Nursing Elites

1. 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.

2. What test measures the electrical activity of the heart to detect arrhythmias and other heart conditions?

• A. Electrocardiogram (ECG or EKG)
• B. Chest X-ray
• C. Stress test
• D. Arterial blood gas (ABG)

Correct answer: A

Rationale: An electrocardiogram (ECG or EKG) is used to measure the heart's electrical activity, aiding in the detection of arrhythmias and other heart conditions. Choice B, a chest X-ray, is not used to measure electrical activity but to visualize the structures of the chest. Choice C, a stress test, evaluates the heart's response to exertion and is not primarily focused on measuring electrical activity. Choice D, an arterial blood gas (ABG) test, is used to assess oxygen and carbon dioxide levels in the blood, not the heart's electrical activity.

3. What is a device that delivers a fine spray of medication into the airways?

• A. Nebulizer
• B. Inhaler
• C. Oxygen concentrator
• D. Peak flow meter

Correct answer: A

Rationale: A nebulizer is a device that converts liquid medication into a fine mist, allowing it to be inhaled directly into the lungs. This makes it the correct answer to the question. Choice B, an inhaler, delivers medication in a different form - as a pressurized dose that needs to be inhaled. Choice C, an oxygen concentrator, is used to deliver oxygen to patients with breathing difficulties but does not deliver medication. Choice D, a peak flow meter, is used to measure how fast air can be blown out of the lungs and is not involved in delivering medication.

4. What is the term for the amount of blood ejected by the left ventricle into the aorta per beat, determined by preload, contractility, and afterload?

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

Correct answer: A

Rationale: The correct answer is A: Stroke volume. Stroke volume refers to the volume of blood ejected by the left ventricle during each heartbeat. This is determined by preload (the degree of stretch of the cardiac muscle fibers at the end of diastole), contractility (the force of myocardial contraction), and afterload (the pressure or resistance that the ventricle must overcome to eject blood). Choice B, Cardiac output, is the volume of blood pumped by the heart per minute and is calculated by multiplying the heart rate by the stroke volume. Choice C, End-diastolic volume, is the volume of blood in the ventricle at the end of diastole before contraction. Choice D, Ejection fraction, is the proportion of blood pumped out of the ventricle with each contraction, calculated by dividing the stroke volume by the end-diastolic volume.

5. The client is being taught about the use of warfarin. What is the most important dietary instruction?

• A. Avoid foods high in vitamin K.
• B. Increase the intake of vitamin K-rich foods.
• C. Avoid foods high in protein.
• D. Increase the intake of foods high in calcium.

Correct answer: A

Rationale: The correct answer is A: Avoid foods high in vitamin K. Warfarin is a medication that works by decreasing the activity of vitamin K in the body to prevent blood clotting. Therefore, consuming foods high in vitamin K like green leafy vegetables can interfere with the medication's effectiveness. Choices B, C, and D are incorrect. Increasing the intake of vitamin K-rich foods would counteract the effects of warfarin. Avoiding foods high in protein or increasing the intake of foods high in calcium are not specifically related to the use of warfarin.

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