Nursing Elites

1. The nurse is administering digoxin to a client with a heart rate of 45 bpm. What is the nurse’s priority action?

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

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A heart rate of 45 bpm is already low, and digoxin can further decrease the heart rate, leading to serious complications like bradycardia or heart block. Administering the medication can exacerbate the bradycardia, hence it should be withheld. Increasing the dose of digoxin is contraindicated due to the client's low heart rate. Monitoring the heart rate alone without taking immediate action to withhold the medication is not the priority when faced with the risk of further lowering the heart rate.

2. The nurse is caring for a heart client on digoxin and notes a potassium level of 2.5. What is the appropriate priority nursing intervention?

• A. Do nothing as this is a normal potassium level.
• B. The potassium level is low so the nurse asks for an order for potassium.
• C. The nurse asks to check the digoxin level as low potassium can increase digoxin toxicity.
• D. The nurse stops the digoxin.

Correct answer: C

Rationale: The correct answer is C. When caring for a client on digoxin with a low potassium level, the priority nursing intervention is to check the digoxin level. Low potassium can increase the risk of digoxin toxicity. Checking the digoxin level will help determine if any adjustments to the medication regimen are needed to prevent potential harm. Choice A is incorrect as a potassium level of 2.5 is low, not normal. Choice B is not the priority as simply giving potassium may not address the underlying issue of potential digoxin toxicity. Choice D is not the initial action to take without assessing the digoxin level first.

3. What is a surgical procedure to redirect blood flow around a blocked or narrowed artery, often involving the use of a graft from another part of the body?

• A. Coronary artery bypass graft (CABG)
• B. Valve replacement
• C. Aneurysm repair
• D. Atherectomy

Correct answer: A

Rationale: The correct answer is A: Coronary artery bypass graft (CABG). This surgical procedure is used to redirect blood flow around a blocked or narrowed artery by using a graft from another part of the body. Choices B, C, and D are incorrect because valve replacement involves replacing heart valves, aneurysm repair addresses the treatment of aneurysms, and atherectomy is a procedure to remove plaque from blood vessels, none of which match the description provided in the question.

4. Which type of medication helps to lower cholesterol levels in the blood?

• A. Statins
• B. Beta-blockers
• C. ACE inhibitors
• D. Diuretics

Correct answer: A

Rationale: Statins are a type of medication specifically designed to lower cholesterol levels in the blood by inhibiting an enzyme involved in cholesterol production. Beta-blockers are mainly used to treat conditions like high blood pressure and heart problems by reducing the heart rate and workload. ACE inhibitors are used to manage conditions like high blood pressure and heart failure by relaxing blood vessels. Diuretics are medications that help the body get rid of excess salt and water by increasing urine production. Therefore, in the context of lowering cholesterol levels, statins are the most appropriate choice.

5. What test measures the pressure in the arteries during the contraction and relaxation of the heart?

• A. Blood pressure test
• B. Electrocardiogram (ECG or EKG)
• C. Spirometry
• D. Pulse oximetry

Correct answer: A

Rationale: The correct answer is 'Blood pressure test.' This test measures the pressure in the arteries during the contraction (systolic) and relaxation (diastolic) phases of the heart, providing important information about heart health. Choice B, 'Electrocardiogram (ECG or EKG),' records the heart's electrical activity and is not specifically related to measuring arterial pressure. Choice C, 'Spirometry,' assesses lung function by measuring airflow. Choice D, 'Pulse oximetry,' measures oxygen saturation in the blood, not arterial pressure.

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