Nursing Elites

1. The nurse is caring for a client with atrial fibrillation on dabigatran (Pradaxa). What is the most important instruction to give to the client?

• A. Take the medication with food to prevent stomach upset.
• B. Do not miss a dose and take it at the same time each day.
• C. Avoid consuming alcohol while on this medication.
• D. Monitor for signs of bleeding.

Correct answer: B

Rationale: The most important instruction to give to a client on dabigatran (Pradaxa) is not to miss a dose and take it at the same time each day. This is crucial for maintaining the anticoagulant effect of the medication. Choice A is not necessary as dabigatran does not need to be taken with food. Choice C is important but not as crucial as ensuring proper dosing. Choice D is also important but falls behind in priority compared to maintaining consistent dosing.

2. Which condition occurs when the heart muscle is damaged due to a lack of oxygen, often resulting from a heart attack?

• A. Myocardial infarction
• B. Angina
• C. Pericarditis
• D. Pulmonary embolism

Correct answer: A

Rationale: The correct answer is A: Myocardial infarction. Myocardial infarction, commonly known as a heart attack, is the condition where the heart muscle is damaged due to a lack of oxygen, typically caused by a blocked coronary artery. Angina (choice B) is chest pain or discomfort that occurs when the heart muscle doesn't receive enough oxygen-rich blood. Pericarditis (choice C) is the inflammation of the pericardium, the thin sac-like membrane surrounding the heart. Pulmonary embolism (choice D) is a blockage in one of the pulmonary arteries in the lungs, often caused by a blood clot.

3. What is a condition characterized by episodes of severe, acute shortness of breath, often occurring at night?

• 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 sudden episodes of severe shortness of breath during sleep, often waking the individual. Choice B, Sleep apnea, involves pauses in breathing during sleep but does not usually present with acute shortness of breath. Choice C, Orthopnea, refers to shortness of breath that occurs when lying flat and is relieved by sitting up. Choice D, Dyspnea, is a general term for difficult or labored breathing and does not specifically describe acute episodes at night.

4. Which term refers to the ability of the heart to initiate impulses repetitively and spontaneously?

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

Correct answer: C

Rationale: The correct answer is C: Automaticity. Automaticity is the specific term used to describe the heart's ability to generate impulses repetitively and spontaneously. Contractility (A) refers to the ability of muscle fibers to contract, not the initiation of impulses. Excitability (B) is the ability of cells to respond to stimuli but is not specific to the heart's impulse generation. Rhythmicity (D) is a related term but does not specifically describe the heart's spontaneous impulse initiation.

5. The client is on amiodarone and reports blurred vision. What is the nurse’s best response?

• A. Reassure the client that this is a common side effect.
• B. Instruct the client to report this symptom to the healthcare provider immediately.
• C. Advise the client to stop taking the medication.
• D. Discontinue the amiodarone immediately.

Correct answer: B

Rationale: Blurred vision is a potential side effect of amiodarone. Instructing the client to report this symptom to the healthcare provider immediately is the most appropriate response. Choice A is incorrect because although blurred vision can be a common side effect of amiodarone, it should not be dismissed without further evaluation. Choice C is incorrect as advising the client to stop taking the medication without consulting the healthcare provider can be dangerous and is not the first course of action. Choice D is too drastic as discontinuing the medication should be done under the guidance of a healthcare provider after proper evaluation.

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