Nursing Elites

1. 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.

2. The nurse is administering a beta blocker to a client with a heart rate of 58 bpm. What is the nurse’s priority action?

• A. Administer the beta blocker as ordered.
• B. Hold the beta blocker and notify the healthcare provider.
• C. Increase the dose of the beta blocker.
• D. Monitor the client’s heart rate and reassess in 30 minutes.

Correct answer: B

Rationale: The correct answer is B. A heart rate of 58 bpm is considered low, and beta blockers can further decrease the heart rate. Therefore, the nurse's priority action should be to hold the beta blocker and notify the healthcare provider for further assessment. Choice A is incorrect because administering the beta blocker without considering the low heart rate can worsen the condition. Choice C is incorrect as increasing the dose of the beta blocker can lead to further slowing of the heart rate, which is not safe in this situation. Choice D is not the priority action; holding the medication and seeking guidance from the healthcare provider is more crucial.

3. What is the ability of cardiac cells to respond to an impulse by transmitting the impulse along cell membranes?

• A. Contractility
• B. Automaticity
• C. Conductivity
• D. Rhythmicity

Correct answer: C

Rationale: The correct answer is C, Conductivity. Conductivity refers to the ability of cardiac cells to transmit impulses along cell membranes. Contractility (Choice A) is the ability of cardiac cells to contract in response to an electrical stimulus, not transmit impulses. Automaticity (Choice B) is the ability of cardiac cells to spontaneously generate electrical impulses. Rhythmicity (Choice D) refers to the regular generation of electrical impulses by the heart's pacemaker cells, not the transmission of impulses along cell membranes.

4. The nurse is administering 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, making it essential to ensure the heart rate is within the appropriate range. Blood pressure, respiratory rate, and oxygen saturation are also important parameters to monitor in a clinical setting, but when administering digoxin, the focus should primarily be on the heart rate due to its potential effects on cardiac function.

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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