Nursing Elites

1. Which neurotransmitter released by the parasympathetic nervous system can decrease heart rate?

• A. Acetylcholine
• B. Norepinephrine
• C. Dopamine
• D. Serotonin

Correct answer: A

Rationale: Acetylcholine is the correct answer. It is a neurotransmitter released by the parasympathetic nervous system that can decrease heart rate. Norepinephrine, dopamine, and serotonin are neurotransmitters that usually have different effects on the body and are not specifically associated with decreasing heart rate. Norepinephrine, for example, is often related to the fight-or-flight response and can increase heart rate.

2. Which procedure is used to restore a normal heart rhythm in patients with arrhythmias, typically using electrical shocks?

• A. Cardioversion
• B. Defibrillation
• C. Ablation
• D. Angioplasty

Correct answer: A

Rationale: The correct answer is A: Cardioversion. Cardioversion is the procedure used to restore a normal heart rhythm in patients with arrhythmias by delivering controlled electrical shocks to the heart. Choice B, Defibrillation, is incorrect because defibrillation is used to treat life-threatening arrhythmias by delivering an unsynchronized high-energy shock to the heart. Choice C, Ablation, is incorrect as it involves destroying abnormal tissue that causes arrhythmias, not necessarily restoring normal heart rhythm. Choice D, Angioplasty, is unrelated to heart rhythm restoration and is a procedure to open blocked or narrowed blood vessels.

3. The client is on enalapril (Vasotec) for hypertension. What side effect is most commonly associated with this medication?

• A. Dry cough
• B. Hypotension
• C. Hyperkalemia
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Dry cough. A dry cough is a common side effect of ACE inhibitors like enalapril. ACE inhibitors can cause the accumulation of bradykinin, leading to irritation of the respiratory tract and resulting in a persistent dry cough. Hypotension (choice B) is a possible side effect of ACE inhibitors but is less common than a dry cough. Hyperkalemia (choice C) is another side effect of ACE inhibitors, but it is not the most commonly associated one. Headache (choice D) is not a common side effect of enalapril compared to a dry cough. Therefore, the most commonly associated side effect with enalapril is a dry cough.

4. What is the term for the ability of cardiac cells to respond to a stimulus by initiating a cardiac impulse?

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

Correct answer: A

Rationale: The correct answer is A, Excitability. Excitability is the ability of cardiac cells to respond to a stimulus by initiating a cardiac impulse. Choice B, Contractility, refers to the ability of cardiac muscle to shorten forcibly. Choice C, Rhythmicity, refers to the cardiac muscle's ability to contract rhythmically. Choice D, Conductivity, refers to the ability of the heart's cells to conduct electrical impulses.

5. The nurse is administering a beta blocker to a client with a heart rate of 50 bpm. What is the priority action?

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

Correct answer: A

Rationale: The correct action is to hold the beta blocker and notify the healthcare provider. A heart rate of 50 bpm is already low, and beta blockers can further decrease the heart rate, potentially causing adverse effects like bradycardia or heart block. Administering the beta blocker as ordered (Choice B) can exacerbate the low heart rate. Decreasing the dose of the beta blocker (Choice C) may not be sufficient to address the potential harm. Monitoring the client’s heart rate and reassessing in 30 minutes (Choice D) may delay necessary interventions if the heart rate drops further. Therefore, the priority is to hold the medication and seek guidance from the healthcare provider.

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