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 heart's ability to pump blood is reduced because the heart muscle is enlarged, thickened, or stiffened?

• A. Cardiomyopathy
• B. Endocarditis
• C. Myocarditis
• D. Aortic stenosis

Correct answer: A

Rationale: Cardiomyopathy is the correct answer. It is a condition characterized by the enlargement, thickening, or stiffening of the heart muscle, leading to a reduced ability of the heart to pump blood effectively. Endocarditis (Choice B) is the inflammation of the inner lining of the heart chambers and valves, not specifically related to the heart muscle. Myocarditis (Choice C) is inflammation of the heart muscle typically caused by a viral infection, not directly related to the heart muscle's structure. Aortic stenosis (Choice D) is a condition characterized by the narrowing of the aortic valve opening, affecting blood flow from the heart's left ventricle to the aorta, different from the structural changes seen in cardiomyopathy.

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. Which type of medication is used to reduce the workload on the heart by slowing down the heart rate and lowering blood pressure?

• A. Beta-blocker
• B. ACE inhibitor
• C. Calcium channel blocker
• D. Diuretic

Correct answer: A

Rationale: The correct answer is A: Beta-blocker. Beta-blockers are medications that reduce the workload on the heart by slowing down the heart rate and lowering blood pressure. They are commonly used in the treatment of heart conditions such as hypertension and heart failure. ACE inhibitors (B) work by dilating blood vessels to reduce blood pressure, calcium channel blockers (C) prevent calcium from entering the heart muscle and blood vessel walls, and diuretics (D) help the body get rid of excess salt and water by increasing urine production.

5. Which neurotransmitter released by the parasympathetic nervous system can decrease heart rate?

• A. Acetylcholine
• B. Norepinephrine
• C. Dopamine
• D. Serotonin

Correct answer: A

Rationale: Acetylcholine is the correct answer. It is a neurotransmitter released by the parasympathetic nervous system that can decrease heart rate. Norepinephrine, dopamine, and serotonin are neurotransmitters that usually have different effects on the body and are not specifically associated with decreasing heart rate. Norepinephrine, for example, is often related to the fight-or-flight response and can increase heart rate.

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