Nursing Elites

1. What is a condition where the heart muscle becomes thickened without an obvious cause, leading to a reduction in the heart's ability to pump blood?

• A. Hypertrophic cardiomyopathy
• B. Dilated cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Myocarditis

Correct answer: A

Rationale: Hypertrophic cardiomyopathy is the correct answer. It is a condition characterized by the abnormal thickening of the heart muscle without an obvious cause, which impairs the heart's ability to effectively pump blood. Dilated cardiomyopathy (choice B) involves the enlargement and weakening of the heart chambers, not thickening. Restrictive cardiomyopathy (choice C) refers to the stiffening of the heart muscle, limiting its ability to fill properly. Myocarditis (choice D) is inflammation of the heart muscle usually caused by a viral infection, not thickening.

2. The client on spironolactone (Aldactone) has a potassium level of 5.6 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 5.6 mEq/L is high, indicating hyperkalemia. Spironolactone is a potassium-sparing diuretic that can further elevate potassium levels. Therefore, the priority action is to withhold the medication to prevent exacerbating hyperkalemia and notify the healthcare provider for further management. Option B is incorrect because administering potassium supplements would worsen the hyperkalemia. Option C is incorrect as continuing spironolactone can lead to a further increase in potassium levels. Option D is incorrect as increasing the dose of spironolactone would be inappropriate in the presence of elevated potassium levels.

3. What is this surgical procedure that restores blood flow to the heart by diverting blood around a blocked artery?

• A. Coronary artery bypass graft (CABG)
• B. Angioplasty
• C. Stent placement
• D. Valve replacement

Correct answer: A

Rationale: The correct answer is A, Coronary artery bypass graft (CABG), which is a surgical procedure to improve blood flow to the heart by redirecting blood around blocked or narrowed arteries. This procedure is specifically designed to bypass blocked coronary arteries, allowing blood to flow more freely to the heart muscle. Choices B, C, and D are incorrect because angioplasty involves opening up narrowed or blocked blood vessels, stent placement involves inserting a mesh tube to keep arteries open, and valve replacement involves replacing a damaged heart valve - none of which directly address diverting blood flow around a blocked artery.

4. What is a condition where the lungs become stiff and scarred, making it difficult to breathe and get enough oxygen into the bloodstream?

• A. Pulmonary fibrosis
• B. Pulmonary edema
• C. Pulmonary embolism
• D. Pulmonary hypertension

Correct answer: A

Rationale: Pulmonary fibrosis is a condition characterized by the stiffening and scarring of the lungs, leading to difficulty breathing and impairing the transfer of oxygen into the bloodstream. Pulmonary edema refers to fluid accumulation in the lungs, causing breathing difficulties due to fluid filling the air sacs. Pulmonary embolism is a blockage in one of the pulmonary arteries in the lungs, often caused by a blood clot. Pulmonary hypertension is high blood pressure in the arteries of the lungs, which can lead to strain on the heart and affect oxygen levels in the blood.

5. The client is on nitroglycerin and reports chest pain. What is the nurse’s priority action?

• A. Administer nitroglycerin as ordered.
• B. Administer morphine as ordered.
• C. Administer aspirin as ordered.
• D. Notify the healthcare provider immediately.

Correct answer: D

Rationale: The correct answer is D: Notify the healthcare provider immediately. If a client on nitroglycerin reports chest pain, the priority action is to notify the healthcare provider immediately. This is crucial to ensure prompt reassessment of the client's condition and treatment plan. Administering nitroglycerin, morphine, or aspirin without consulting the healthcare provider first can be risky as the chest pain may indicate a need for a change in treatment or further evaluation. Administering medications without proper assessment and guidance can lead to complications and is not recommended in this scenario.

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