Nursing Elites

1. What is a condition where the heart muscle becomes thickened without an obvious cause, leading to a reduction in the heart's ability to pump blood?

• A. Hypertrophic cardiomyopathy
• B. Dilated cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Myocarditis

Correct answer: A

Rationale: Hypertrophic cardiomyopathy is the correct answer. It is a condition characterized by the abnormal thickening of the heart muscle without an obvious cause, which impairs the heart's ability to effectively pump blood. Dilated cardiomyopathy (choice B) involves the enlargement and weakening of the heart chambers, not thickening. Restrictive cardiomyopathy (choice C) refers to the stiffening of the heart muscle, limiting its ability to fill properly. Myocarditis (choice D) is inflammation of the heart muscle usually caused by a viral infection, not thickening.

2. For what reason might the nurse be given an order to administer milrinone (Primacor)?

• A. For congestive heart failure
• B. For hypertension
• C. For cardiac arrhythmias
• D. For bradycardia

Correct answer: A

Rationale: Milrinone is commonly prescribed for congestive heart failure to help improve cardiac function and alleviate symptoms. Choices B, C, and D are incorrect as milrinone is not typically used for hypertension, cardiac arrhythmias, or bradycardia. It is specifically indicated for congestive heart failure for short-term management.

3. The client on furosemide (Lasix) is complaining of muscle cramps. What electrolyte imbalance should the nurse suspect?

• A. Hyperkalemia
• B. Hyponatremia
• C. Hypocalcemia
• D. Hypokalemia

Correct answer: D

Rationale: The correct answer is D, Hypokalemia. Muscle cramps are a common symptom of hypokalemia, an electrolyte imbalance characterized by low potassium levels. Furosemide, a loop diuretic like Lasix, can lead to potassium loss in the body, contributing to hypokalemia. Choice A, Hyperkalemia, is incorrect as it refers to high potassium levels. Choice B, Hyponatremia, is incorrect as it pertains to low sodium levels. Choice C, Hypocalcemia, is incorrect as it relates to low calcium levels, not typically associated with muscle cramps in the context of furosemide use.

4. In cases of myocardial infarction leading to shock, which medication is appropriate to counteract shock?

• A. Atropine
• B. Dopamine
• C. Digoxin
• D. Adenosine

Correct answer: B

Rationale: In cases of myocardial infarction leading to shock, dopamine is the drug of choice. Dopamine helps increase blood pressure and improve blood flow to vital organs, making it beneficial in managing shock. Atropine is mainly used for symptomatic bradycardia, not for shock. Digoxin is a cardiac glycoside used in heart failure and atrial fibrillation, not for managing shock. Adenosine is typically used for diagnosing and treating supraventricular tachycardias, not for shock associated with myocardial infarction.

5. A client on an ACE inhibitor reports a persistent cough. What is the nurse’s best response?

• A. Reassure the client that the cough is a common side effect and is usually not serious.
• B. Instruct the client to report the cough to the healthcare provider as it may require discontinuation of the medication.
• C. Advise the client to use a humidifier at night to relieve the cough.
• D. Suggest the client take an over-the-counter cough suppressant.

Correct answer: B

Rationale: The correct answer is B. A persistent cough in a client on an ACE inhibitor may indicate a serious side effect that requires discontinuation of the medication. Instructing the client to report the cough to the healthcare provider is essential for proper evaluation and management. Choice A is incorrect because simply reassuring the client may delay necessary action. Choice C is incorrect as using a humidifier may not address the underlying cause of the cough. Choice D is incorrect because taking a cough suppressant without healthcare provider guidance may mask symptoms without addressing the cause.

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