Nursing Elites

1. What is the condition where the heart's mitral valve does not close properly, allowing blood to leak backward into the left atrium?

• A. Mitral regurgitation
• B. Aortic stenosis
• C. Tricuspid regurgitation
• D. Pulmonary hypertension

Correct answer: A

Rationale: Mitral regurgitation is the condition where the heart's mitral valve does not close properly, allowing blood to leak backward into the left atrium. This can result in symptoms like shortness of breath and fatigue. Choices B, C, and D are incorrect because aortic stenosis, tricuspid regurgitation, and pulmonary hypertension involve different heart valves or conditions, not the mitral valve specifically.

2. The client on spironolactone (Aldactone) has a potassium level of 5.8 mEq/L. What is the nurse’s priority action?

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

Correct answer: A

Rationale: With a potassium level of 5.8 mEq/L, which is high, the priority action for the nurse is to hold the spironolactone. Spironolactone is a potassium-sparing diuretic that can further increase potassium levels. Therefore, it is crucial to prevent exacerbating hyperkalemia by discontinuing the medication. Notifying the healthcare provider is necessary for further guidance and potential adjustments to the treatment plan. Administering a potassium supplement (Choice B) would be contraindicated since the client already has elevated potassium levels. Continuing the spironolactone as ordered (Choice C) can worsen hyperkalemia. Increasing the dose of spironolactone (Choice D) would be unsafe and exacerbate the high potassium levels.

3. What procedure involves inserting a flexible tube with a light and camera into the airways to examine the lungs and collect samples?

• A. Bronchoscopy
• B. Thoracentesis
• C. Lung biopsy
• D. Chest X-ray

Correct answer: A

Rationale: The correct answer is A: Bronchoscopy. Bronchoscopy is a procedure that entails inserting a flexible tube with a light and camera into the airways to examine the lungs and collect tissue or fluid samples. This procedure is commonly performed to diagnose lung conditions such as infections, tumors, or obstructions. Choice B, thoracentesis, involves inserting a needle into the pleural space to remove fluid for diagnostic or therapeutic purposes related to the lungs or pleura, not the airways. Choice C, lung biopsy, typically involves obtaining tissue samples from the lungs for further examination, not directly visualizing the airways. Choice D, chest X-ray, is a diagnostic imaging technique that uses radiation to create images of the chest area, providing a different type of information compared to bronchoscopy.

4. 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.

5. Which type of medication is used to reduce the workload on the heart by slowing down the heart rate and lowering blood pressure?

• A. Beta-blocker
• B. ACE inhibitor
• C. Calcium channel blocker
• D. Diuretic

Correct answer: A

Rationale: The correct answer is A: Beta-blocker. Beta-blockers are medications that reduce the workload on the heart by slowing down the heart rate and lowering blood pressure. They are commonly used in the treatment of heart conditions such as hypertension and heart failure. ACE inhibitors (B) work by dilating blood vessels to reduce blood pressure, calcium channel blockers (C) prevent calcium from entering the heart muscle and blood vessel walls, and diuretics (D) help the body get rid of excess salt and water by increasing urine production.

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