The client on digoxin has a potassium level of 2.7 mEq/L. What is the nurse's priority action?
- A. Hold the digoxin and notify the healthcare provider.
- B. Administer the digoxin as ordered.
- C. Increase the dose of digoxin.
- D. Administer potassium supplements.
Correct Answer: A
Rationale: The correct answer is A: Hold the digoxin and notify the healthcare provider. A potassium level of 2.7 mEq/L is below the normal range (3.5-5.0 mEq/L), which can increase the risk of digoxin toxicity. Holding the digoxin and informing the healthcare provider is crucial to prevent potential harm. Administering the digoxin (choice B) can exacerbate toxicity symptoms. Increasing the dose of digoxin (choice C) is contraindicated due to the low potassium level. Administering potassium supplements (choice D) may be necessary, but the priority is to address the digoxin therapy first.
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Which condition occurs when the heart muscle is damaged due to a lack of oxygen, often resulting from a heart attack?
- A. Myocardial infarction
- B. Angina
- C. Pericarditis
- D. Pulmonary embolism
Correct Answer: A
Rationale: The correct answer is A: Myocardial infarction. Myocardial infarction, commonly known as a heart attack, occurs when the heart muscle is damaged due to a lack of oxygen supply, often caused by a blockage in the coronary arteries. This results in irreversible damage to the heart tissue.
Explanation:
A: Myocardial infarction is the correct answer as it specifically refers to heart muscle damage due to oxygen deprivation.
B: Angina is chest pain or discomfort caused by reduced blood flow to the heart muscle, but it does not result in permanent damage like a heart attack.
C: Pericarditis is inflammation of the pericardium, the sac surrounding the heart, and does not directly involve heart muscle damage.
D: Pulmonary embolism is a blockage in the pulmonary artery in the lungs, not directly related to heart muscle damage.
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: The correct answer is A: For congestive heart failure. Milrinone is a phosphodiesterase inhibitor used to improve cardiac output in patients with severe heart failure. It works by increasing the force of heart contractions. Therefore, it is specifically indicated for congestive heart failure to help improve cardiac function. Choices B, C, and D are incorrect because milrinone is not typically used for hypertension, cardiac arrhythmias, or bradycardia. It is important to understand the specific indications and mechanisms of action of medications to determine the appropriate use in clinical practice.
What is a condition where the heart's ability to pump blood is reduced because the heart muscle is enlarged, thickened, or stiffened?
- A. Cardiomyopathy
- B. Endocarditis
- C. Myocarditis
- D. Aortic stenosis
Correct Answer: A
Rationale: The correct answer is A: Cardiomyopathy. Cardiomyopathy refers to a condition where the heart muscle is enlarged, thickened, or stiffened, leading to a reduced ability to pump blood effectively. This condition directly relates to the heart's structural changes, impacting its pumping function. Endocarditis (B) is an infection of the heart's inner lining, not directly related to heart muscle changes. Myocarditis (C) is inflammation of the heart muscle but does not necessarily involve structural changes leading to reduced pumping ability. Aortic stenosis (D) is a condition where the heart's aortic valve is narrowed, impeding blood flow, but it does not specifically refer to the heart muscle changes seen in cardiomyopathy.
The nurse is giving nitroglycerin sublingually for chest pain. What is the most important instruction to give to the client?
- A. Place the tablet under the tongue and let it dissolve completely.
- B. Swallow the tablet whole with a glass of water.
- C. Chew the tablet and then swallow it.
- D. Take one tablet every 5 minutes until pain is relieved.
Correct Answer: A
Rationale: The correct answer is A: Place the tablet under the tongue and let it dissolve completely. Nitroglycerin is absorbed quickly through the oral mucosa, providing rapid relief for chest pain. Placing it under the tongue allows for direct absorption into the bloodstream. Swallowing the tablet whole (B) would delay absorption. Chewing the tablet (C) would cause rapid absorption and possibly lead to a drop in blood pressure. Taking one tablet every 5 minutes (D) is not recommended as it can lead to hypotension. Therefore, option A is the most appropriate instruction for the client.
Which term refers to the contraction phase of the heart when blood is ejected from the chambers?
- A. Systole
- B. Diastole
- C. Contractility
- D. Afterload
Correct Answer: A
Rationale: The correct answer is A: Systole. During systole, the heart muscle contracts to pump blood out of the chambers. This phase is essential for delivering oxygenated blood to the body. Diastole (B) is the relaxation phase when the heart fills with blood. Contractility (C) refers to the heart's ability to contract, not a specific phase. Afterload (D) is the pressure the heart must pump against to eject blood, not a phase of the cardiac cycle. Therefore, the term that specifically refers to the contraction phase of the heart is systole.