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. The client has a prescription for sublingual nitroglycerin. What is the nurse's instruction for how to take this medication during an episode of chest pain?

• A. Take one tablet every 5 minutes, up to three tablets.
• B. Take one tablet every hour until the pain subsides.
• C. Take two tablets immediately if chest pain occurs.
• D. Take one tablet with a full glass of water.

Correct answer: A

Rationale: The correct answer is A. The standard instruction for sublingual nitroglycerin during an episode of chest pain is to take one tablet every 5 minutes, up to three tablets. If the pain persists after taking three tablets, the client should seek emergency help. Choice B is incorrect because taking one tablet every hour is not the appropriate dosing for acute chest pain. Choice C is incorrect as taking two tablets immediately is not in line with the recommended dosing instructions. Choice D is incorrect because sublingual nitroglycerin should be placed under the tongue, not swallowed with water.

3. In cases of myocardial infarction leading to shock, which medication is appropriate to counteract shock?

• A. Atropine
• B. Dopamine
• C. Digoxin
• D. Adenosine

Correct answer: B

Rationale: In cases of myocardial infarction leading to shock, dopamine is the drug of choice. Dopamine helps increase blood pressure and improve blood flow to vital organs, making it beneficial in managing shock. Atropine is mainly used for symptomatic bradycardia, not for shock. Digoxin is a cardiac glycoside used in heart failure and atrial fibrillation, not for managing shock. Adenosine is typically used for diagnosing and treating supraventricular tachycardias, not for shock associated with myocardial infarction.

4. What is an infection that causes inflammation in the air sacs of one or both lungs, which may fill with fluid or pus?

• A. Pneumonia
• B. Tuberculosis
• C. Pleurisy
• D. Pulmonary edema

Correct answer: A

Rationale: The correct answer is A, Pneumonia. Pneumonia is an infection that inflames the air sacs in one or both lungs, which may fill with fluid or pus, causing symptoms like cough, fever, chills, and difficulty breathing. Tuberculosis (B) is a bacterial infection that primarily affects the lungs but is caused by a different bacterium. Pleurisy (C) is inflammation of the tissues that line the lungs and chest cavity, not the air sacs. Pulmonary edema (D) is a condition where fluid accumulates in the lungs' air sacs but is often due to heart problems rather than an infection.

5. The healthcare provider is monitoring a client on an ACE inhibitor. What lab value is most important to monitor?

• A. Potassium
• B. Sodium
• C. Creatinine
• D. Calcium

Correct answer: A

Rationale: The correct answer is A: Potassium. When a client is on an ACE inhibitor, it is crucial to monitor potassium levels because ACE inhibitors can lead to an increase in potassium, potentially causing hyperkalemia. Monitoring sodium levels (Choice B) is not as critical in this scenario. Creatinine levels (Choice C) are important for assessing kidney function but are not the most crucial lab value to monitor with ACE inhibitors. Calcium levels (Choice D) are not directly affected by ACE inhibitors and are not the priority for monitoring in this case.

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