Nursing Elites

1. Which condition is characterized by the sudden onset of shortness of breath, often occurring at night and associated with heart failure?

• A. Paroxysmal nocturnal dyspnea
• B. Sleep apnea
• C. Orthopnea
• D. Dyspnea

Correct answer: A

Rationale: Paroxysmal nocturnal dyspnea is the correct answer. It is characterized by the sudden onset of shortness of breath during sleep, often associated with heart failure. Choice B, Sleep apnea, involves pauses in breathing during sleep but is not specifically associated with heart failure. Choice C, Orthopnea, is difficulty breathing that occurs when lying down and is relieved by sitting up, not necessarily associated with heart failure. Choice D, Dyspnea, is a general term for difficulty breathing and does not specifically describe the sudden onset at night associated with heart failure as seen in paroxysmal nocturnal dyspnea.

2. Which valves close during ventricular systole and open during ventricular diastole?

• A. Semilunar valves
• B. Atrioventricular Valves
• C. Mitral valve
• D. Tricuspid valve

Correct answer: B

Rationale: The correct answer is B: Atrioventricular Valves. The atrioventricular (AV) valves, including the mitral valve and tricuspid valve, close during ventricular systole to prevent backflow of blood from the ventricles into the atria. They open during ventricular diastole to allow blood flow from the atria into the ventricles. Semilunar valves, choice A, are located at the exits of the ventricles and prevent backflow into the ventricles. The mitral valve and tricuspid valve, choices C and D, are specific types of AV valves.

3. The nurse is caring for a client on amiodarone who develops a cough. What is the most appropriate action?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect.
• C. Continue the amiodarone and monitor the client’s symptoms.
• D. Discontinue the amiodarone immediately.

Correct answer: A

Rationale: The correct action when a client on amiodarone develops a cough, which can be a sign of pulmonary toxicity, a serious side effect of amiodarone, is to notify the healthcare provider immediately. This is crucial because pulmonary toxicity can lead to severe complications if not addressed promptly. Choices B and C are incorrect as they do not address the potential severity of the situation and may delay necessary intervention. Choice D of discontinuing amiodarone immediately without consulting the healthcare provider can be risky, as sudden discontinuation of the medication may have adverse effects on the client's condition.

4. What is a condition where the right side of the heart fails due to increased pressure in the pulmonary arteries, often caused by chronic lung disease?

• A. Cor pulmonale
• B. Heart failure
• C. Pulmonary embolism
• D. Myocarditis

Correct answer: A

Rationale: Cor pulmonale is the correct answer. It is a condition where the right side of the heart fails due to increased pressure in the pulmonary arteries, often caused by chronic lung disease such as COPD. Pulmonary embolism (choice C) is a blockage in one of the pulmonary arteries in your lungs. Myocarditis (choice D) is inflammation of the heart muscle. While heart failure (choice B) is a broad term that can involve the failure of either the right or left side of the heart.

5. The client is on spironolactone (Aldactone). What is the most important dietary instruction?

• A. Avoid foods high in potassium.
• B. Increase intake of foods high in potassium.
• C. Avoid foods high in sodium.
• D. Increase intake of foods high in sodium.

Correct answer: A

Rationale: The correct answer is to avoid foods high in potassium. Spironolactone is a potassium-sparing diuretic, meaning it helps the body retain potassium and can lead to hyperkalemia if too much potassium is consumed. Choices B, C, and D are incorrect because increasing intake of potassium-rich foods can worsen hyperkalemia, while avoiding foods high in sodium is not the primary concern when taking spironolactone.

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