Nursing Elites

1. The nurse is caring for a client on enalapril (Vasotec). What is the most important side effect to monitor?

• A. Cough
• B. Hyperkalemia
• C. Hypotension
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Cough. Enalapril is an ACE inhibitor, and cough is a common side effect associated with this class of medication. Monitoring for cough is crucial as it can indicate the development of a potentially serious condition known as angioedema. Hyperkalemia (choice B) is a possible side effect of ACE inhibitors but is not the most important side effect to monitor. Hypotension (choice C) and dizziness (choice D) are also potential side effects of enalapril; however, cough takes precedence due to its association with angioedema, a severe adverse reaction.

2. When administering an ACE inhibitor to a client with heart failure, what is the expected outcome of this medication?

• A. Decreased blood pressure
• B. Increased heart rate
• C. Increased cardiac output
• D. Decreased heart rate

Correct answer: C

Rationale: The correct answer is C: Increased cardiac output. ACE inhibitors are commonly used in heart failure to reduce the workload on the heart by decreasing blood pressure and increasing cardiac output. This ultimately helps improve the heart's efficiency and function. Choice A is incorrect because ACE inhibitors generally lead to a reduction in blood pressure. Choice B is incorrect as ACE inhibitors do not increase heart rate. Choice D is incorrect as ACE inhibitors do not typically decrease heart rate in the context of heart failure.

3. What test uses sound waves to create pictures of the heart, allowing doctors to see how well the heart is functioning?

• A. Echocardiogram
• B. MRI
• C. CT scan
• D. X-ray

Correct answer: A

Rationale: The correct answer is an echocardiogram. This test utilizes sound waves to generate images of the heart, enabling doctors to evaluate both the function and structure of the heart. Choice B, MRI, uses magnetic fields and radio waves to produce detailed images of the body's organs and structures, not specifically focused on the heart. Choice C, CT scan, employs X-rays to create detailed cross-sectional images of the body, not primarily for the heart. Choice D, X-ray, uses electromagnetic radiation to produce images of internal structures, but it does not provide the detailed pictures of the heart's function that an echocardiogram does.

4. The nurse is administering a beta blocker to a client with a heart rate of 58 bpm. What is the nurse’s priority action?

• A. Administer the beta blocker as ordered.
• B. Hold the beta blocker and notify the healthcare provider.
• C. Increase the dose of the beta blocker.
• D. Monitor the client’s heart rate and reassess in 30 minutes.

Correct answer: B

Rationale: The correct answer is B. A heart rate of 58 bpm is considered low, and beta blockers can further decrease the heart rate. Therefore, the nurse's priority action should be to hold the beta blocker and notify the healthcare provider for further assessment. Choice A is incorrect because administering the beta blocker without considering the low heart rate can worsen the condition. Choice C is incorrect as increasing the dose of the beta blocker can lead to further slowing of the heart rate, which is not safe in this situation. Choice D is not the priority action; holding the medication and seeking guidance from the healthcare provider is more crucial.

5. What is the average cardiac output?

• A. Approximately 4 to 6 L per minute
• B. Approximately 4 to 8 L per minute
• C. Approximately 5 to 8 L per minute
• D. Approximately 3 to 7 L per minute

Correct answer: B

Rationale: The correct answer is B: Approximately 4 to 8 L per minute. Cardiac output is defined as the volume of blood the heart pumps per minute, typically ranging between 4 to 8 liters. Choices A, C, and D provide ranges that are either too narrow or outside the standard average values for cardiac output, making them incorrect.

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