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. What test measures the pressure in the arteries during the contraction and relaxation of the heart?

• A. Blood pressure test
• B. Electrocardiogram (ECG or EKG)
• C. Spirometry
• D. Pulse oximetry

Correct answer: A

Rationale: The correct answer is 'Blood pressure test.' This test measures the pressure in the arteries during the contraction (systolic) and relaxation (diastolic) phases of the heart, providing important information about heart health. Choice B, 'Electrocardiogram (ECG or EKG),' records the heart's electrical activity and is not specifically related to measuring arterial pressure. Choice C, 'Spirometry,' assesses lung function by measuring airflow. Choice D, 'Pulse oximetry,' measures oxygen saturation in the blood, not arterial pressure.

3. What are the pressure-sensitive structures located in the aortic and carotid bodies called?

• A. Baroreceptors
• B. Chemoreceptors
• C. Nociceptors
• D. Mechanoreceptors

Correct answer: A

Rationale: Baroreceptors are the correct answer. Baroreceptors are specialized sensory receptors that detect changes in pressure within blood vessels. They are primarily located in the aortic arch and carotid sinuses, where they play a crucial role in regulating blood pressure. Chemoreceptors (Choice B) are receptors that detect chemical changes, not pressure changes. Nociceptors (Choice C) are responsible for detecting painful stimuli. Mechanoreceptors (Choice D) respond to mechanical stimuli such as touch, pressure, and vibration, but they are not specifically located in the aortic and carotid bodies.

4. When monitoring a client on dobutamine, what is the most important parameter to assess?

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

Correct answer: A

Rationale: The correct answer is A: Blood pressure. When a client is on dobutamine, it is crucial to closely monitor their blood pressure as dobutamine can cause significant changes in blood pressure. While heart rate is also important to monitor during this time, blood pressure is the most critical parameter to assess. Oxygen saturation and respiratory rate are also important parameters to monitor in a patient receiving dobutamine, but they are not as crucial as blood pressure in this scenario.

5. What procedure uses a catheter to open blocked coronary arteries and improve blood flow to the heart muscle?

• A. Angioplasty
• B. Stent placement
• C. Coronary artery bypass graft (CABG)
• D. Valve replacement

Correct answer: A

Rationale: The correct answer is A, Angioplasty. Angioplasty is a procedure where a catheter is used to open blocked coronary arteries and may involve the insertion of a stent to improve blood flow to the heart muscle. Stent placement (B) is a related procedure but specifically refers to the insertion of a stent. Coronary artery bypass graft (CABG) (C) is a surgical procedure that uses blood vessels to bypass blocked coronary arteries. Valve replacement (D) is a different procedure that involves replacing a heart valve, not opening blocked coronary arteries.

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