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 administering nitroglycerin IV to a client with chest pain. What is the most important parameter to monitor?

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

Correct answer: A

Rationale: The correct answer is A: Blood pressure. When administering nitroglycerin IV to a client with chest pain, monitoring blood pressure is crucial as nitroglycerin can cause significant hypotension. While heart rate, oxygen saturation, and respiratory rate are important parameters to assess, blood pressure takes precedence in this scenario due to the potential hypotensive effects of nitroglycerin.

3. What is a chronic condition where the blood pressure in the arteries is persistently elevated, increasing the risk of heart disease and stroke?

• A. Hypertension
• B. Hypotension
• C. Hyperlipidemia
• D. Hyperglycemia

Correct answer: A

Rationale: Hypertension, also known as high blood pressure, is a chronic condition characterized by persistently elevated pressure in the arteries. This condition increases the risk of heart disease, stroke, and other health issues. Hypotension (choice B) refers to low blood pressure and is not the correct answer. Hyperlipidemia (choice C) is high levels of fats in the blood, not related to blood pressure. Hyperglycemia (choice D) is high blood sugar levels, not directly related to elevated blood pressure.

4. Which condition is characterized by the sudden onset of shortness of breath, often occurring at night and associated with heart failure?

• A. Paroxysmal nocturnal dyspnea
• B. Sleep apnea
• C. Orthopnea
• D. Dyspnea

Correct answer: A

Rationale: Paroxysmal nocturnal dyspnea is the correct answer. It is characterized by the sudden onset of shortness of breath during sleep, often associated with heart failure. Choice B, Sleep apnea, involves pauses in breathing during sleep but is not specifically associated with heart failure. Choice C, Orthopnea, is difficulty breathing that occurs when lying down and is relieved by sitting up, not necessarily associated with heart failure. Choice D, Dyspnea, is a general term for difficulty breathing and does not specifically describe the sudden onset at night associated with heart failure as seen in paroxysmal nocturnal dyspnea.

5. What is the condition where the lung collapses due to air leaking into the space between the lung and chest wall?

• A. Pneumothorax
• B. Pleural effusion
• C. Pulmonary fibrosis
• D. Lung cancer

Correct answer: A

Rationale: Pneumothorax is the correct answer. It is the collapse of a lung due to air leaking into the space between the lung and chest wall. This condition often requires emergency treatment. Choice B, Pleural effusion, is the buildup of excess fluid between the layers of the pleura outside the lung, not air. Choice C, Pulmonary fibrosis, is a lung disease characterized by scarring and thickening of lung tissue, not related to lung collapse. Choice D, Lung cancer, is the uncontrolled growth of abnormal cells in the lung, not directly causing lung collapse.

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