Nursing Elites

1. 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.

2. What test measures the electrical activity of the heart over a period of time, typically 24 to 48 hours?

• A. Holter monitor
• B. Echocardiogram
• C. Stress test
• D. Arterial blood gas (ABG)

Correct answer: A

Rationale: The correct answer is A, Holter monitor. A Holter monitor is a portable device that records the electrical activity of the heart over a period of 24 to 48 hours. It is used to detect arrhythmias and other heart conditions. Choice B, Echocardiogram, is a test that uses sound waves to create images of the heart's structure and function, not focused on the electrical activity. Choice C, Stress test, evaluates the heart's function under stress but does not monitor electrical activity over an extended period. Choice D, Arterial blood gas (ABG), measures the levels of oxygen and carbon dioxide in the blood, unrelated to measuring the electrical activity of the heart over time.

3. 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.

4. This is a test that measures the oxygen saturation level in the blood, often used to assess respiratory function.

• A. Pulse oximetry
• B. Spirometry
• C. Arterial blood gas (ABG)
• D. Lung function test

Correct answer: A

Rationale: The correct answer is A, Pulse oximetry. Pulse oximetry is a non-invasive test that measures the oxygen saturation level in the blood, helping to assess respiratory and cardiovascular function. Choice B, Spirometry, measures lung function by assessing airflow and volume. Choice C, Arterial blood gas (ABG), evaluates the acidity, oxygen, and carbon dioxide levels in the blood. Choice D, Lung function test, is a broad term that may include various tests to assess lung health, but specifically measuring oxygen saturation is done through pulse oximetry.

5. The nurse is administering an ACE inhibitor to a client. What is the most common side effect?

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

Correct answer: A

Rationale: The correct answer is A: Cough. Cough is a well-known side effect of ACE inhibitors due to an increase in bradykinin levels. This irritating cough can be bothersome to clients and should be monitored. Choice B, Dizziness, is not the most common side effect of ACE inhibitors. While ACE inhibitors can cause hypotension (Choice C), cough is more prevalent. Hyperkalemia (Choice D) is a possible side effect of ACE inhibitors but is less common compared to cough.

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