the nurse is administering a beta blocker to a client with a heart rate of 50 bpm what is the priority action
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Nursing Elites

ATI RN

Physical Exam Cardiovascular System

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

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. Which condition refers to the heart being unable to pump sufficient blood to meet the body's needs?

Correct answer: A

Rationale: The correct answer is A, heart failure. This condition occurs when the heart can't pump enough blood to fulfill the body's requirements. Myocardial infarction (choice B) is the medical term for a heart attack, which is caused by a blockage in the coronary arteries. Cardiomyopathy (choice C) is a disease of the heart muscle that makes it harder for the heart to pump blood. Pericarditis (choice D) is the inflammation of the pericardium, the thin sac-like membrane surrounding the heart, and does not specifically involve the heart's inability to pump sufficient blood.

3. The nurse is administering enoxaparin (Lovenox) to a client. What is the most important lab value to monitor?

Correct answer: A

Rationale: The correct answer is A: Platelet count. When administering enoxaparin, it is crucial to monitor the platelet count because enoxaparin can lead to a rare but serious side effect known as thrombocytopenia, which is a decrease in platelet levels. Monitoring the platelet count helps in detecting this adverse effect early. Choices B, C, and D are incorrect because hemoglobin, white blood cell count, and aPTT are not the most important lab values to monitor specifically for enoxaparin administration.

4. What is the condition where a blood clot blocks an artery in the lungs, causing shortness of breath, chest pain, and other symptoms?

Correct answer: A

Rationale: The correct answer is Pulmonary embolism. Pulmonary embolism occurs when a blood clot blocks an artery in the lungs, leading to symptoms like shortness of breath and chest pain. This condition is life-threatening and requires prompt treatment. Choices B, C, and D are incorrect as they refer to different medical conditions: Pneumothorax is a collapsed lung, Pleural effusion is an abnormal accumulation of fluid around the lungs, and an Aneurysm is a bulge in a blood vessel.

5. Which artery supplies the anterior wall of the left ventricle, the anterior interventricular septum, the anterior papillary muscles, and apex of the heart?

Correct answer: A

Rationale: The correct answer is the Left anterior descending artery. This artery supplies the anterior wall of the left ventricle, the anterior interventricular septum, the anterior papillary muscles, and apex of the heart. The Left circumflex artery (choice B) supplies the lateral and posterior walls of the left ventricle, the posterior descending artery (choice C) supplies the inferior part of the heart, and the aortic artery (choice D) is not a specific coronary artery.

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