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. When administering dobutamine to a client, what is the most important parameter to assess?

• A. Blood pressure
• B. Heart rate
• C. Oxygen saturation
• D. Respiratory rate

Correct answer: A

Rationale: When giving dobutamine, the most critical parameter to assess is blood pressure. Dobutamine is known to cause significant changes in blood pressure, making it essential to closely monitor this parameter to prevent adverse effects. While heart rate is also important to monitor, blood pressure takes precedence due to the potential for hemodynamic instability caused by dobutamine. Oxygen saturation and respiratory rate, although vital signs to monitor, are not typically affected directly by dobutamine administration.

3. The healthcare provider is preparing to administer heparin to a client. What lab value should be monitored?

• A. PT/INR
• B. aPTT
• C. Platelet count
• D. Hemoglobin

Correct answer: B

Rationale: The correct lab value that should be monitored when administering heparin is the aPTT (activated partial thromboplastin time). Heparin affects the intrinsic pathway of the coagulation cascade, and aPTT is a sensitive measure to assess the effectiveness of heparin therapy. Monitoring aPTT helps in adjusting the heparin dose to maintain the desired anticoagulant effect. PT/INR is more specific to monitor warfarin therapy, not heparin. Platelet count and hemoglobin levels are important parameters to assess bleeding tendencies and oxygen-carrying capacity but are not directly related to monitoring heparin therapy.

4. What is a condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle?

• A. Coronary artery disease (CAD)
• B. Atherosclerosis
• C. Stroke
• D. Peripheral artery disease

Correct answer: A

Rationale: The correct answer is A, Coronary artery disease (CAD). CAD is a condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle and an increased risk of heart attack. Choice B, Atherosclerosis, is a related condition involving the buildup of fats, cholesterol, and other substances in and on the artery walls, but it is not specific to the coronary arteries. Choices C and D, Stroke and Peripheral artery disease, respectively, involve different arteries and conditions, not directly related to the narrowing or blockage of the coronary arteries.

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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