Nursing Elites

1. The client on a beta blocker has a blood pressure of 88/58 mm Hg. What is the nurse’s priority action?

• A. Hold the beta blocker and notify the healthcare provider.
• B. Administer the beta blocker as ordered.
• C. Increase the dose of the beta blocker.
• D. Continue to monitor the client and reassess in 30 minutes.

Correct answer: A

Rationale: The correct action for the nurse to take when a client on a beta blocker presents with a blood pressure of 88/58 mm Hg is to hold the beta blocker and notify the healthcare provider. Beta blockers can further decrease blood pressure, which is already low in this case. Administering the beta blocker as ordered (Choice B) would exacerbate the hypotension. Increasing the dose of the beta blocker (Choice C) would be inappropriate and unsafe given the low blood pressure. Continuing to monitor the client and reassessing in 30 minutes (Choice D) could lead to a delay in necessary intervention. Therefore, the priority is to hold the medication and seek guidance from the healthcare provider.

2. Which of the following is a central vasoconstrictor and peripheral vasodilator?

• A. Parasympathetic nervous system
• B. Sympathetic nervous system
• C. Dopamine
• D. Epinephrine

Correct answer: D

Rationale: The correct answer is D, Epinephrine. Epinephrine acts as a central vasoconstrictor and peripheral vasodilator. It increases heart rate and blood flow to muscles, helping to prepare the body for a 'fight or flight' response. Parasympathetic nervous system (choice A) does not cause vasoconstriction but rather vasodilation. The sympathetic nervous system (choice B) is primarily responsible for the fight or flight response, causing vasoconstriction. Dopamine (choice C) primarily acts as a neurotransmitter and hormone, not directly causing central vasoconstriction and peripheral vasodilation.

3. Which condition involves the enlargement and weakening of the left ventricle of the heart, leading to reduced pumping ability?

• A. Dilated cardiomyopathy
• B. Hypertrophic cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Pericarditis

Correct answer: A

Rationale: The correct answer is A: Dilated cardiomyopathy. Dilated cardiomyopathy is characterized by the enlargement and weakening of the left ventricle of the heart, which results in a reduced ability to pump blood effectively. Choice B, Hypertrophic cardiomyopathy, involves thickening of the heart muscle, not enlargement. Choice C, Restrictive cardiomyopathy, is characterized by stiffening of the heart muscle, not enlargement. Choice D, Pericarditis, refers to inflammation of the pericardium, the lining surrounding the heart, and does not involve enlargement and weakening of the left ventricle.

4. What is the amount of blood the heart pumps through the circulatory system in a minute?

• A. Cardiac output
• B. Stroke volume
• C. End-diastolic volume
• D. Ejection fraction

Correct answer: A

Rationale: The correct answer is A: Cardiac output. Cardiac output is the volume of blood pumped by the heart per minute. It is calculated by multiplying the stroke volume (the amount of blood pumped out of the heart in each beat) by the heart rate (number of heartbeats per minute). This question specifically asks for the total amount of blood pumped through the circulatory system in a minute, which is represented by cardiac output. Choices B, C, and D are incorrect because stroke volume refers to the amount of blood pumped out of the heart in each beat, end-diastolic volume is the volume of blood in the heart at the end of diastole, and ejection fraction is the percentage of blood pumped out of the heart with each contraction, not the total amount pumped per minute.

5. The client is on digoxin and has severe digoxin toxicity. What is the nursing priority action?

• A. Check the potassium level.
• B. Give Digibind as an antidote.
• C. Change the dosing of digoxin to every other day.
• D. Administer a potassium supplement to decrease digoxin toxicity.

Correct answer: B

Rationale: The correct answer is to give Digibind as an antidote in cases of severe digoxin toxicity. Digibind works by binding to digoxin and preventing it from causing further harm. Checking the potassium level (choice A) is important but not the priority when the client has severe toxicity. Changing the dosing to every other day (choice C) is not appropriate in the setting of severe toxicity where immediate action is required. Giving a potassium supplement (choice D) may be needed eventually, but the priority is to administer Digibind to counteract the toxic effects of digoxin.

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