Nursing Elites

1. The nurse is caring for a client on digoxin with a heart rate of 48 bpm. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Administer atropine to increase the heart rate.
• D. Increase the dose of digoxin.

Correct answer: A

Rationale: In this scenario, the nurse's priority action should be to hold the digoxin and notify the healthcare provider. A heart rate of 48 bpm is low, and digoxin, being a medication that can further decrease the heart rate, should be withheld. Administering the digoxin as ordered (Choice B) would not be appropriate in this situation as it can exacerbate bradycardia. Atropine (Choice C) is not the initial treatment for this scenario; holding the digoxin is the first action. Increasing the dose of digoxin (Choice D) would be contraindicated due to the client's bradycardia. Therefore, the correct action is to hold the digoxin and inform the healthcare provider for further guidance.

2. Which condition involves the heart muscle becoming abnormally thickened, reducing its ability to pump blood?

• A. Hypertrophic cardiomyopathy
• B. Dilated cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Ischemic cardiomyopathy

Correct answer: A

Rationale: The correct answer is A: Hypertrophic cardiomyopathy. In this condition, the heart muscle thickens, leading to a decreased ability to pump blood effectively. Choice B, Dilated cardiomyopathy, is characterized by the heart chambers enlarging and weakening. Choice C, Restrictive cardiomyopathy, involves the heart muscle becoming rigid and less compliant. Choice D, Ischemic cardiomyopathy, is when the heart muscle is weakened due to reduced blood flow.

3. What is the ability of cardiac cells to respond to an impulse by transmitting the impulse along cell membranes?

• A. Contractility
• B. Automaticity
• C. Conductivity
• D. Rhythmicity

Correct answer: C

Rationale: The correct answer is C, Conductivity. Conductivity refers to the ability of cardiac cells to transmit impulses along cell membranes. Contractility (Choice A) is the ability of cardiac cells to contract in response to an electrical stimulus, not transmit impulses. Automaticity (Choice B) is the ability of cardiac cells to spontaneously generate electrical impulses. Rhythmicity (Choice D) refers to the regular generation of electrical impulses by the heart's pacemaker cells, not the transmission of impulses along cell membranes.

4. The client on nitroglycerin complains of a headache. What is the most appropriate response by the nurse?

• A. Administer acetaminophen as prescribed for the headache.
• B. Hold the next dose of nitroglycerin.
• C. Discontinue the nitroglycerin immediately.
• D. Notify the healthcare provider immediately.

Correct answer: A

Rationale: The correct response is to administer acetaminophen as prescribed for the headache. Headaches are a common side effect of nitroglycerin due to vasodilation. Administering acetaminophen can help relieve the headache. Holding the next dose of nitroglycerin (Choice B) may not address the current headache, and discontinuing nitroglycerin immediately (Choice C) without healthcare provider guidance can be dangerous due to the potential for rebound hypertension. Notifying the healthcare provider immediately (Choice D) is not necessary for a common side effect like a headache, and the nurse can manage this symptom independently.

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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