Nursing Elites

1. The nurse is giving digoxin to a client. What is the most important parameter to check before administration?

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

Correct answer: A

Rationale: The correct answer is A: Heart rate. Before administering digoxin, it is crucial to check the client's heart rate because digoxin can cause bradycardia, an abnormally slow heart rate. Monitoring the heart rate is essential to prevent potential complications associated with digoxin therapy. Choices B, C, and D are less critical parameters to assess before administering digoxin. While blood pressure is also important to monitor during digoxin therapy, the most crucial parameter to check due to the medication's potential effect on heart rate is the heart rate itself.

2. What condition is characterized by narrowed or blocked arteries in the legs or arms, leading to pain and mobility issues?

• A. Peripheral artery disease
• B. Atherosclerosis
• C. Raynaud's disease
• D. Varicose veins

Correct answer: A

Rationale: The correct answer is A: Peripheral artery disease (PAD). PAD is a condition where the arteries in the legs or arms become narrowed or blocked, leading to pain and mobility issues. Choice B, Atherosclerosis, refers to the buildup of fats, cholesterol, and other substances in and on the artery walls, not specifically the narrowing or blockage in the extremities. Choice C, Raynaud's disease, is characterized by reduced blood flow to the extremities, leading to coldness, numbness, and color changes in the skin, but it is not primarily about narrowed or blocked arteries. Choice D, Varicose veins, involves enlarged, twisted veins usually in the legs, but it is not related to narrowed or blocked arteries causing pain and mobility issues.

3. What is a surgical procedure to create an opening in the windpipe to assist with breathing?

• A. Tracheostomy
• B. Lobectomy
• C. Thoracotomy
• D. Pleurodesis

Correct answer: A

Rationale: Tracheostomy is the correct answer. It is a surgical procedure to create an opening in the windpipe (trachea) to assist with breathing. This procedure is commonly used for patients who require long-term ventilation support. Choice B, Lobectomy, involves the removal of a lobe of the lung and is not related to creating an opening in the windpipe. Choice C, Thoracotomy, is a surgical incision into the chest wall and is not specifically related to creating an opening in the windpipe. Choice D, Pleurodesis, is a procedure to treat recurrent pleural effusions by causing the pleural layers to stick together, and it is not related to creating an opening in the windpipe.

4. The nurse is giving the client digoxin for heart failure and recognizes that the drug has what type of effect on the heart?

• A. Negative inotropic, negative chronotropic effect
• B. Positive inotropic, negative chronotropic effect
• C. Negative inotropic, positive chronotropic effect
• D. Positive inotropic, positive chronotropic effect

Correct answer: B

Rationale: The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin strengthens the heart muscle, providing a positive inotropic effect, which increases the force of contraction. It also decreases the heart rate, having a negative chronotropic effect. Choice A is incorrect because digoxin has a positive inotropic effect, not a negative inotropic effect. Choice C is incorrect as digoxin does not have a positive chronotropic effect but a negative one. Choice D is incorrect because while digoxin has a positive inotropic effect, it does not have a positive chronotropic effect.

5. What is the amount of blood the heart pumps through the circulatory system in a minute?

• A. Cardiac output
• B. Stroke volume
• C. End-diastolic volume
• D. Ejection fraction

Correct answer: A

Rationale: The correct answer is A: Cardiac output. Cardiac output is the volume of blood pumped by the heart per minute. It is calculated by multiplying the stroke volume (the amount of blood pumped out of the heart in each beat) by the heart rate (number of heartbeats per minute). This question specifically asks for the total amount of blood pumped through the circulatory system in a minute, which is represented by cardiac output. Choices B, C, and D are incorrect because stroke volume refers to the amount of blood pumped out of the heart in each beat, end-diastolic volume is the volume of blood in the heart at the end of diastole, and ejection fraction is the percentage of blood pumped out of the heart with each contraction, not the total amount pumped per minute.

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