involves a more prolonged interruption of blood flow to the brain. Option C, 'Aneurysm,' is incorrect as it is a bulge in a blood vessel that can rupture and cause bleeding, not a temporary blockage of blood flow. Option D, 'Myocardial infarction,' is also incorrect as it refers to a heart attack, not a condition involving the brain's blood flow.

3. 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.

4. During which process does coronary artery blood flow to the myocardium occur during diastole, when coronary vascular resistance is reduced?

• A. Coronary perfusion pressure
• B. Coronary vascular resistance
• C. Diastolic filling
• D. Ventricular ejection

Correct answer: A

Rationale: The correct answer is A: Coronary perfusion pressure. Coronary perfusion pressure refers to the process of coronary artery blood flow to the myocardium during diastole when coronary vascular resistance is reduced. This process ensures that the myocardium receives sufficient oxygen and nutrients for proper functioning. Choice B, Coronary vascular resistance, is the opposite of what is described in the question. During coronary perfusion, resistance is reduced to enhance blood flow. Choices C and D, Diastolic filling and Ventricular ejection, do not directly relate to the process of coronary artery blood flow during diastole.

5. In cases of myocardial infarction leading to shock, which medication is appropriate to counteract shock?

• A. Atropine
• B. Dopamine
• C. Digoxin
• D. Adenosine

Correct answer: B

Rationale: In cases of myocardial infarction leading to shock, dopamine is the drug of choice. Dopamine helps increase blood pressure and improve blood flow to vital organs, making it beneficial in managing shock. Atropine is mainly used for symptomatic bradycardia, not for shock. Digoxin is a cardiac glycoside used in heart failure and atrial fibrillation, not for managing shock. Adenosine is typically used for diagnosing and treating supraventricular tachycardias, not for shock associated with myocardial infarction.

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