Nursing Elites

1. The nurse is teaching a client about side effects of ACE inhibitors. What is the most important side effect to monitor?

• A. Cough
• B. Hyperkalemia
• C. Hypotension
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Cough. ACE inhibitors commonly cause a persistent dry cough in patients. This side effect is important to monitor because it can indicate the development of angioedema, a serious adverse reaction that requires immediate medical attention. Hyperkalemia (choice B) is a potential side effect of ACE inhibitors but is not typically the most important one to monitor. Hypotension (choice C) and dizziness (choice D) are also possible side effects of ACE inhibitors, but they are not as critical to monitor as the development of a persistent cough.

2. Which term refers to the relaxation phase of the heart, during which the chambers fill with blood?

• A. Diastole
• B. Systole
• C. Refractoriness
• D. Automaticity

Correct answer: A

Rationale: The correct answer is A, Diastole. Diastole is the phase of the cardiac cycle when the heart muscles relax, allowing the chambers to fill with blood. Choice B, Systole, is incorrect as systole is the contraction phase of the heart when blood is pumped out of the chambers. Choice C, Refractoriness, refers to a period during which the heart muscle is unresponsive to stimuli. Choice D, Automaticity, relates to the heart's ability to generate its own electrical impulses.

3. What procedure involves using a balloon to open a narrowed or blocked blood vessel, often followed by the placement of a stent?

• A. Angioplasty
• B. Valve replacement
• C. Coronary artery bypass graft (CABG)
• D. Endarterectomy

Correct answer: A

Rationale: The correct answer is A, Angioplasty. Angioplasty is a procedure that uses a balloon to open a narrowed or blocked blood vessel, often followed by the placement of a stent to maintain vessel patency. Choice B, Valve replacement, involves replacing damaged heart valves, not treating narrowed blood vessels. Choice C, Coronary artery bypass graft (CABG), is a procedure to bypass blocked coronary arteries, not directly open them using a balloon. Choice D, Endarterectomy, is a surgical procedure to remove plaque from the inner lining of an artery, not involving the use of a balloon and stent to open a vessel.

4. Which valve prevents backflow of blood into the left ventricle from the aorta?

• A. Aortic valve
• B. Mitral valve
• C. Tricuspid valve
• D. Pulmonary valve

Correct answer: A

Rationale: The correct answer is Aortic valve. The aortic valve is positioned between the left ventricle and the aorta. It prevents blood from flowing back into the left ventricle after it has been pumped into the aorta. The mitral valve (Choice B) is located between the left atrium and the left ventricle, the tricuspid valve (Choice C) is between the right atrium and right ventricle, and the pulmonary valve (Choice D) is situated between the right ventricle and the pulmonary artery. Therefore, they are not responsible for preventing backflow from the aorta into the left ventricle.

5. The nurse is giving the client digoxin for heart failure and recognizes that the drug has what type of effect on the heart?

• A. Negative inotropic, negative chronotropic effect
• B. Positive inotropic, negative chronotropic effect
• C. Negative inotropic, positive chronotropic effect
• D. Positive inotropic, positive chronotropic effect

Correct answer: B

Rationale: The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin strengthens the heart muscle, providing a positive inotropic effect, which increases the force of contraction. It also decreases the heart rate, having a negative chronotropic effect. Choice A is incorrect because digoxin has a positive inotropic effect, not a negative inotropic effect. Choice C is incorrect as digoxin does not have a positive chronotropic effect but a negative one. Choice D is incorrect because while digoxin has a positive inotropic effect, it does not have a positive chronotropic effect.

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