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 condition is characterized by chest pain due to reduced blood flow to the heart muscle?

• A. Angina
• B. Myocardial infarction
• C. Pericarditis
• D. Arrhythmia

Correct answer: A

Rationale: The correct answer is A, Angina. Angina is chest pain or discomfort caused by reduced blood flow to the heart muscle, often due to coronary artery disease. Choice B, Myocardial infarction, involves the death of heart muscle tissue due to a lack of blood supply, presenting with symptoms similar to angina but more severe. Pericarditis (Choice C) is inflammation of the pericardium, the sac surrounding the heart, which may cause chest pain but is not primarily due to reduced blood flow. Arrhythmia (Choice D) refers to abnormal heart rhythms but is not directly related to chest pain due to reduced blood flow.

3. The client is prescribed warfarin. What should the client be taught about this medication?

• A. Avoid foods high in vitamin K.
• B. Take the medication with food to prevent stomach upset.
• C. Take the medication at the same time every day.
• D. Increase the dose if a dose is missed.

Correct answer: A

Rationale: The correct answer is A: Avoid foods high in vitamin K. Warfarin is an anticoagulant medication, and vitamin K can counteract its effects. Therefore, it is important for clients taking warfarin to avoid foods high in vitamin K to maintain the medication's effectiveness. Choice B is incorrect because warfarin should be taken consistently as prescribed, regardless of food intake. Choice C is incorrect because while consistency in timing is important, it is not specific to the effectiveness of warfarin. Choice D is incorrect because clients should never increase the dose of warfarin on their own, especially to make up for a missed dose, as it can lead to serious bleeding risks.

4. What is a chronic inflammatory disease that affects the small airways in the lungs, leading to episodes of wheezing, breathlessness, and coughing?

• A. Asthma
• B. COPD
• C. Bronchitis
• D. Lung cancer

Correct answer: A

Rationale: Asthma is the correct answer. It is a chronic inflammatory disease that affects the small airways in the lungs, leading to symptoms like wheezing, breathlessness, and coughing. Asthma is commonly triggered by allergens, exercise, respiratory infections, and other factors. Choice B, COPD (Chronic Obstructive Pulmonary Disease), is characterized by airflow limitation and is often caused by smoking. Choice C, Bronchitis, is an inflammation of the bronchial tubes and can be acute or chronic. Choice D, Lung cancer, is a disease characterized by uncontrolled cell growth in lung tissues and is commonly associated with smoking or environmental factors.

5. Which neurotransmitter is released by the sympathetic nervous system (SNS) to increase heart rate and the force of contraction of the heart?

• A. Norepinephrine
• B. Epinephrine
• C. Dopamine
• D. Acetylcholine

Correct answer: A

Rationale: The correct answer is Norepinephrine. Norepinephrine is the neurotransmitter released by the sympathetic nervous system that increases heart rate and the force of contraction. Epinephrine, though similar, is more involved in the fight-or-flight response and has a broader range of effects on various organs. Dopamine is not primarily responsible for increasing heart rate and contractility. Acetylcholine is a neurotransmitter that predominantly acts on the parasympathetic nervous system to decrease heart rate and contractility.

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