Nursing Elites

1. After the AV node, the electrical impulse is then transmitted into the _________, and into the _________.

• A. Purkinje fibers, ventricles
• B. Atria, ventricles
• C. Bundle of His, Purkinje fibers
• D. Ventricles, Purkinje fibers

Correct answer: C

Rationale: The correct answer is C. After the AV node, the electrical impulse is transmitted to the Bundle of His and then to the Purkinje fibers. This sequence is crucial for the coordinated contraction of the ventricles. Choice A (Purkinje fibers, ventricles) is incorrect because the Purkinje fibers come after the Bundle of His in the sequence of electrical conduction. Choice B (Atria, ventricles) is incorrect because the impulse does not go back to the atria after passing through the AV node. Choice D (Ventricles, Purkinje fibers) is incorrect because the impulse first reaches the Bundle of His before spreading to the Purkinje fibers.

2. 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.

3. What is a blood clot that forms in a vein, often in the legs, and can cause serious complications if it travels to the lungs?

• A. Deep vein thrombosis (DVT)
• B. Pulmonary embolism
• C. Varicose veins
• D. Atherosclerosis

Correct answer: A

Rationale: The correct answer is Deep vein thrombosis (DVT). DVT is a blood clot that forms in a deep vein, typically in the legs, and can lead to serious complications if it breaks loose and travels to the lungs, causing a pulmonary embolism. Varicose veins (choice C) are enlarged, twisted veins usually found in the legs but are not related to blood clots. Atherosclerosis (choice D) is a condition where arteries become narrowed and hardened due to a buildup of plaque, not directly related to blood clots.

4. The client is on hydrochlorothiazide and digoxin. What effect can the nurse expect?

• A. Hydrochlorothiazide increases digoxin levels.
• B. Hydrochlorothiazide decreases digoxin levels.
• C. Hydrochlorothiazide decreases potassium, increasing the risk of digoxin toxicity.
• D. Digoxin can increase the effectiveness of hydrochlorothiazide.

Correct answer: C

Rationale: The correct answer is C. Hydrochlorothiazide is a diuretic that can decrease potassium levels, which in turn can increase the risk of digoxin toxicity. Digoxin typically doesn't impact hydrochlorothiazide levels or effectiveness, making choices A, B, and D incorrect. Choice A stating that hydrochlorothiazide increases digoxin levels is inaccurate. Choice B suggesting that hydrochlorothiazide decreases digoxin levels is also incorrect. Choice D, stating that digoxin can increase the effectiveness of hydrochlorothiazide, is not a typical interaction seen between these medications.

5. A client on a beta blocker has a blood pressure of 90/60 mm Hg. What is the nurse’s priority action?

• A. Hold the beta blocker and notify the healthcare provider.
• B. Administer the beta blocker as ordered.
• C. Administer a diuretic to reduce blood pressure.
• D. Continue to monitor the client and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the beta blocker and notify the healthcare provider. A blood pressure of 90/60 mm Hg is already low, and beta blockers can further decrease blood pressure. Administering the beta blocker can potentially worsen the situation, leading to complications. Administering a diuretic or continuing to monitor the client without taking immediate action could delay necessary intervention. Therefore, holding the beta blocker and involving the healthcare provider promptly is crucial in this scenario.

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