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 test measures the pressure inside the arteries as the heart pumps blood?

• A. Blood pressure test
• B. Pulse oximetry
• C. Echocardiogram
• D. Spirometry

Correct answer: A

Rationale: The correct answer is A) Blood pressure test. A blood pressure test is specifically designed to measure the pressure inside the arteries as the heart pumps blood. This test is crucial in providing information about cardiovascular health by determining the force of blood against the artery walls. Choice B, Pulse oximetry, measures oxygen saturation in the blood, not blood pressure. Choice C, Echocardiogram, is an ultrasound test that evaluates the structure and function of the heart, not specifically blood pressure. Choice D, Spirometry, is a test used to assess lung function, not blood pressure.

3. The client is receiving digoxin and has a potassium level of 2.8 mEq/L. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Increase the dose of digoxin.
• C. Continue the current dose of digoxin.
• D. Administer potassium supplements.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 2.8 mEq/L indicates hypokalemia, which can increase the risk of digoxin toxicity. Holding the medication and informing the healthcare provider is crucial to prevent adverse effects. Choice B is incorrect because increasing the dose of digoxin would further raise the risk of toxicity. Choice C is incorrect as continuing the current dose could exacerbate the toxicity risk. Choice D is incorrect because administering potassium supplements alone is not sufficient to address the potential digoxin toxicity; the first step should be to hold the digoxin and seek further guidance.

4. What does the PR interval measure?

• A. Time it takes for the electrical impulse to travel from the atria to the ventricles
• B. Measurement of ventricular depolarization
• C. Duration of ventricular repolarization
• D. Segment representing the time between ventricular depolarization and repolarization

Correct answer: A

Rationale: The PR interval measures the time it takes for the electrical impulse to travel from the atria to the ventricles. It is crucial in diagnosing heart rhythm disorders, as abnormalities in this interval can indicate conduction abnormalities between the atria and ventricles. Choices B, C, and D are incorrect. The QRS complex represents ventricular depolarization, the QT interval represents the duration of ventricular repolarization, and the ST segment represents the time between ventricular depolarization and repolarization.

5. 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.

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