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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.
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What is a condition where the alveoli are gradually destroyed, leading to shortness of breath and reduced oxygen exchange?
- A. Emphysema
- B. Pulmonary fibrosis
- C. Pulmonary edema
- D. Lung cancer
Correct Answer: A
Rationale: Emphysema is the correct answer. Alveoli destruction in emphysema leads to shortness of breath and reduced oxygen exchange. This condition is primarily caused by smoking and results in irreversible damage to the air sacs in the lungs. Pulmonary fibrosis involves scarring of lung tissue, not alveoli destruction. Pulmonary edema is fluid accumulation in the lungs, disrupting oxygen exchange. Lung cancer is the uncontrolled growth of abnormal cells in the lung, which may not directly lead to alveoli destruction.
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.
In third-degree atrioventricular block, all sinus impulses fail to activate the ventricles. This will be detected by
- A. A highly variable PR interval
- B. Regular PP intervals
- C. A slow heart rate
- D. Regular RR intervals
Correct Answer: C
Rationale: Slow heart rate reflects lack of conduction from atria to ventricles.
What is the primary BP effect of β-adrenergic blockers such as atenolol (Tenormin)?
- A. Vasodilation of arterioles by blocking movement of calcium into cells
- B. Decrease Na+ and water reabsorption by blocking the effect of aldosterone
- C. Decrease CO by decreasing rate and strength of the heart and renin secretion by the kidneys
- D. Vasodilation caused by inhibiting sympathetic outflow from the central nervous system (CNS)
Correct Answer: C
Rationale: β-blockers reduce cardiac workload and renin release.
You are working in the ED caring for a patient who was just admitted with left anterior chest pain, possible unstable angina or myocardial infarction. Which nursing activity will you accomplish first?
- A. Auscultate heart sounds.
- B. Administer sublingual nitroglycerin.
- C. Insert an IV catheter.
- D. Obtain a brief patient health history.
Correct Answer: B
Rationale: Relieving chest pain is a priority to reduce myocardial oxygen demand and prevent further damage.