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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: Step 1: Digoxin is primarily used to treat heart conditions.
Step 2: Heart rate is crucial as digoxin can affect the heart rhythm.
Step 3: Monitoring heart rate ensures safety and effectiveness of digoxin.
Step 4: Blood pressure, respiratory rate, and oxygen saturation are important but not as directly impacted by digoxin.
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The client is receiving digoxin and complains of nausea. What is the nurse's priority action?
- A. Check the client's digoxin level.
- B. Continue the current dose of digoxin.
- C. Administer an antiemetic for nausea.
- D. Discontinue the digoxin immediately.
Correct Answer: A
Rationale: The correct answer is A: Check the client's digoxin level. The priority action is to assess the digoxin level to determine if it is within the therapeutic range, as nausea can be a sign of digoxin toxicity. Checking the level will guide further actions. Continuing the dose without assessment (B) may worsen toxicity. Administering an antiemetic (C) only addresses the symptom, not the underlying cause. Discontinuing digoxin immediately (D) without assessing the level can be harmful if the client actually needs the medication.
The patient is experiencing chest pain and pain radiating to his arms, jaw, and back. The provider diagnosed his condition as a myocardial infarction. The patient asks what happened to him. The best response is:
- A. You cannot tell him what has happened; he needs to wait for the provider to return and explain what is going on currently.
- B. His aortic valve was malformed at birth causing a disruption in blood flow.
- C. All patients who are overweight like him will have a heart attack.
- D. One or more arteries that supply blood to his heart are blocked, thereby preventing an adequate amount of blood from getting to his cardiac muscles.
Correct Answer: D
Rationale: A myocardial infarction occurs when there is a blockage in one or more arteries supplying blood to the heart.
Which term refers to a condition where the blood supply to part of the heart muscle is blocked, often referred to as a heart attack?
- A. Myocardial infarction
- B. Arrhythmia
- C. Stroke
- D. Aneurysm
Correct Answer: A
Rationale: The correct answer is A: Myocardial infarction. Myocardial infarction refers to the condition where the blood supply to part of the heart muscle is blocked, leading to tissue damage or cell death. This is commonly known as a heart attack. It is crucial to understand that arrhythmia (B), stroke (C), and aneurysm (D) are different medical conditions that do not specifically involve the blockage of blood flow to the heart muscle. Arrhythmia is an irregular heartbeat, stroke is the interruption of blood supply to the brain, and an aneurysm is a bulge in a blood vessel. Therefore, the correct term for a condition involving a blocked blood supply to the heart muscle is myocardial infarction.
What term refers to the degree of myocardial fiber stretch before contraction, related to the volume of blood distending the ventricles at the end of diastole, and determined by the amount of venous return?
- A. Preload
- B. Afterload
- C. Contractility
- D. Ejection fraction
Correct Answer: A
Rationale: Rationale:
1. Preload refers to myocardial fiber stretch before contraction.
2. It is related to the volume of blood in ventricles at end of diastole.
3. Preload is determined by the amount of venous return to the heart.
4. It influences the force of contraction and stroke volume.
5. Afterload (B) is the resistance the heart must overcome to pump blood.
6. Contractility (C) is the intrinsic strength of the heart muscle.
7. Ejection fraction (D) is the percentage of blood ejected from ventricles.
Summary:
- Preload is correct as it specifically relates to fiber stretch and volume of blood.
- Afterload, contractility, and ejection fraction do not directly relate to ventricular volume and venous return.
What is a condition where the heart muscle becomes abnormally enlarged, thickened, or stiffened, often leading to heart failure?
- A. Cardiomyopathy
- B. Pericarditis
- C. Aortic stenosis
- D. Mitral valve prolapse
Correct Answer: A
Rationale: The correct answer is A: Cardiomyopathy. Cardiomyopathy is a condition characterized by abnormal enlargement, thickening, or stiffening of the heart muscle, which can lead to heart failure. This condition directly affects the heart muscle itself, causing it to function improperly. Pericarditis (B) is inflammation of the pericardium, the outer lining of the heart, not the heart muscle. Aortic stenosis (C) and Mitral valve prolapse (D) involve issues with heart valves, not the heart muscle itself. Therefore, A is the correct choice as it directly addresses the abnormal changes in the heart muscle leading to heart failure.