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. 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.

3. Which disease is characterized by the damage to the alveoli in the lungs, leading to breathlessness?

• A. Emphysema
• B. Pulmonary fibrosis
• C. Lung cancer
• D. Lung abscess

Correct answer: A

Rationale: The correct answer is A, Emphysema. Emphysema is a lung condition characterized by the damage to the air sacs (alveoli) in the lungs, which results in breathlessness and reduced lung function. Pulmonary fibrosis (B) is a condition where lung tissue becomes damaged and scarred, leading to stiffness in the lungs. Lung cancer (C) is a malignancy affecting the lungs, which can cause various symptoms depending on the stage. Lung abscess (D) is a localized collection of pus within the lung tissue, typically caused by a bacterial infection.

4. Which term describes a type of abnormal heart rhythm characterized by rapid and irregular beating of the atria?

• A. Atrial fibrillation
• B. Ventricular fibrillation
• C. Atrial flutter
• D. Sinus tachycardia

Correct answer: A

Rationale: The correct answer is Atrial fibrillation. Atrial fibrillation is indeed a type of abnormal heart rhythm characterized by rapid and irregular beating of the atria. This condition can increase the risk of stroke and heart failure. Choice B, Ventricular fibrillation, is incorrect because it refers to a life-threatening arrhythmia that occurs in the ventricles, not the atria. Choice C, Atrial flutter, is incorrect as it describes a different type of atrial arrhythmia characterized by a regular but fast heartbeat. Choice D, Sinus tachycardia, is incorrect because it is a normal increase in heart rate originating from the sinus node, not an abnormal rhythm.

5. What term describes the phenomenon wherein decreased BP causes a reflex SNS response with increased pulse, increased contractility, and vasoconstriction; and increased BP causes reflex vagal responses resulting in decreased heart rate and passive vasodilation in the systemic arterioles?

• A. Baroreflex
• B. Cheyne-Stokes breathing
• C. Frank-Starling Law
• D. Starling reflex

Correct answer: A

Rationale: The correct answer is A: Baroreflex. The Baroreflex is a mechanism by which the body maintains blood pressure homeostasis through reflexive adjustments in heart rate and vascular tone. Choice B, Cheyne-Stokes breathing, is a pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing. Choices C and D, Frank-Starling Law and Starling reflex, are related to the intrinsic ability of the heart to adjust its output based on venous return, not specifically regulating blood pressure through reflex adjustments in heart rate and vascular tone as seen in the described phenomenon.

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