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. This term refers to a change in the inotropic state of the muscle without a change in myocardial fiber length.

• A. Contractility
• B. Excitability
• C. Refractoriness
• D. Automaticity

Correct answer: A

Rationale: The correct answer is A: Contractility. Contractility specifically refers to the change in the force of contraction of the heart muscle without changing its length. In this scenario, the focus is on the change in the inotropic state of the muscle, which directly relates to contractility. Choice B, Excitability, refers to the ability of a cell to respond to a stimulus, not specifically related to changes in contractile force. Choice C, Refractoriness, pertains to the period during which a cell is unresponsive to a new stimulus. Choice D, Automaticity, refers to the ability of cardiac cells to spontaneously generate electrical impulses.

3. What is a condition where the walls of the arteries in the lungs become thickened and stiff, leading to increased blood pressure in the pulmonary arteries?

• A. Pulmonary hypertension
• B. Pulmonary fibrosis
• C. Pulmonary embolism
• D. Pulmonary edema

Correct answer: A

Rationale: Pulmonary hypertension is a condition characterized by the thickening and stiffening of the arteries in the lungs, resulting in elevated blood pressure in the pulmonary arteries. This condition is distinct from the other choices provided. Pulmonary fibrosis involves scarring of lung tissue, pulmonary embolism is a blockage in the pulmonary artery, and pulmonary edema is the accumulation of fluid in the lungs.

4. The client on furosemide is at risk for which electrolyte imbalance?

• A. Hypokalemia
• B. Hypernatremia
• C. Hyperkalemia
• D. Hyponatremia

Correct answer: A

Rationale: The correct answer is A: Hypokalemia. Furosemide is a loop diuretic that can lead to potassium loss, resulting in hypokalemia. This electrolyte imbalance is a significant risk associated with the use of diuretics. Choice B, Hypernatremia, is incorrect as furosemide is not known to cause high sodium levels. Choice C, Hyperkalemia, is also incorrect as furosemide tends to cause potassium depletion rather than excess. Choice D, Hyponatremia, is not directly related to furosemide use.

5. What test measures the oxygen level in the blood, often used to monitor patients with respiratory or cardiovascular conditions?

• A. Pulse oximetry
• B. Arterial blood gas (ABG)
• C. Echocardiogram
• D. Chest X-ray

Correct answer: A

Rationale: The correct answer is A, Pulse oximetry. Pulse oximetry is a non-invasive test that measures the oxygen saturation level in the blood, commonly used to monitor respiratory and cardiovascular health. Arterial blood gas (ABG) measures the levels of oxygen and carbon dioxide in the blood, providing more detailed information than pulse oximetry. Echocardiogram is an ultrasound test used to visualize the heart's structure and function, while a chest X-ray is used to visualize the structures in the chest, such as the heart, lungs, and bones.

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