Nursing Elites

1. What term describes a condition where a person experiences difficulty breathing when lying flat and requires multiple pillows to sleep comfortably?

• A. Orthopnea
• B. Dyspnea
• C. Tachypnea
• D. Bradypnea

Correct answer: A

Rationale: The correct answer is A, Orthopnea. Orthopnea is a condition where a person finds it hard to breathe while lying flat and needs to use multiple pillows to sleep comfortably. This position helps relieve the discomfort by allowing better lung expansion. Choice B, Dyspnea, refers to difficulty breathing in general, not specifically related to lying flat. Choice C, Tachypnea, is rapid breathing and is not directly related to difficulty breathing while lying down. Choice D, Bradypnea, is slow breathing and does not describe the condition of having trouble breathing when lying flat.

2. The client is receiving digoxin and has a potassium level of 2.8 mEq/L. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Increase the dose of digoxin.
• C. Continue the current dose of digoxin.
• D. Administer potassium supplements.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 2.8 mEq/L indicates hypokalemia, which can increase the risk of digoxin toxicity. Holding the medication and informing the healthcare provider is crucial to prevent adverse effects. Choice B is incorrect because increasing the dose of digoxin would further raise the risk of toxicity. Choice C is incorrect as continuing the current dose could exacerbate the toxicity risk. Choice D is incorrect because administering potassium supplements alone is not sufficient to address the potential digoxin toxicity; the first step should be to hold the digoxin and seek further guidance.

3. This is a more accurate indicator of tissue perfusion. It represents the cardiac output in terms of liters per minute per square meter of body surface area. Its normal range is 2.4-4 L/min.

• A. Cardiac Index
• B. Stroke volume
• C. Ejection fraction
• D. Cardiac output

Correct answer: A

Rationale: The correct answer is A: Cardiac Index. Cardiac Index is a measure of cardiac output relative to body surface area, providing a more accurate assessment of tissue perfusion. It is calculated by dividing the cardiac output by the body surface area. The normal range for cardiac index is 2.4-4 L/min/m². Choice B, Stroke volume, refers to the amount of blood ejected by the heart in one contraction and is not adjusted for body surface area. Choice C, Ejection fraction, is the percentage of blood pumped out of the heart's ventricles with each contraction, not adjusted for body surface area. Choice D, Cardiac output, is the total volume of blood pumped by the heart per minute, without considering body surface area.

4. Which procedure is used to restore a normal heart rhythm in patients with arrhythmias, typically using electrical shocks?

• A. Cardioversion
• B. Defibrillation
• C. Ablation
• D. Angioplasty

Correct answer: A

Rationale: The correct answer is A: Cardioversion. Cardioversion is the procedure used to restore a normal heart rhythm in patients with arrhythmias by delivering controlled electrical shocks to the heart. Choice B, Defibrillation, is incorrect because defibrillation is used to treat life-threatening arrhythmias by delivering an unsynchronized high-energy shock to the heart. Choice C, Ablation, is incorrect as it involves destroying abnormal tissue that causes arrhythmias, not necessarily restoring normal heart rhythm. Choice D, Angioplasty, is unrelated to heart rhythm restoration and is a procedure to open blocked or narrowed blood vessels.

5. What test measures the electrical activity of the heart over a 24- or 48-hour period?

• A. Holter monitor
• B. Electrocardiogram
• C. Stress test
• D. Chest X-ray

Correct answer: A

Rationale: The correct answer is A, Holter monitor. A Holter monitor is a portable device that continuously records the heart's electrical activity over 24 to 48 hours, aiding in the diagnosis of arrhythmias and other heart conditions. Choice B, an Electrocardiogram, provides a snapshot of the heart's electrical activity at a specific point in time, not over an extended period like a Holter monitor. Choice C, a Stress test, measures how the heart responds to physical activity and is not used for continuous monitoring of electrical activity. Choice D, a Chest X-ray, is used to visualize the structures of the chest, not to measure the heart's electrical activity.

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