Nursing Elites

1. The client is receiving digoxin and complains of nausea. What is the nurse’s priority action?

• A. Check the client’s digoxin level.
• B. Continue the current dose of digoxin.
• C. Administer an antiemetic for nausea.
• D. Discontinue the digoxin immediately.

Correct answer: A

Rationale: The correct answer is to check the client’s digoxin level (Choice A). Nausea can be a sign of digoxin toxicity, so assessing the digoxin level is crucial to determine if the medication dosage needs adjustment. Continuing the current dose of digoxin (Choice B) may worsen the symptoms if toxicity is present. Administering an antiemetic (Choice C) may provide temporary relief but does not address the underlying issue of digoxin toxicity. Discontinuing digoxin immediately (Choice D) without assessing the digoxin level can be harmful if the medication is within the therapeutic range.

2. What is a condition where the heart's electrical impulses are delayed or blocked, leading to a slower or irregular heartbeat?

• A. Heart block
• B. Tachycardia
• C. Bradycardia
• D. Arrhythmia

Correct answer: A

Rationale: Heart block is the correct answer because it specifically refers to a condition where the heart's electrical impulses are delayed or blocked, resulting in a slower or irregular heartbeat. Tachycardia (choice B) is a condition characterized by a fast heart rate, Bradycardia (choice C) is a slow heart rate, and Arrhythmia (choice D) is a general term used to describe any abnormal heart rhythm, which may or may not involve delays or blocks in electrical impulses.

3. Which type of heart disease involves the stiffening of the heart muscle, reducing its ability to relax and fill with blood?

• A. Restrictive cardiomyopathy
• B. Hypertrophic cardiomyopathy
• C. Dilated cardiomyopathy
• D. Ventricular hypertrophy

Correct answer: A

Rationale: The correct answer is A, restrictive cardiomyopathy. This condition specifically involves the stiffening of the heart muscle, leading to a reduced ability to relax and fill with blood between beats. Choice B, hypertrophic cardiomyopathy, is characterized by abnormal thickening of the heart muscle, not stiffening. Choice C, dilated cardiomyopathy, involves the enlargement and weakening of the heart chambers, not stiffening. Choice D, ventricular hypertrophy, refers to the thickening of the walls of the heart's pumping chambers but does not specifically involve the stiffening that is characteristic of restrictive cardiomyopathy.

4. The client on nitroglycerin patches reports dizziness when standing up. What is the nurse’s best response?

• A. Advise the client to rise slowly to prevent dizziness.
• B. Instruct the client to discontinue the nitroglycerin patches.
• C. Encourage the client to rest and avoid physical activity.
• D. Suggest the client take an over-the-counter antiemetic.

Correct answer: A

Rationale: The correct answer is to advise the client to rise slowly to prevent dizziness. Dizziness when standing up can be a sign of orthostatic hypotension, a common side effect of nitroglycerin. Rising slowly can help minimize this symptom. Instructing the client to discontinue the nitroglycerin patches (Choice B) is not appropriate without consulting a healthcare provider as sudden discontinuation can lead to adverse effects. Encouraging the client to rest and avoid physical activity (Choice C) does not address the specific issue of orthostatic hypotension. Suggesting the client take an over-the-counter antiemetic (Choice D) is not indicated for dizziness related to orthostatic hypotension.

5. What is a surgical procedure to redirect blood flow around a blocked or narrowed artery, often involving the use of a graft from another part of the body?

• A. Coronary artery bypass graft (CABG)
• B. Valve replacement
• C. Aneurysm repair
• D. Atherectomy

Correct answer: A

Rationale: The correct answer is A: Coronary artery bypass graft (CABG). This surgical procedure is used to redirect blood flow around a blocked or narrowed artery by using a graft from another part of the body. Choices B, C, and D are incorrect because valve replacement involves replacing heart valves, aneurysm repair addresses the treatment of aneurysms, and atherectomy is a procedure to remove plaque from blood vessels, none of which match the description provided in the question.

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