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. What is a condition where the arteries that supply blood to the heart muscle become hardened and narrowed due to the buildup of plaque?

• A. Atherosclerosis
• B. Aneurysm
• C. Arrhythmia
• D. Peripheral artery disease

Correct answer: A

Rationale: Atherosclerosis is the correct answer. It is a condition characterized by the hardening and narrowing of arteries supplying blood to the heart due to plaque buildup. This condition increases the risk of heart attacks. Choice B, aneurysm, refers to a balloon-like bulge in an artery, not the hardening and narrowing of arteries. Choice C, arrhythmia, is an irregular heartbeat and not related to arterial hardening. Choice D, peripheral artery disease, involves the narrowing of arteries that supply blood to the limbs, not specifically to the heart.

3. What is a chronic condition where the heart is unable to pump blood efficiently, leading to fluid buildup in the lungs and other parts of the body?

• A. Heart failure
• B. Cardiomyopathy
• C. Pericarditis
• D. Aortic stenosis

Correct answer: A

Rationale: Heart failure is the correct answer. It is a chronic condition characterized by the heart's inability to pump blood efficiently, resulting in symptoms like fluid buildup in the lungs and other parts of the body, shortness of breath, fatigue, and fluid retention. Cardiomyopathy (choice B) refers to diseases of the heart muscle, but it is a broader category that includes various conditions affecting the heart muscle. Pericarditis (choice C) is the inflammation of the pericardium, the sac surrounding the heart, and aortic stenosis (choice D) is a condition where the aortic valve narrows, restricting blood flow from the heart.

4. What procedure is used to remove fluid from the pleural space to help a patient breathe more easily?

• A. Thoracentesis
• B. Bronchoscopy
• C. Echocardiogram
• D. CT scan

Correct answer: A

Rationale: Thoracentesis is the correct answer. It is a procedure where a needle is inserted into the pleural space to drain fluid, relieving pressure and helping the patient breathe more easily. Bronchoscopy (choice B) is a procedure used to examine the airways, not to drain fluid. An echocardiogram (choice C) is an imaging test to assess the heart's structure and function, not related to draining pleural fluid. A CT scan (choice D) is a cross-sectional imaging test that provides detailed pictures of the inside of the body, not used for draining pleural fluid.

5. Which type of medication is used to reduce the workload on the heart by slowing down the heart rate and lowering blood pressure?

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

Correct answer: A

Rationale: The correct answer is A: Beta-blocker. Beta-blockers are medications that reduce the workload on the heart by slowing down the heart rate and lowering blood pressure. They are commonly used in the treatment of heart conditions such as hypertension and heart failure. ACE inhibitors (B) work by dilating blood vessels to reduce blood pressure, calcium channel blockers (C) prevent calcium from entering the heart muscle and blood vessel walls, and diuretics (D) help the body get rid of excess salt and water by increasing urine production.

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