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 condition is characterized by the inflammation of the heart's outer lining, often causing chest pain and other symptoms?

• A. Pericarditis
• B. Endocarditis
• C. Myocarditis
• D. Valvular heart disease

Correct answer: A

Rationale: Pericarditis is the correct answer because it is the inflammation of the pericardium, the outer lining of the heart. This condition commonly presents with symptoms like chest pain. Endocarditis (choice B) is the inflammation of the inner lining of the heart chambers and valves. Myocarditis (choice C) is the inflammation of the heart muscle itself. Valvular heart disease (choice D) refers to various conditions affecting the heart valves, not specifically the outer lining of the heart.

3. After the AV node, the electrical impulse is then transmitted into the _________, and into the _________.

• A. Purkinje fibers, ventricles
• B. Atria, ventricles
• C. Bundle of His, Purkinje fibers
• D. Ventricles, Purkinje fibers

Correct answer: C

Rationale: The correct answer is C. After the AV node, the electrical impulse is transmitted to the Bundle of His and then to the Purkinje fibers. This sequence is crucial for the coordinated contraction of the ventricles. Choice A (Purkinje fibers, ventricles) is incorrect because the Purkinje fibers come after the Bundle of His in the sequence of electrical conduction. Choice B (Atria, ventricles) is incorrect because the impulse does not go back to the atria after passing through the AV node. Choice D (Ventricles, Purkinje fibers) is incorrect because the impulse first reaches the Bundle of His before spreading to the Purkinje fibers.

4. Which condition involves the enlargement and weakening of the left ventricle of the heart, leading to reduced pumping ability?

• A. Dilated cardiomyopathy
• B. Hypertrophic cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Pericarditis

Correct answer: A

Rationale: The correct answer is A: Dilated cardiomyopathy. Dilated cardiomyopathy is characterized by the enlargement and weakening of the left ventricle of the heart, which results in a reduced ability to pump blood effectively. Choice B, Hypertrophic cardiomyopathy, involves thickening of the heart muscle, not enlargement. Choice C, Restrictive cardiomyopathy, is characterized by stiffening of the heart muscle, not enlargement. Choice D, Pericarditis, refers to inflammation of the pericardium, the lining surrounding the heart, and does not involve enlargement and weakening of the left ventricle.

5. What test measures the pressure inside the arteries as the heart pumps blood?

• A. Blood pressure test
• B. Pulse oximetry
• C. Echocardiogram
• D. Spirometry

Correct answer: A

Rationale: The correct answer is A) Blood pressure test. A blood pressure test is specifically designed to measure the pressure inside the arteries as the heart pumps blood. This test is crucial in providing information about cardiovascular health by determining the force of blood against the artery walls. Choice B, Pulse oximetry, measures oxygen saturation in the blood, not blood pressure. Choice C, Echocardiogram, is an ultrasound test that evaluates the structure and function of the heart, not specifically blood pressure. Choice D, Spirometry, is a test used to assess lung function, not blood pressure.

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