Nursing Elites

1. The client on a beta blocker has a blood pressure of 88/58 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. Increase the dose of the beta blocker.
• D. Continue to monitor the client and reassess in 30 minutes.

Correct answer: A

Rationale: The correct action for the nurse to take when a client on a beta blocker presents with a blood pressure of 88/58 mm Hg is to hold the beta blocker and notify the healthcare provider. Beta blockers can further decrease blood pressure, which is already low in this case. Administering the beta blocker as ordered (Choice B) would exacerbate the hypotension. Increasing the dose of the beta blocker (Choice C) would be inappropriate and unsafe given the low blood pressure. Continuing to monitor the client and reassessing in 30 minutes (Choice D) could lead to a delay in necessary intervention. Therefore, the priority is to hold the medication and seek guidance from the healthcare provider.

2. Where is the impulse from the SA node delayed, enabling atrial contraction to complete before the ventricles are stimulated and contract?

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

Correct answer: A

Rationale: The correct answer is AV node. The AV node is responsible for delaying the impulse from the SA node, allowing the atria to contract before the ventricles. This delay ensures the effective pumping of blood in a coordinated manner. Choices B, C, and D are incorrect because the Bundle of His is responsible for transmitting the impulse to the Purkinje fibers, the SA node is the pacemaker of the heart responsible for initiating the heartbeat, and the aorta is the main artery carrying oxygenated blood from the heart to the body, respectively, none of which are involved in delaying the impulse to allow atrial contraction before ventricular contraction.

3. 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: Cardiomyopathy is the correct answer. It is a condition characterized by the abnormal enlargement, thickening, or stiffening of the heart muscle, which can lead to heart failure. Pericarditis (choice B) is inflammation of the pericardium, the sac surrounding the heart, not directly related to heart muscle enlargement. Aortic stenosis (choice C) is the narrowing of the aortic valve opening, affecting blood flow from the heart, but not directly related to heart muscle enlargement. Mitral valve prolapse (choice D) is a condition where the valve between the left atrium and left ventricle doesn't close properly, causing blood to leak backward, and is not directly related to heart muscle enlargement.

4. What is a condition where the heart's mitral valve does not close properly, causing blood to leak backward into the left atrium?

• A. Mitral valve prolapse
• B. Aortic stenosis
• C. Mitral stenosis
• D. Tricuspid regurgitation

Correct answer: A

Rationale: Mitral valve prolapse is the correct answer. It occurs when the mitral valve does not close properly, leading to blood leaking backward into the left atrium. This condition can manifest with symptoms such as palpitations and chest pain. Choices B, C, and D are incorrect because aortic stenosis involves narrowing of the aortic valve, mitral stenosis is the narrowing of the mitral valve, and tricuspid regurgitation is when blood leaks backward through the tricuspid valve.

5. Which heart chamber ejects blood into the systemic arterial circulation via the aorta?

• A. Right atrium
• B. Left atrium
• C. Right ventricle
• D. Left ventricle

Correct answer: D

Rationale: The correct answer is D, Left ventricle. The left ventricle pumps oxygenated blood into the systemic circulation via the aorta. This chamber receives oxygen-rich blood from the left atrium and contracts forcefully to propel blood into the aorta, distributing it to the body. The other options, right atrium, left atrium, and right ventricle, do not directly eject blood into the systemic arterial circulation via the aorta. The right atrium receives deoxygenated blood from the body, the left atrium receives oxygenated blood from the lungs, and the right ventricle pumps blood to the lungs for oxygenation.

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