Nursing Elites

1. The healthcare provider is administering IV nitroglycerin to a patient for chest pain. What is the most critical parameter to monitor?

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

Correct answer: B

Rationale: The correct answer is 'Blood pressure.' Nitroglycerin is a vasodilator that can cause a rapid drop in blood pressure, leading to hypotension. Monitoring the blood pressure is crucial to prevent potential complications such as hypotension-induced dizziness, syncope, or organ hypoperfusion. While heart rate, oxygen saturation, and respiratory rate are important parameters to monitor in a clinical setting, the immediate concern with IV nitroglycerin administration is the risk of hypotension, making blood pressure the most critical parameter to assess.

2. What is the term for a blood clot blocking an artery in the lungs, leading to symptoms like shortness of breath and chest pain?

• A. Pulmonary embolism
• B. Deep vein thrombosis (DVT)
• C. Myocardial infarction
• D. Pneumothorax

Correct answer: A

Rationale: The correct answer is A, pulmonary embolism. A pulmonary embolism occurs when a blood clot travels to the lungs and blocks an artery, causing symptoms like shortness of breath and chest pain. Choice B, deep vein thrombosis (DVT), involves a blood clot forming in a deep vein, usually in the legs. Choice C, myocardial infarction, refers to a heart attack due to blocked blood flow to the heart muscle. Choice D, pneumothorax, is a collapsed lung due to air leaking into the chest cavity.

3. The nurse is giving nitroglycerin sublingually for chest pain. What is the most important instruction to give to the client?

• A. Place the tablet under the tongue and let it dissolve completely.
• B. Swallow the tablet whole with a glass of water.
• C. Chew the tablet and then swallow it.
• D. Take one tablet every 5 minutes until pain is relieved.

Correct answer: A

Rationale: The correct answer is A. The tablet should be placed under the tongue and allowed to dissolve completely to ensure rapid absorption. This route of administration allows the medication to be quickly absorbed into the bloodstream. Choice B is incorrect because nitroglycerin is meant to be absorbed sublingually, not swallowed. Choice C is incorrect as chewing the tablet can cause the medication to be rapidly absorbed, leading to adverse effects like a drop in blood pressure. Choice D is incorrect because the client should take only one tablet every 5 minutes up to a maximum of three tablets for chest pain relief.

4. The client is on spironolactone (Aldactone) and has a potassium level of 5.9 mEq/L. What is the nurse’s priority action?

• A. Hold the spironolactone and notify the healthcare provider.
• B. Administer potassium supplements.
• C. Continue the spironolactone as ordered.
• D. Increase the dose of spironolactone.

Correct answer: A

Rationale: The correct answer is A: Hold the spironolactone and notify the healthcare provider. A potassium level of 5.9 mEq/L is high, indicating hyperkalemia. Spironolactone is a potassium-sparing diuretic that can further increase potassium levels. Therefore, the priority action is to hold the medication to prevent exacerbating hyperkalemia and notify the healthcare provider for further guidance. Choice B is incorrect because administering potassium supplements would worsen hyperkalemia. Choice C is incorrect because continuing spironolactone could lead to a further increase in potassium levels. Choice D is incorrect because increasing the dose of spironolactone would exacerbate the hyperkalemia.

5. What is a life-threatening condition where the heart suddenly stops beating?

• A. Cardiac arrest
• B. Myocardial infarction
• C. Heart failure
• D. Atrial fibrillation

Correct answer: A

Rationale: Cardiac arrest is the correct answer. It is a sudden, unexpected loss of heart function, breathing, and consciousness, typically resulting in death if not treated immediately. Myocardial infarction (choice B) refers to a heart attack caused by a blockage in the coronary arteries. Heart failure (choice C) is a chronic condition where the heart is unable to pump blood efficiently. Atrial fibrillation (choice D) is an irregular and often rapid heart rate that can lead to complications but is not the same as cardiac arrest.

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