Nursing Elites

1. The client is on digoxin and has severe digoxin toxicity. What is the nursing priority action?

• A. Check the potassium level.
• B. Give Digibind as an antidote.
• C. Change the dosing of digoxin to every other day.
• D. Administer a potassium supplement to decrease digoxin toxicity.

Correct answer: B

Rationale: The correct answer is to give Digibind as an antidote in cases of severe digoxin toxicity. Digibind works by binding to digoxin and preventing it from causing further harm. Checking the potassium level (choice A) is important but not the priority when the client has severe toxicity. Changing the dosing to every other day (choice C) is not appropriate in the setting of severe toxicity where immediate action is required. Giving a potassium supplement (choice D) may be needed eventually, but the priority is to administer Digibind to counteract the toxic effects of digoxin.

2. Which fibers distribute the electrical impulse to the ventricles, causing them to contract?

• A. Purkinje fibers
• B. SA node
• C. AV node
• D. Bundle of His

Correct answer: A

Rationale: The correct answer is Purkinje fibers. Purkinje fibers are specialized conducting fibers that distribute the electrical impulse to the ventricles, leading to their contraction. The SA node (sinoatrial node) is responsible for initiating the electrical impulse in the heart, the AV node (atrioventricular node) delays the impulse to allow for proper atrial contraction before ventricular contraction, and the Bundle of His transmits the impulse from the AV node to the ventricles. Therefore, choices B, C, and D are not the correct options for fibers directly distributing the impulse to the ventricles.

3. Which of the following is a central vasodilator and peripheral vasoconstrictor?

• A. Sympathetic nervous system
• B. Parasympathetic nervous system
• C. Norepinephrine
• D. Acetylcholine

Correct answer: A

Rationale: The correct answer is the Sympathetic nervous system. The sympathetic nervous system is a branch of the autonomic nervous system that is responsible for the fight-or-flight response. It causes vasodilation in central vessels to increase blood flow to vital organs during stress or exercise, while inducing vasoconstriction in peripheral vessels to redirect blood to essential areas. Norepinephrine and acetylcholine are neurotransmitters associated with the sympathetic and parasympathetic nervous systems, respectively, but they are not themselves central vasodilators and peripheral vasoconstrictors.

4. 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. A myocardial infarction, commonly known as a heart attack, occurs when the blood supply to part of the heart muscle is blocked, often by a blood clot. Choices B, C, and D are incorrect because arrhythmia refers to an irregular heartbeat, stroke involves the interruption of blood flow to the brain, and an aneurysm is a bulge in a blood vessel.

5. Which condition is characterized by the lungs becoming scarred and stiff, leading to difficulty breathing and inadequate oxygen intake into the bloodstream?

• A. Pulmonary fibrosis
• B. Cystic fibrosis
• C. COPD
• D. Tuberculosis

Correct answer: A

Rationale: The correct answer is A, Pulmonary fibrosis. Pulmonary fibrosis is a lung disease where lung tissue is damaged and scarred, resulting in breathing difficulties and decreased oxygen transfer into the bloodstream. Cystic fibrosis (B) is a genetic disorder primarily affecting the lungs and digestive system, not causing lung scarring. COPD (C) includes conditions like chronic bronchitis and emphysema but doesn't specifically involve lung scarring. Tuberculosis (D) is a bacterial infection that primarily affects the lungs but doesn't cause lung tissue scarring and stiffness as seen in pulmonary fibrosis.

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