Nursing Elites

1. Which heart chamber receives venous blood returning to the heart via the superior and inferior vena cava?

• A. Right atrium
• B. Left atrium
• C. Right ventricle
• D. Left ventricle

Correct answer: A

Rationale: The correct answer is A: Right atrium. The right atrium is the heart chamber that receives deoxygenated blood returning from the body via the superior and inferior vena cava. The blood enters the right atrium from the vena cava and then passes through the tricuspid valve into the right ventricle. Choices B, C, and D are incorrect because the left atrium receives oxygenated blood from the lungs, the right ventricle pumps blood to the lungs for oxygenation, and the left ventricle pumps oxygenated blood to the body.

2. Which order should the nurse question?

• A. The addition of a loop diuretic with digoxin.
• B. The addition of a beta blocker with digoxin.
• C. A digoxin dose of 0.125 mg per day.
• D. The addition of an ACE inhibitor with digoxin.

Correct answer: B

Rationale: The correct answer is B because adding a beta blocker to digoxin can potentiate the bradycardic effect of digoxin, leading to serious complications such as heart block. This combination requires caution as it can significantly slow down the heart rate. Choices A, C, and D are not the best options to question in this scenario. Loop diuretics are commonly used with digoxin, a digoxin dose of 0.125 mg per day is within the typical range, and ACE inhibitors are often prescribed alongside digoxin for managing heart conditions.

3. The client on digoxin has a potassium level of 3.0 mEq/L. What is the nurse’s priority action?

• A. Administer a potassium supplement
• B. Hold the digoxin and notify the healthcare provider
• C. Continue the current digoxin dose
• D. Administer Digibind

Correct answer: B

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 3.0 mEq/L indicates hypokalemia, which can increase the risk of digoxin toxicity. Digoxin and low potassium levels can lead to serious cardiac arrhythmias. Administering a potassium supplement (choice A) without healthcare provider guidance can worsen the situation. Continuing the current digoxin dose (choice C) can further increase the risk of toxicity. Administering Digibind (choice D) is used in severe cases of digoxin toxicity, not for addressing low potassium levels.

4. 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.

5. The client on amiodarone develops symptoms of hypothyroidism. What is the nurse’s best response?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect of amiodarone.
• C. Monitor the client’s thyroid function tests regularly.
• D. Discontinue the amiodarone immediately.

Correct answer: C

Rationale: When a client on amiodarone develops symptoms of hypothyroidism, the nurse's best response is to monitor the client's thyroid function tests regularly. Amiodarone can affect thyroid function, so monitoring is essential to assess the impact and adjust treatment if necessary. Notifying the healthcare provider immediately (Choice A) may be necessary in some cases but the priority is to monitor first. Reassuring the client (Choice B) is not sufficient as monitoring is crucial. Discontinuing amiodarone (Choice D) abruptly without healthcare provider guidance can lead to serious consequences.

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