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. Which medication is used to lower high blood pressure and reduce the risk of heart attacks and strokes?

• A. ACE inhibitor
• B. Beta-blocker
• C. Diuretic
• D. Calcium channel blocker

Correct answer: A

Rationale: The correct answer is an ACE inhibitor. ACE inhibitors are medications specifically designed to lower high blood pressure and reduce the risk of heart attacks, strokes, and other cardiovascular events. Beta-blockers, diuretics, and calcium channel blockers are also used to treat high blood pressure, but ACE inhibitors are particularly effective in reducing the risk of heart attacks and strokes.

3. When administering dobutamine to a client, what is the most important parameter to assess?

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

Correct answer: A

Rationale: When giving dobutamine, the most critical parameter to assess is blood pressure. Dobutamine is known to cause significant changes in blood pressure, making it essential to closely monitor this parameter to prevent adverse effects. While heart rate is also important to monitor, blood pressure takes precedence due to the potential for hemodynamic instability caused by dobutamine. Oxygen saturation and respiratory rate, although vital signs to monitor, are not typically affected directly by dobutamine administration.

4. The nurse is caring for a client on heparin. What is the most important lab value to monitor?

• A. aPTT
• B. INR
• C. Platelet count
• D. Hemoglobin

Correct answer: A

Rationale: The correct answer is A: aPTT. When a client is on heparin therapy, monitoring the aPTT is crucial. The aPTT helps assess the effectiveness of heparin in preventing blood clots and guides dose adjustments as needed. INR (Choice B) is more commonly used to monitor warfarin therapy. Platelet count (Choice C) is important to assess for potential bleeding disorders or thrombocytopenia but is not the primary lab value to monitor for heparin therapy. Hemoglobin (Choice D) is essential for assessing oxygen-carrying capacity but is not the most important lab value to monitor when a client is on heparin.

5. What is the condition where the heart's mitral valve becomes narrowed, restricting blood flow from the left atrium to the left ventricle?

• A. Mitral stenosis
• B. Aortic stenosis
• C. Tricuspid regurgitation
• D. Pulmonary hypertension

Correct answer: A

Rationale: Mitral stenosis is the correct answer. It is a condition characterized by the narrowing of the heart's mitral valve, which hinders the flow of blood from the left atrium to the left ventricle. This obstruction can lead to symptoms such as shortness of breath and fatigue. Aortic stenosis (choice B) is the narrowing of the aortic valve, not the mitral valve. Tricuspid regurgitation (choice C) is the backflow of blood through the tricuspid valve, not narrowing. Pulmonary hypertension (choice D) is increased blood pressure in the pulmonary arteries, not narrowing of the mitral valve.

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