Nursing Elites

1. The nurse is administering digoxin to a client. What is the most important parameter to check before administration?

• A. Heart rate
• B. Blood pressure
• C. Respiratory rate
• D. Oxygen saturation

Correct answer: A

Rationale: The correct answer is A: Heart rate. Before administering digoxin, it is crucial to check the client's heart rate because digoxin can cause bradycardia, making it essential to ensure the heart rate is within the appropriate range. Blood pressure, respiratory rate, and oxygen saturation are also important parameters to monitor in a clinical setting, but when administering digoxin, the focus should primarily be on the heart rate due to its potential effects on cardiac function.

2. What is the condition where the pericardium, the sac surrounding the heart, becomes inflamed, leading to chest pain and other symptoms?

• A. Pericarditis
• B. Myocarditis
• C. Endocarditis
• D. Pulmonary hypertension

Correct answer: A

Rationale: Pericarditis is the correct answer. It is the inflammation of the pericardium, the sac surrounding the heart, which can lead to chest pain and other symptoms. Myocarditis (choice B) is inflammation of the heart muscle, not the pericardium. Endocarditis (choice C) is inflammation of the inner lining of the heart chambers and valves, not the pericardium. Pulmonary hypertension (choice D) is high blood pressure in the arteries of the lungs, not related to pericardial inflammation.

3. The client on atorvastatin (Lipitor) should be advised to report which of the following symptoms?

• A. Muscle pain
• B. Headache
• C. Nausea
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Muscle pain. Muscle pain can be a sign of rhabdomyolysis, a serious side effect of statins like atorvastatin. Rhabdomyolysis is a condition where muscle fibers break down rapidly and release their contents into the bloodstream, which can lead to kidney damage. Headache, nausea, and dizziness are not commonly associated with atorvastatin use and are less likely to indicate a serious adverse reaction compared to muscle pain.

4. This is a procedure where a small mesh tube is inserted into an artery to keep it open and improve blood flow.

• A. Stent placement
• B. Angioplasty
• C. Bypass surgery
• D. Coronary artery bypass graft (CABG)

Correct answer: A

Rationale: Stent placement is a procedure where a small mesh tube (stent) is inserted into an artery to keep it open and improve blood flow, often following angioplasty.

5. 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.

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