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 is unable to relax properly between beats, reducing its ability to fill with blood?

• A. Diastolic heart failure
• B. Systolic heart failure
• C. Hypertrophic cardiomyopathy
• D. Restrictive cardiomyopathy

Correct answer: A

Rationale: The correct answer is A: Diastolic heart failure. In diastolic heart failure, the heart is unable to relax properly between beats, leading to a reduced ability to fill with blood. This condition primarily affects the heart's filling function rather than its pumping function, which is characteristic of systolic heart failure (choice B). Hypertrophic cardiomyopathy (choice C) involves the abnormal thickening of the heart muscle, while restrictive cardiomyopathy (choice D) is characterized by the heart muscle becoming stiff and less compliant. Therefore, choices B, C, and D are incorrect in the context of a heart condition where relaxation between beats is impaired.

3. What is a procedure to remove fluid or air from the pleural space to help a patient breathe easier?

• A. Thoracentesis
• B. Bronchoscopy
• C. Chest X-ray
• D. CT scan

Correct answer: A

Rationale: Correct! Thoracentesis is the correct answer. It is a procedure where fluid or air is removed from the pleural space in the chest to help the patient breathe more easily. Bronchoscopy (choice B) is a procedure to visualize the airways, while Chest X-ray (choice C) and CT scan (choice D) are imaging tests and do not involve the removal of fluid or air from the pleural space.

4. What procedure uses a catheter to open up a blocked or narrowed coronary artery, often involving the placement of a stent?

• A. Angioplasty
• B. Echocardiogram
• C. CT angiography
• D. Coronary artery bypass graft (CABG)

Correct answer: A

Rationale: The correct answer is Angioplasty. Angioplasty is a procedure that uses a catheter to open up a blocked or narrowed coronary artery, often involving the placement of a stent. Echocardiogram is a diagnostic test that uses sound waves to create images of the heart. CT angiography is a type of imaging test that looks at blood vessels, but it does not involve the placement of a stent. Coronary artery bypass graft (CABG) is a surgical procedure to improve blood flow to the heart muscle by bypassing blocked coronary arteries.

5. The client on enoxaparin (Lovenox) is scheduled for surgery. What is the nurse’s priority action?

• A. Hold the enoxaparin and notify the healthcare provider.
• B. Administer the enoxaparin as scheduled.
• C. Administer vitamin K before the surgery.
• D. Monitor the client’s INR and proceed with surgery.

Correct answer: A

Rationale: The correct answer is A: Hold the enoxaparin and notify the healthcare provider. Enoxaparin, being an anticoagulant, should be held before surgery to reduce the risk of excessive bleeding during the procedure. It is crucial to inform the healthcare provider to determine the appropriate management plan. Choice B is incorrect because administering enoxaparin before surgery can increase the risk of bleeding. Choice C is incorrect as vitamin K administration is not typically indicated in this situation. Choice D is incorrect because monitoring the client's INR and proceeding with surgery without addressing the enoxaparin can lead to significant bleeding complications.

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