Nursing Elites

1. Which condition is characterized by the narrowing or blockage of arteries that supply blood to the heart by plaque?

• A. Coronary artery disease (CAD)
• B. Atherosclerosis
• C. Peripheral artery disease
• D. Congestive heart failure

Correct answer: A

Rationale: The correct answer is A, Coronary artery disease (CAD). CAD specifically refers to the condition where the arteries supplying blood to the heart become narrowed or blocked by plaque buildup. Choice B, Atherosclerosis, is a general term for the hardening and narrowing of arteries due to plaque buildup but does not specifically mention the heart. Choice C, Peripheral artery disease, involves narrowing of arteries that supply blood to areas other than the heart. Choice D, Congestive heart failure, is a condition where the heart is unable to pump blood effectively but is not primarily caused by narrowed or blocked arteries.

2. The client on warfarin has an INR of 1.2. What is the nurse’s priority action?

• A. Increase the dose of warfarin
• B. Administer vitamin K
• C. Monitor for signs of bleeding
• D. Hold the next dose and notify the healthcare provider

Correct answer: A

Rationale: The correct answer is to increase the dose of warfarin. An INR of 1.2 is below the therapeutic range for a client on warfarin, indicating that the dose is subtherapeutic. The priority action in this situation is to adjust the dose to achieve the target therapeutic INR range (usually 2-3) to prevent thromboembolic events. Administering vitamin K is not necessary as the INR is low, and there are no signs of bleeding. Monitoring for signs of bleeding is important but not the priority in this case since the INR is subtherapeutic. Holding the next dose and notifying the healthcare provider would delay the intervention needed to adjust the dose and achieve the therapeutic range.

3. Which condition is characterized by the weakening and rupture of the walls of the alveoli in the lungs, reducing the surface area available for gas exchange?

• A. Emphysema
• B. Bronchitis
• C. Atelectasis
• D. Pulmonary fibrosis

Correct answer: A

Rationale: The correct answer is A, Emphysema. Emphysema is a lung condition where the walls of the alveoli become weak and rupture, reducing the surface area available for gas exchange. This leads to shortness of breath. Choice B, Bronchitis, is characterized by inflammation of the bronchial tubes, not the alveoli. Choice C, Atelectasis, involves the collapse of a part or entire lung, not the weakening and rupture of alveolar walls. Choice D, Pulmonary fibrosis, is a condition where lung tissue becomes thickened and stiff, not involving the weakening and rupture of alveoli walls.

4. When administering dobutamine to a client, what is the most important parameter to assess?

• A. Blood pressure
• B. Heart rate
• C. Oxygen saturation
• D. Respiratory rate

Correct answer: A

Rationale: When giving dobutamine, the most critical parameter to assess is blood pressure. Dobutamine is known to cause significant changes in blood pressure, making it essential to closely monitor this parameter to prevent adverse effects. While heart rate is also important to monitor, blood pressure takes precedence due to the potential for hemodynamic instability caused by dobutamine. Oxygen saturation and respiratory rate, although vital signs to monitor, are not typically affected directly by dobutamine administration.

5. What is the ability of cardiac cells to respond to an impulse by contracting?

• A. Excitability
• B. Contractility
• C. Rhythmicity
• D. Conductivity

Correct answer: A

Rationale: Excitability is the correct term that describes the ability of cardiac cells to respond to an impulse by contracting. Excitability refers to the cell's ability to respond to stimuli and generate an action potential. Choice B, Contractility, is incorrect as it refers to the ability of cardiac cells to contract after receiving a stimulus, not the response to the impulse itself. Choice C, Rhythmicity, is incorrect as it pertains to the heart's ability to contract rhythmically without external stimulation. Choice D, Conductivity, is incorrect as it refers to the ability of cardiac cells to transmit an impulse from cell to cell, not the direct response to the impulse by contracting.

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