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 an ACE inhibitor to a client with heart failure, what is the expected outcome of this medication?

• A. Decreased blood pressure
• B. Increased heart rate
• C. Increased cardiac output
• D. Decreased heart rate

Correct answer: C

Rationale: The correct answer is C: Increased cardiac output. ACE inhibitors are commonly used in heart failure to reduce the workload on the heart by decreasing blood pressure and increasing cardiac output. This ultimately helps improve the heart's efficiency and function. Choice A is incorrect because ACE inhibitors generally lead to a reduction in blood pressure. Choice B is incorrect as ACE inhibitors do not increase heart rate. Choice D is incorrect as ACE inhibitors do not typically decrease heart rate in the context of heart failure.

3. Which valve prevents backflow of blood into the left ventricle from the aorta?

• A. Aortic valve
• B. Mitral valve
• C. Tricuspid valve
• D. Pulmonary valve

Correct answer: A

Rationale: The correct answer is Aortic valve. The aortic valve is positioned between the left ventricle and the aorta. It prevents blood from flowing back into the left ventricle after it has been pumped into the aorta. The mitral valve (Choice B) is located between the left atrium and the left ventricle, the tricuspid valve (Choice C) is between the right atrium and right ventricle, and the pulmonary valve (Choice D) is situated between the right ventricle and the pulmonary artery. Therefore, they are not responsible for preventing backflow from the aorta into the left ventricle.

4. The nurse is caring for a client on amiodarone who complains of visual disturbances. 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. Advise the client to monitor their symptoms at home.
• D. Suggest the client reduce physical activity.

Correct answer: A

Rationale: The correct answer is to notify the healthcare provider immediately. Visual disturbances in a client taking amiodarone can indicate amiodarone toxicity, a serious side effect. Notifying the healthcare provider promptly is essential for further assessment and management. Reassuring the client that this is a common side effect (choice B) is incorrect as visual disturbances should not be dismissed without evaluation. Advising the client to monitor their symptoms at home (choice C) may delay necessary intervention. Suggesting the client reduce physical activity (choice D) is unrelated to addressing visual disturbances caused by amiodarone.

5. The nurse is giving digoxin to a client. What is the most important parameter to check before administration?

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

Correct answer: A

Rationale: The correct answer is A: Heart rate. Before administering digoxin, it is crucial to check the client's heart rate because digoxin can cause bradycardia, an abnormally slow heart rate. Monitoring the heart rate is essential to prevent potential complications associated with digoxin therapy. Choices B, C, and D are less critical parameters to assess before administering digoxin. While blood pressure is also important to monitor during digoxin therapy, the most crucial parameter to check due to the medication's potential effect on heart rate is the heart rate itself.

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