Nursing Elites

1. What procedure uses a catheter to open blocked coronary arteries and improve blood flow to the heart muscle?

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

Correct answer: A

Rationale: The correct answer is A, Angioplasty. Angioplasty is a procedure where a catheter is used to open blocked coronary arteries and may involve the insertion of a stent to improve blood flow to the heart muscle. Stent placement (B) is a related procedure but specifically refers to the insertion of a stent. Coronary artery bypass graft (CABG) (C) is a surgical procedure that uses blood vessels to bypass blocked coronary arteries. Valve replacement (D) is a different procedure that involves replacing a heart valve, not opening blocked coronary arteries.

2. Which of the following is a central vasoconstrictor and peripheral vasodilator?

• A. Parasympathetic nervous system
• B. Sympathetic nervous system
• C. Dopamine
• D. Epinephrine

Correct answer: D

Rationale: The correct answer is D, Epinephrine. Epinephrine acts as a central vasoconstrictor and peripheral vasodilator. It increases heart rate and blood flow to muscles, helping to prepare the body for a 'fight or flight' response. Parasympathetic nervous system (choice A) does not cause vasoconstriction but rather vasodilation. The sympathetic nervous system (choice B) is primarily responsible for the fight or flight response, causing vasoconstriction. Dopamine (choice C) primarily acts as a neurotransmitter and hormone, not directly causing central vasoconstriction and peripheral vasodilation.

3. The nurse is giving a client an IV bolus of heparin. What is the most important nursing action?

• A. Monitor the client's heart rate.
• B. Check the client's blood pressure.
• C. Check for signs of bleeding.
• D. Monitor the client's respiratory rate.

Correct answer: A

Rationale: When administering an IV bolus of heparin, the most important nursing action is to monitor the client's heart rate. Heparin can cause bradycardia as a side effect, making it crucial to assess the heart rate for any abnormalities. Checking the blood pressure (Choice B) is important but not as critical as monitoring the heart rate. While checking for signs of bleeding (Choice C) is essential, it is not the most crucial action when administering heparin. Monitoring the respiratory rate (Choice D) is also important but not as directly related to the potential side effects of heparin as monitoring the heart rate.

4. What is the ability of cardiac cells to respond to an impulse by contracting?

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

Correct answer: A

Rationale: Excitability is the correct term that describes the ability of cardiac cells to respond to an impulse by contracting. Excitability refers to the cell's ability to respond to stimuli and generate an action potential. Choice B, Contractility, is incorrect as it refers to the ability of cardiac cells to contract after receiving a stimulus, not the response to the impulse itself. Choice C, Rhythmicity, is incorrect as it pertains to the heart's ability to contract rhythmically without external stimulation. Choice D, Conductivity, is incorrect as it refers to the ability of cardiac cells to transmit an impulse from cell to cell, not the direct response to the impulse by contracting.

5. The client on digoxin has a potassium level of 3.0 mEq/L. What is the nurse’s priority action?

• A. Administer a potassium supplement
• B. Hold the digoxin and notify the healthcare provider
• C. Continue the current digoxin dose
• D. Administer Digibind

Correct answer: B

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 3.0 mEq/L indicates hypokalemia, which can increase the risk of digoxin toxicity. Digoxin and low potassium levels can lead to serious cardiac arrhythmias. Administering a potassium supplement (choice A) without healthcare provider guidance can worsen the situation. Continuing the current digoxin dose (choice C) can further increase the risk of toxicity. Administering Digibind (choice D) is used in severe cases of digoxin toxicity, not for addressing low potassium levels.

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