Nursing Elites

1. The nurse is caring for a client on digoxin. What is the most important assessment before administering this medication?

• A. Check the client’s heart rate.
• B. Check the client’s blood pressure.
• C. Check the client’s respiratory rate.
• D. Check the client’s oxygen saturation.

Correct answer: A

Rationale: The correct answer is to check the client’s heart rate before administering digoxin because one of the side effects of digoxin is bradycardia. Monitoring the heart rate is crucial to assess whether the client's heart rate is within the acceptable range before giving the medication. Checking the blood pressure (Choice B), respiratory rate (Choice C), or oxygen saturation (Choice D) are important assessments in general patient care, but they are not specifically related to the administration of digoxin.

2. What is the condition where the heart's mitral valve does not close properly, allowing blood to leak backward into the left atrium?

• A. Mitral regurgitation
• B. Aortic stenosis
• C. Tricuspid regurgitation
• D. Pulmonary hypertension

Correct answer: A

Rationale: Mitral regurgitation is the condition where the heart's mitral valve does not close properly, allowing blood to leak backward into the left atrium. This can result in symptoms like shortness of breath and fatigue. Choices B, C, and D are incorrect because aortic stenosis, tricuspid regurgitation, and pulmonary hypertension involve different heart valves or conditions, not the mitral valve specifically.

3. Which condition is an infection that inflames the air sacs in one or both lungs, which may fill with fluid?

• A. Pneumonia
• B. Bronchitis
• C. Tuberculosis
• D. Cystic fibrosis

Correct answer: A

Rationale: The correct answer is A, Pneumonia. Pneumonia is an infection that inflames the air sacs in the lungs, which may fill with fluid or pus, causing symptoms like cough, fever, and difficulty breathing. Bronchitis (choice B) is an inflammation of the bronchial tubes, not the air sacs in the lungs. Tuberculosis (choice C) is a bacterial infection that primarily affects the lungs but does not always cause fluid accumulation in the air sacs. Cystic fibrosis (choice D) is a genetic disorder that affects the lungs but does not directly cause inflammation of the air sacs with fluid.

4. The nurse is caring for a client on warfarin with an INR of 1.8. What is the most appropriate action?

• A. Increase the dose of warfarin.
• B. Administer vitamin K.
• C. Hold the warfarin and notify the healthcare provider.
• D. Monitor the client’s INR closely.

Correct answer: D

Rationale: An INR of 1.8 is below the therapeutic range for a client on warfarin, indicating the need for monitoring closely to ensure that the INR levels reach the desired therapeutic range. Increasing the dose of warfarin (Choice A) without proper monitoring may lead to an increased risk of bleeding. Administering vitamin K (Choice B) is not typically recommended unless the client is experiencing major bleeding or requires rapid reversal of warfarin's effects. Holding the warfarin and notifying the healthcare provider (Choice C) may be necessary in certain situations, but the immediate action in this case should be to monitor the client's INR closely to guide further management.

5. What is the amount of tension the ventricle must develop during contraction to eject blood from the left ventricle into the aorta?

• A. Afterload
• B. Preload
• C. Automaticity
• D. Ejection fraction

Correct answer: A

Rationale: Afterload is the correct answer because it refers to the pressure or tension that the ventricle must overcome during systole to eject blood into the aorta. Preload, on the other hand, is the degree of stretch of the ventricular muscle at the end of diastole before it contracts. Automaticity is the ability of the heart to generate electrical impulses independently, and ejection fraction is the percentage of blood pumped out of the ventricle with each heartbeat. Therefore, in the context of the question, afterload best describes the amount of tension the ventricle must develop to eject blood into the aorta.

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