Nursing Elites

1. What is a condition where the heart muscle is weakened and unable to pump blood effectively, often leading to heart failure?

• A. Cardiomyopathy
• B. Myocarditis
• C. Endocarditis
• D. Pericarditis

Correct answer: A

Rationale: Cardiomyopathy is the correct answer. In cardiomyopathy, the heart muscle becomes weak and cannot pump blood effectively, which can lead to heart failure. Myocarditis (choice B) is inflammation of the heart muscle, not specifically causing muscle weakness. Endocarditis (choice C) is an infection of the inner lining of the heart chambers and valves. Pericarditis (choice D) is inflammation of the pericardium, the outer lining of the heart.

2. The nurse is administering digoxin to a client with a heart rate of 45 bpm. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Increase the dose of digoxin.
• D. Monitor the client’s heart rate and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A heart rate of 45 bpm is already low, and digoxin can further decrease the heart rate, leading to serious complications like bradycardia or heart block. Administering the medication can exacerbate the bradycardia, hence it should be withheld. Increasing the dose of digoxin is contraindicated due to the client's low heart rate. Monitoring the heart rate alone without taking immediate action to withhold the medication is not the priority when faced with the risk of further lowering the heart rate.

3. What structures hold up the AV valves and are anchored to the ventricular wall by the papillary muscles?

• A. Chordae tendineae
• B. Papillary muscles
• C. Semilunar valves
• D. Aortic valve

Correct answer: A

Rationale: The correct answer is A: Chordae tendineae. Chordae tendineae are fibrous cords that connect the AV valves to the papillary muscles, preventing the valves from inverting during ventricular contraction. Papillary muscles (choice B) anchor the chordae tendineae to the ventricular wall but do not hold up the AV valves directly. Semilunar valves (choice C) are located between the ventricles and the major arteries and are not involved in holding up the AV valves. The aortic valve (choice D) is one of the semilunar valves and is not responsible for holding up the AV valves.

4. What is the ability of cardiac cells to generate an electrical impulse without being stimulated by an external source?

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

Correct answer: A

Rationale: Automaticity is the correct answer because it refers to the inherent ability of cardiac cells to generate electrical impulses without the need for external stimulation. Contractility (Choice B) is the ability of the heart muscle to contract and generate force, not related to electrical impulse generation. Conductivity (Choice C) refers to the ability of cardiac cells to transmit electrical impulses from cell to cell, not the spontaneous generation of impulses. Refractoriness (Choice D) is the period during which the cardiac cells are recovering and not able to respond to a new stimulus, not the spontaneous generation of impulses.

5. What is the term that describes the inability of cardiac cells to respond to a new stimulus while they are still in contraction from a previous stimulus?

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

Correct answer: A

Rationale: Refractoriness is the correct term to describe the inability of cardiac cells to respond to a new stimulus while they are still in contraction from a previous stimulus. This period is essential for the heart to complete its contraction and relaxation phases without interference. Excitability refers to the ability of cells to respond to stimuli, not the inability to respond. Contractility is the force of cardiac muscle contraction, and automaticity is the ability of cardiac cells to generate electrical impulses spontaneously, which are not relevant to the described scenario.

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