Nursing Elites

1. The client is receiving digoxin and has a potassium level of 2.8 mEq/L. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Increase the dose of digoxin.
• C. Continue the current dose of digoxin.
• D. Administer potassium supplements.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 2.8 mEq/L indicates hypokalemia, which can increase the risk of digoxin toxicity. Holding the medication and informing the healthcare provider is crucial to prevent adverse effects. Choice B is incorrect because increasing the dose of digoxin would further raise the risk of toxicity. Choice C is incorrect as continuing the current dose could exacerbate the toxicity risk. Choice D is incorrect because administering potassium supplements alone is not sufficient to address the potential digoxin toxicity; the first step should be to hold the digoxin and seek further guidance.

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 is the condition where the blood flow through the coronary arteries is reduced or blocked, leading to chest pain or heart attack?

• A. Coronary artery disease
• B. Atherosclerosis
• C. Pulmonary embolism
• D. Pulmonary hypertension

Correct answer: A

Rationale: The correct answer is A, Coronary artery disease (CAD). CAD occurs when the coronary arteries are narrowed or blocked, reducing blood flow to the heart muscle and increasing the risk of chest pain or heart attack. Choice B, Atherosclerosis, is a condition characterized by the hardening and narrowing of arteries due to the buildup of plaque. Choices C and D, Pulmonary embolism and Pulmonary hypertension, involve issues related to the lungs and not the coronary arteries.

4. The client on amiodarone reports shortness of breath. What is the nurse’s best response?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect.
• C. Instruct the client to monitor their symptoms at home.
• D. Suggest the client reduce physical activity.

Correct answer: A

Rationale: When a client on amiodarone reports shortness of breath, it can be indicative of pulmonary toxicity, a severe side effect associated with this medication. The nurse's priority is to notify the healthcare provider immediately to assess the situation and determine the appropriate course of action. Choice B is incorrect because shortness of breath with amiodarone should not be dismissed as a common side effect. Instructing the client to monitor symptoms at home (Choice C) may delay necessary intervention. Suggesting the client reduce physical activity (Choice D) does not address the potential serious nature of the symptom and the need for prompt evaluation.

5. What is the amount of tension the ventricle must develop during contraction to eject blood from the left ventricle into the aorta?

• A. Afterload
• B. Preload
• C. Automaticity
• D. Ejection fraction

Correct answer: A

Rationale: Afterload is the correct answer because it refers to the pressure or tension that the ventricle must overcome during systole to eject blood into the aorta. Preload, on the other hand, is the degree of stretch of the ventricular muscle at the end of diastole before it contracts. Automaticity is the ability of the heart to generate electrical impulses independently, and ejection fraction is the percentage of blood pumped out of the ventricle with each heartbeat. Therefore, in the context of the question, afterload best describes the amount of tension the ventricle must develop to eject blood into the aorta.

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