Nursing Elites

1. The nurse is administering digoxin to a client with a heart rate of 45 bpm. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Increase the dose of digoxin.
• D. Monitor the client’s heart rate and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A heart rate of 45 bpm is already low, and digoxin can further decrease the heart rate, leading to serious complications like bradycardia or heart block. Administering the medication can exacerbate the bradycardia, hence it should be withheld. Increasing the dose of digoxin is contraindicated due to the client's low heart rate. Monitoring the heart rate alone without taking immediate action to withhold the medication is not the priority when faced with the risk of further lowering the heart rate.

2. What structures hold up the AV valves and are anchored to the ventricular wall by the papillary muscles?

• A. Chordae tendineae
• B. Papillary muscles
• C. Semilunar valves
• D. Aortic valve

Correct answer: A

Rationale: The correct answer is A: Chordae tendineae. Chordae tendineae are fibrous cords that connect the AV valves to the papillary muscles, preventing the valves from inverting during ventricular contraction. Papillary muscles (choice B) anchor the chordae tendineae to the ventricular wall but do not hold up the AV valves directly. Semilunar valves (choice C) are located between the ventricles and the major arteries and are not involved in holding up the AV valves. The aortic valve (choice D) is one of the semilunar valves and is not responsible for holding up the AV valves.

3. What is a condition where the heart beats with an irregular or abnormal rhythm?

• A. Arrhythmia
• B. Hypertension
• C. Tachycardia
• D. Bradycardia

Correct answer: A

Rationale: Arrhythmia is the correct answer because it refers to an irregular or abnormal heart rhythm, which can cause the heart to beat too fast, too slow, or erratically. Hypertension (choice B) is high blood pressure and not directly related to irregular heart rhythm. Tachycardia (choice C) is a condition where the heart beats too quickly, not necessarily irregularly. Bradycardia (choice D) is a condition where the heart beats too slowly, not necessarily irregularly. Therefore, only arrhythmia (choice A) fits the description provided in the question.

4. Which of the following is a chronic lung disease that includes conditions such as chronic bronchitis and emphysema, characterized by obstructed airflow from the lungs?

• A. Chronic obstructive pulmonary disease (COPD)
• B. Pulmonary fibrosis
• C. Asthma
• D. Pneumonia

Correct answer: A

Rationale: The correct answer is A, Chronic obstructive pulmonary disease (COPD). COPD is a chronic lung disease that encompasses conditions like chronic bronchitis and emphysema. These conditions lead to obstructed airflow from the lungs, causing symptoms such as cough, shortness of breath, and wheezing. Choice B, Pulmonary fibrosis, involves scarring of the lung tissue, leading to breathing difficulties but is not specifically characterized by obstructed airflow like COPD. Asthma (Choice C) is a chronic condition characterized by airway inflammation and bronchoconstriction, not always resulting in obstructed airflow. Pneumonia (Choice D) is an acute infection of the lung tissue, causing symptoms like fever, cough, and difficulty breathing, but is not a chronic condition like COPD.

5. What procedure uses a catheter to open up a blocked or narrowed coronary artery, often involving the placement of a stent?

• A. Angioplasty
• B. Echocardiogram
• C. CT angiography
• D. Coronary artery bypass graft (CABG)

Correct answer: A

Rationale: The correct answer is Angioplasty. Angioplasty is a procedure that uses a catheter to open up a blocked or narrowed coronary artery, often involving the placement of a stent. Echocardiogram is a diagnostic test that uses sound waves to create images of the heart. CT angiography is a type of imaging test that looks at blood vessels, but it does not involve the placement of a stent. Coronary artery bypass graft (CABG) is a surgical procedure to improve blood flow to the heart muscle by bypassing blocked coronary arteries.

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