Nursing Elites

1. 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.

2. What procedure uses a balloon to open narrowed or blocked blood vessels in the heart?

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

Correct answer: A

Rationale: The correct answer is Angioplasty. Angioplasty is a procedure that involves using a balloon to open narrowed or blocked blood vessels in the heart, thereby improving blood flow. This choice is correct because it directly matches the description provided in the question. Choices B, C, and D are incorrect because they involve different procedures: Bypass graft is a surgical procedure to redirect blood flow, stent placement involves inserting a mesh tube to keep an artery open, and valve replacement is the surgical replacement of a heart valve.

3. 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.

4. What procedure is used to visualize the airways and diagnose lung disease?

• A. Bronchoscopy
• B. Thoracentesis
• C. Pulmonary function test
• D. Chest X-ray

Correct answer: A

Rationale: Bronchoscopy is the correct answer because it is a procedure specifically designed to visualize the airways and diagnose lung diseases by allowing doctors to examine the inside of the airways. Thoracentesis involves the removal of fluid from the pleural space around the lungs, not the airways. Pulmonary function tests assess how well the lungs work but do not visualize the airways directly. A chest X-ray provides an image of the lungs and surrounding structures but does not involve direct visualization of the airways.

5. What is a surgical procedure to remove one of the lobes of the lungs, often performed to treat lung cancer?

• A. Lobectomy
• B. Pneumonectomy
• C. Thoracotomy
• D. Tracheostomy

Correct answer: A

Rationale: A lobectomy is the correct answer. This surgical procedure involves removing one of the lobes of the lungs, commonly done to treat lung cancer or other serious lung ailments. Choice B, pneumonectomy, involves the complete removal of a lung, not just a lobe. Choice C, thoracotomy, is a surgical incision into the chest wall and is not specific to removing a lung lobe. Choice D, tracheostomy, is the creation of an opening in the windpipe to assist with breathing and is unrelated to lung lobe removal.

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