Nursing Elites

1. The nurse is preparing to administer a beta blocker to a client with hypertension. What is the priority assessment?

• A. Check the client's heart rate.
• B. Check the client's blood pressure.
• C. Check the client's respiratory rate.
• D. Check the client's temperature.

Correct answer: B

Rationale: The correct answer is to check the client's blood pressure. Before administering a beta blocker to a client with hypertension, assessing the blood pressure is crucial because beta blockers can cause hypotension, potentially leading to adverse effects. Checking the heart rate may also be important but is secondary to monitoring the blood pressure in this scenario. Respiratory rate and temperature assessments are not directly related to assessing the client's response to a beta blocker in hypertension management, making choices C and D less relevant.

2. Which test measures how much and how quickly you can move air out of your lungs?

• A. Spirometry
• B. Peak flow meter
• C. Lung volume test
• D. Arterial blood gas

Correct answer: A

Rationale: The correct answer is A, Spirometry. Spirometry is a common pulmonary function test that measures lung function by assessing the amount (volume) and speed (flow) of air that can be inhaled and exhaled. This test helps in diagnosing conditions like asthma, chronic obstructive pulmonary disease (COPD), and other lung diseases. Peak flow meter (choice B) measures the maximum speed at which a person can exhale air, mainly used in asthma management. Lung volume test (choice C) evaluates the total amount of air the lungs can hold. Arterial blood gas (choice D) measures the levels of oxygen and carbon dioxide in the blood, providing information on how well the lungs are functioning in gas exchange, but it does not specifically measure the amount and speed of air movement in and out of the lungs like spirometry does.

3. The client is receiving digoxin and has a potassium level of 2.8 mEq/L. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Increase the dose of digoxin.
• C. Continue the current dose of digoxin.
• D. Administer potassium supplements.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 2.8 mEq/L indicates hypokalemia, which can increase the risk of digoxin toxicity. Holding the medication and informing the healthcare provider is crucial to prevent adverse effects. Choice B is incorrect because increasing the dose of digoxin would further raise the risk of toxicity. Choice C is incorrect as continuing the current dose could exacerbate the toxicity risk. Choice D is incorrect because administering potassium supplements alone is not sufficient to address the potential digoxin toxicity; the first step should be to hold the digoxin and seek further guidance.

4. Which neurotransmitter is released by the sympathetic nervous system (SNS) to increase heart rate and the force of contraction of the heart?

• A. Norepinephrine
• B. Epinephrine
• C. Dopamine
• D. Acetylcholine

Correct answer: A

Rationale: The correct answer is Norepinephrine. Norepinephrine is the neurotransmitter released by the sympathetic nervous system that increases heart rate and the force of contraction. Epinephrine, though similar, is more involved in the fight-or-flight response and has a broader range of effects on various organs. Dopamine is not primarily responsible for increasing heart rate and contractility. Acetylcholine is a neurotransmitter that predominantly acts on the parasympathetic nervous system to decrease heart rate and contractility.

5. The client on warfarin has an INR of 4.5. What is the most appropriate action by the nurse?

• A. Administer vitamin K.
• B. Hold the next dose of warfarin.
• C. Increase the dose of warfarin.
• D. Monitor the client’s INR closely.

Correct answer: A

Rationale: An INR of 4.5 is elevated, indicating an increased risk of bleeding due to excessive anticoagulation. The most appropriate action for the nurse in this scenario is to administer vitamin K. Vitamin K helps reverse the anticoagulant effects of warfarin, thus lowering the INR and reducing the risk of bleeding. Holding the next dose of warfarin (choice B) is not sufficient to address the immediate high INR level. Increasing the dose of warfarin (choice C) would further elevate the INR, worsening the risk of bleeding. While monitoring the client's INR closely (choice D) is important, immediate action is required to address the critically high INR level, making the administration of vitamin K the priority intervention.

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