Nursing Elites

1. What procedure uses a catheter to open up a blocked or narrowed coronary artery, often involving the placement of a stent?

• A. Angioplasty
• B. Echocardiogram
• C. CT angiography
• D. Coronary artery bypass graft (CABG)

Correct answer: A

Rationale: The correct answer is Angioplasty. Angioplasty is a procedure that uses a catheter to open up a blocked or narrowed coronary artery, often involving the placement of a stent. Echocardiogram is a diagnostic test that uses sound waves to create images of the heart. CT angiography is a type of imaging test that looks at blood vessels, but it does not involve the placement of a stent. Coronary artery bypass graft (CABG) is a surgical procedure to improve blood flow to the heart muscle by bypassing blocked coronary arteries.

2. The client has a prescription for sublingual nitroglycerin. What is the nurse's instruction for how to take this medication during an episode of chest pain?

• A. Take one tablet every 5 minutes, up to three tablets.
• B. Take one tablet every hour until the pain subsides.
• C. Take two tablets immediately if chest pain occurs.
• D. Take one tablet with a full glass of water.

Correct answer: A

Rationale: The correct answer is A. The standard instruction for sublingual nitroglycerin during an episode of chest pain is to take one tablet every 5 minutes, up to three tablets. If the pain persists after taking three tablets, the client should seek emergency help. Choice B is incorrect because taking one tablet every hour is not the appropriate dosing for acute chest pain. Choice C is incorrect as taking two tablets immediately is not in line with the recommended dosing instructions. Choice D is incorrect because sublingual nitroglycerin should be placed under the tongue, not swallowed with water.

3. The client is on hydrochlorothiazide and digoxin. What effect can the nurse expect?

• A. Hydrochlorothiazide increases digoxin levels.
• B. Hydrochlorothiazide decreases digoxin levels.
• C. Hydrochlorothiazide decreases potassium, increasing the risk of digoxin toxicity.
• D. Digoxin can increase the effectiveness of hydrochlorothiazide.

Correct answer: C

Rationale: The correct answer is C. Hydrochlorothiazide is a diuretic that can decrease potassium levels, which in turn can increase the risk of digoxin toxicity. Digoxin typically doesn't impact hydrochlorothiazide levels or effectiveness, making choices A, B, and D incorrect. Choice A stating that hydrochlorothiazide increases digoxin levels is inaccurate. Choice B suggesting that hydrochlorothiazide decreases digoxin levels is also incorrect. Choice D, stating that digoxin can increase the effectiveness of hydrochlorothiazide, is not a typical interaction seen between these medications.

4. What is the condition where the lungs become filled with fluid, often due to heart failure, making it difficult to breathe?

• A. Pulmonary edema
• B. Pleural effusion
• C. Pulmonary hypertension
• D. Pneumothorax

Correct answer: A

Rationale: Pulmonary edema is the correct answer. It occurs when fluid fills the lungs, usually due to heart failure, leading to breathing difficulties. Pleural effusion is the accumulation of fluid around the lungs, not inside. Pulmonary hypertension is high blood pressure in the arteries of the lungs, and pneumothorax is the presence of air between the lung and chest wall.

5. 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.

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