Nursing Elites

1. The nurse is giving nitroglycerin sublingually for chest pain. What is the most important instruction to give to the client?

• A. Place the tablet under the tongue and let it dissolve completely.
• B. Swallow the tablet whole with a glass of water.
• C. Chew the tablet and then swallow it.
• D. Take one tablet every 5 minutes until pain is relieved.

Correct answer: A

Rationale: The correct answer is A. The tablet should be placed under the tongue and allowed to dissolve completely to ensure rapid absorption. This route of administration allows the medication to be quickly absorbed into the bloodstream. Choice B is incorrect because nitroglycerin is meant to be absorbed sublingually, not swallowed. Choice C is incorrect as chewing the tablet can cause the medication to be rapidly absorbed, leading to adverse effects like a drop in blood pressure. Choice D is incorrect because the client should take only one tablet every 5 minutes up to a maximum of three tablets for chest pain relief.

2. The healthcare provider is preparing to administer heparin to a client. What lab value should be monitored?

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

Correct answer: B

Rationale: The correct lab value that should be monitored when administering heparin is the aPTT (activated partial thromboplastin time). Heparin affects the intrinsic pathway of the coagulation cascade, and aPTT is a sensitive measure to assess the effectiveness of heparin therapy. Monitoring aPTT helps in adjusting the heparin dose to maintain the desired anticoagulant effect. PT/INR is more specific to monitor warfarin therapy, not heparin. Platelet count and hemoglobin levels are important parameters to assess bleeding tendencies and oxygen-carrying capacity but are not directly related to monitoring heparin therapy.

3. What is the ability of cardiac cells to respond to an impulse by transmitting the impulse along cell membranes?

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

Correct answer: C

Rationale: The correct answer is C, Conductivity. Conductivity refers to the ability of cardiac cells to transmit impulses along cell membranes. Contractility (Choice A) is the ability of cardiac cells to contract in response to an electrical stimulus, not transmit impulses. Automaticity (Choice B) is the ability of cardiac cells to spontaneously generate electrical impulses. Rhythmicity (Choice D) refers to the regular generation of electrical impulses by the heart's pacemaker cells, not the transmission of impulses along cell membranes.

4. What is a condition where the airways become inflamed and narrow, making breathing difficult?

• A. Asthma
• B. Bronchitis
• C. Pleurisy
• D. Tuberculosis

Correct answer: A

Rationale: Asthma is the correct answer. It is a condition characterized by inflammation, narrowing, and swelling of the airways, leading to symptoms like wheezing, shortness of breath, and coughing. Bronchitis is the inflammation of the bronchial tubes; Pleurisy is inflammation of the tissues that line the lungs and chest cavity; Tuberculosis is a bacterial infection that mainly affects the lungs.

5. Which term refers to the ability of the heart to initiate impulses repetitively and spontaneously?

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

Correct answer: C

Rationale: The correct answer is C: Automaticity. Automaticity is the specific term used to describe the heart's ability to generate impulses repetitively and spontaneously. Contractility (A) refers to the ability of muscle fibers to contract, not the initiation of impulses. Excitability (B) is the ability of cells to respond to stimuli but is not specific to the heart's impulse generation. Rhythmicity (D) is a related term but does not specifically describe the heart's spontaneous impulse initiation.

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