Nursing Elites

1. What is the condition where the arteries in the brain become blocked or narrowed, leading to reduced blood flow and a potential stroke?

• A. Cerebral atherosclerosis
• B. Coronary artery disease
• C. Pulmonary embolism
• D. Peripheral artery disease

Correct answer: A

Rationale: Cerebral atherosclerosis is the correct answer. It is a condition where the arteries in the brain become blocked or narrowed due to plaque buildup, leading to reduced blood flow and an increased risk of stroke. Choice B, Coronary artery disease, specifically affects the arteries supplying blood to the heart, not the brain. Choice C, Pulmonary embolism, involves a blockage in the pulmonary artery that affects blood flow to the lungs, not the brain. Choice D, Peripheral artery disease, refers to a condition where blockages occur in arteries outside of the heart and brain, typically affecting the limbs.

2. The client is on spironolactone (Aldactone) and has a potassium level of 5.9 mEq/L. What is the nurse’s priority action?

• A. Hold the spironolactone and notify the healthcare provider.
• B. Administer potassium supplements.
• C. Continue the spironolactone as ordered.
• D. Increase the dose of spironolactone.

Correct answer: A

Rationale: The correct answer is A: Hold the spironolactone and notify the healthcare provider. A potassium level of 5.9 mEq/L is high, indicating hyperkalemia. Spironolactone is a potassium-sparing diuretic that can further increase potassium levels. Therefore, the priority action is to hold the medication to prevent exacerbating hyperkalemia and notify the healthcare provider for further guidance. Choice B is incorrect because administering potassium supplements would worsen hyperkalemia. Choice C is incorrect because continuing spironolactone could lead to a further increase in potassium levels. Choice D is incorrect because increasing the dose of spironolactone would exacerbate the hyperkalemia.

3. The client on enoxaparin (Lovenox) is scheduled for surgery. What is the nurse’s priority action?

• A. Hold the enoxaparin and notify the healthcare provider.
• B. Administer the enoxaparin as scheduled.
• C. Administer vitamin K before the surgery.
• D. Monitor the client’s INR and proceed with surgery.

Correct answer: A

Rationale: The correct answer is A: Hold the enoxaparin and notify the healthcare provider. Enoxaparin, being an anticoagulant, should be held before surgery to reduce the risk of excessive bleeding during the procedure. It is crucial to inform the healthcare provider to determine the appropriate management plan. Choice B is incorrect because administering enoxaparin before surgery can increase the risk of bleeding. Choice C is incorrect as vitamin K administration is not typically indicated in this situation. Choice D is incorrect because monitoring the client's INR and proceeding with surgery without addressing the enoxaparin can lead to significant bleeding complications.

4. This term refers to a change in the inotropic state of the muscle without a change in myocardial fiber length.

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

Correct answer: A

Rationale: The correct answer is A: Contractility. Contractility specifically refers to the change in the force of contraction of the heart muscle without changing its length. In this scenario, the focus is on the change in the inotropic state of the muscle, which directly relates to contractility. Choice B, Excitability, refers to the ability of a cell to respond to a stimulus, not specifically related to changes in contractile force. Choice C, Refractoriness, pertains to the period during which a cell is unresponsive to a new stimulus. Choice D, Automaticity, refers to the ability of cardiac cells to spontaneously generate electrical impulses.

5. Which of the following is a chronic respiratory disease characterized by the irreversible obstruction of airflow?

• A. Chronic obstructive pulmonary disease (COPD)
• B. Asthma
• C. Pulmonary edema
• D. Bronchiectasis

Correct answer: A

Rationale: The correct answer is A, Chronic obstructive pulmonary disease (COPD). COPD is a chronic respiratory disease where the airflow in the lungs becomes obstructed, making it difficult to breathe. Choice B, Asthma, is a different chronic respiratory condition characterized by reversible airflow obstruction and airway hyperresponsiveness. Choice C, Pulmonary edema, is a condition where fluid accumulates in the lungs, leading to difficulty in breathing but not irreversible airflow obstruction. Choice D, Bronchiectasis, is a condition characterized by abnormal widening of the bronchial tubes, leading to recurrent respiratory infections, but it is not specifically defined by irreversible airflow obstruction.

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