Nursing Elites

1. The client on amiodarone develops symptoms of hypothyroidism. What is the nurse’s best response?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect of amiodarone.
• C. Monitor the client’s thyroid function tests regularly.
• D. Discontinue the amiodarone immediately.

Correct answer: C

Rationale: When a client on amiodarone develops symptoms of hypothyroidism, the nurse's best response is to monitor the client's thyroid function tests regularly. Amiodarone can affect thyroid function, so monitoring is essential to assess the impact and adjust treatment if necessary. Notifying the healthcare provider immediately (Choice A) may be necessary in some cases but the priority is to monitor first. Reassuring the client (Choice B) is not sufficient as monitoring is crucial. Discontinuing amiodarone (Choice D) abruptly without healthcare provider guidance can lead to serious consequences.

2. During which process does coronary artery blood flow to the myocardium occur during diastole, when coronary vascular resistance is reduced?

• A. Coronary perfusion pressure
• B. Coronary vascular resistance
• C. Diastolic filling
• D. Ventricular ejection

Correct answer: A

Rationale: The correct answer is A: Coronary perfusion pressure. Coronary perfusion pressure refers to the process of coronary artery blood flow to the myocardium during diastole when coronary vascular resistance is reduced. This process ensures that the myocardium receives sufficient oxygen and nutrients for proper functioning. Choice B, Coronary vascular resistance, is the opposite of what is described in the question. During coronary perfusion, resistance is reduced to enhance blood flow. Choices C and D, Diastolic filling and Ventricular ejection, do not directly relate to the process of coronary artery blood flow during diastole.

3. When administering enoxaparin (Lovenox) to a client for DVT prophylaxis, what is the most important lab value to monitor?

• A. Platelet count
• B. PT/INR
• C. aPTT
• D. Hemoglobin

Correct answer: A

Rationale: The correct answer is A: Platelet count. When administering enoxaparin (Lovenox) for DVT prophylaxis, it is crucial to monitor the platelet count as enoxaparin can lead to thrombocytopenia, a decrease in platelet levels. Monitoring the platelet count helps in early detection of this potential adverse effect. Choices B, C, and D are incorrect because PT/INR, aPTT, and hemoglobin levels are not the most important lab values to monitor specifically for enoxaparin administration and DVT prophylaxis.

4. What is the term for the ability of cardiac cells to respond to a stimulus by initiating a cardiac impulse?

• A. Excitability
• B. Contractility
• C. Rhythmicity
• D. Conductivity

Correct answer: A

Rationale: The correct answer is A, Excitability. Excitability is the ability of cardiac cells to respond to a stimulus by initiating a cardiac impulse. Choice B, Contractility, refers to the ability of cardiac muscle to shorten forcibly. Choice C, Rhythmicity, refers to the cardiac muscle's ability to contract rhythmically. Choice D, Conductivity, refers to the ability of the heart's cells to conduct electrical impulses.

5. Which term conceptualizes that the greater the myocardial fiber stretch, within physiologic limits, the more forceful the ventricular contraction, thereby increasing stroke volume?

• A. Frank-Starling’s Law
• B. Automaticity
• C. Contractility
• D. Excitability

Correct answer: A

Rationale: The correct answer is A, Frank-Starling’s Law. This law explains that within physiologic limits, the greater the stretch of myocardial fibers, the more forceful the ventricular contraction, leading to an increased stroke volume. Choice B, Automaticity, refers to the ability of cardiac cells to spontaneously generate electrical impulses. Choice C, Contractility, represents the intrinsic ability of the heart muscle to contract. Choice D, Excitability, refers to the ability of cardiac cells to respond to electrical stimuli.

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