Nursing Elites

1. Which of the following is a central vasoconstrictor and peripheral vasodilator?

• A. Parasympathetic nervous system
• B. Sympathetic nervous system
• C. Dopamine
• D. Epinephrine

Correct answer: D

Rationale: The correct answer is D, Epinephrine. Epinephrine acts as a central vasoconstrictor and peripheral vasodilator. It increases heart rate and blood flow to muscles, helping to prepare the body for a 'fight or flight' response. Parasympathetic nervous system (choice A) does not cause vasoconstriction but rather vasodilation. The sympathetic nervous system (choice B) is primarily responsible for the fight or flight response, causing vasoconstriction. Dopamine (choice C) primarily acts as a neurotransmitter and hormone, not directly causing central vasoconstriction and peripheral vasodilation.

2. The nurse is caring for a client on enalapril (Vasotec). 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. Enalapril is an ACE inhibitor, and cough is a common side effect associated with this class of medication. Monitoring for cough is crucial as it can indicate the development of a potentially serious condition known as angioedema. Hyperkalemia (choice B) is a possible side effect of ACE inhibitors but is not the most important side effect to monitor. Hypotension (choice C) and dizziness (choice D) are also potential side effects of enalapril; however, cough takes precedence due to its association with angioedema, a severe adverse reaction.

3. The client on amiodarone develops pulmonary fibrosis. What action should the nurse take?

• A. Notify the healthcare provider immediately.
• B. Continue the medication and monitor lung function.
• C. Discontinue the medication and start oxygen therapy.
• D. Reduce the dose and monitor respiratory status.

Correct answer: A

Rationale: When a client on amiodarone develops pulmonary fibrosis, a serious side effect, the immediate action the nurse should take is to notify the healthcare provider. This is crucial because pulmonary fibrosis can lead to severe respiratory compromise and requires prompt evaluation and management by the healthcare provider. Continuing the medication (choice B) can worsen the condition, and delaying action by reducing the dose and monitoring respiratory status (choice D) may not be appropriate given the seriousness of pulmonary fibrosis. Discontinuing the medication and starting oxygen therapy (choice C) may be necessary, but the priority is to notify the healthcare provider first for further assessment and guidance.

4. What is a condition where the heart muscle is weakened and unable to pump blood effectively, often leading to heart failure?

• A. Cardiomyopathy
• B. Myocarditis
• C. Endocarditis
• D. Pericarditis

Correct answer: A

Rationale: Cardiomyopathy is the correct answer. In cardiomyopathy, the heart muscle becomes weak and cannot pump blood effectively, which can lead to heart failure. Myocarditis (choice B) is inflammation of the heart muscle, not specifically causing muscle weakness. Endocarditis (choice C) is an infection of the inner lining of the heart chambers and valves. Pericarditis (choice D) is inflammation of the pericardium, the outer lining of the heart.

5. What structure separates the left and right sides of the heart?

• A. Interventricular septum
• B. Endocardium
• C. Epicardium
• D. Pericardium

Correct answer: A

Rationale: The interventricular septum is the correct answer as it is the wall that separates the left and right sides of the heart, ensuring the oxygenated and deoxygenated blood do not mix. The endocardium is the inner lining of the heart chambers, the epicardium is the outermost layer of the heart wall, and the pericardium is the sac that surrounds the heart, providing protection and anchoring the heart in place. Therefore, choices B, C, and D are incorrect in the context of separating the left and right sides of the heart.

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