Nursing Elites

1. The nurse is administering a beta blocker to a client with a heart rate of 50 bpm. What is the priority action?

• A. Hold the beta blocker and notify the healthcare provider.
• B. Administer the beta blocker as ordered.
• C. Decrease the dose of the beta blocker.
• D. Monitor the client’s heart rate and reassess in 30 minutes.

Correct answer: A

Rationale: The correct action is to hold the beta blocker and notify the healthcare provider. A heart rate of 50 bpm is already low, and beta blockers can further decrease the heart rate, potentially causing adverse effects like bradycardia or heart block. Administering the beta blocker as ordered (Choice B) can exacerbate the low heart rate. Decreasing the dose of the beta blocker (Choice C) may not be sufficient to address the potential harm. Monitoring the client’s heart rate and reassessing in 30 minutes (Choice D) may delay necessary interventions if the heart rate drops further. Therefore, the priority is to hold the medication and seek guidance from the healthcare provider.

2. The client on atorvastatin (Lipitor) should be advised to report which of the following symptoms?

• A. Muscle pain
• B. Headache
• C. Nausea
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Muscle pain. Muscle pain can be a sign of rhabdomyolysis, a serious side effect of statins like atorvastatin. Rhabdomyolysis is a condition where muscle fibers break down rapidly and release their contents into the bloodstream, which can lead to kidney damage. Headache, nausea, and dizziness are not commonly associated with atorvastatin use and are less likely to indicate a serious adverse reaction compared to muscle pain.

3. Which of the following is a chronic condition characterized by difficulty breathing due to airflow obstruction, commonly associated with long-term smoking?

• A. Chronic obstructive pulmonary disease (COPD)
• B. Asthma
• C. Pulmonary hypertension
• D. Bronchitis

Correct answer: A

Rationale: The correct answer is A, Chronic obstructive pulmonary disease (COPD). COPD is a chronic lung condition characterized by persistent airflow obstruction, commonly linked to long-term smoking. Choice B, Asthma, is a chronic condition characterized by reversible airflow obstruction and airway inflammation triggered by various factors like allergens and irritants. Choice C, Pulmonary hypertension, is a condition characterized by high blood pressure in the arteries of the lungs. Choice D, Bronchitis, is an inflammation of the bronchial tubes that may be acute or chronic, but it is not typically associated with long-term smoking like COPD.

4. Which of the following is a chronic inflammatory disease of the airways that causes episodes of wheezing, breathlessness, chest tightness, and coughing?

• A. Asthma
• B. Bronchitis
• C. Pneumonia
• D. Emphysema

Correct answer: A

Rationale: Asthma is the correct answer. It is a chronic inflammatory disease of the airways characterized by episodes of wheezing, breathlessness, chest tightness, and coughing. These symptoms are often triggered by allergens or exercise. Bronchitis is an inflammation of the bronchial tubes, but it is not typically chronic or involve the same triggers as asthma. Pneumonia is an infection of the lungs, and emphysema is a type of chronic obstructive pulmonary disease (COPD) often caused by smoking.

5. Which neurotransmitter released by the parasympathetic nervous system can decrease heart rate?

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

Correct answer: A

Rationale: Acetylcholine is the correct answer. It is a neurotransmitter released by the parasympathetic nervous system that can decrease heart rate. Norepinephrine, dopamine, and serotonin are neurotransmitters that usually have different effects on the body and are not specifically associated with decreasing heart rate. Norepinephrine, for example, is often related to the fight-or-flight response and can increase heart rate.

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