Nursing Elites

1. Which surgical procedure involves grafting a blood vessel to bypass a blocked artery in the heart?

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

Correct answer: A

Rationale: The correct answer is A, Coronary artery bypass graft (CABG). This surgical procedure involves grafting a blood vessel to bypass a blocked coronary artery, improving blood flow to the heart muscle. Choice B, Valve replacement, is a procedure to replace a damaged heart valve and is not directly related to bypassing blocked arteries. Choice C, Stent placement, involves inserting a mesh tube to keep blocked arteries open and is different from grafting a blood vessel. Choice D, Angioplasty, is a procedure to widen narrowed or blocked arteries, typically using a balloon catheter, and does not involve grafting a blood vessel.

2. A client on a beta blocker has a heart rate of 52 bpm. What is the nurse’s priority action?

• A. Hold the beta blocker and notify the healthcare provider.
• B. Administer the beta blocker as ordered.
• C. Increase the dose of the beta blocker.
• D. Continue to monitor the client and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the beta blocker and notify the healthcare provider. A heart rate of 52 bpm is low, and beta blockers can further decrease the heart rate, potentially causing harm. Therefore, withholding the medication and promptly informing the healthcare provider is crucial for further assessment and possible adjustment of the treatment plan. Administering the beta blocker as ordered (Choice B) can exacerbate the bradycardia. Increasing the dose of the beta blocker (Choice C) would further suppress the heart rate. Continuing to monitor the client and reassessing in 30 minutes (Choice D) might delay necessary interventions and increase the risk of complications in a client with a heart rate of 52 bpm.

3. The client is on digoxin and has severe digoxin toxicity. What is the nursing priority action?

• A. Check the potassium level.
• B. Give Digibind as an antidote.
• C. Change the dosing of digoxin to every other day.
• D. Administer a potassium supplement to decrease digoxin toxicity.

Correct answer: B

Rationale: The correct answer is to give Digibind as an antidote in cases of severe digoxin toxicity. Digibind works by binding to digoxin and preventing it from causing further harm. Checking the potassium level (choice A) is important but not the priority when the client has severe toxicity. Changing the dosing to every other day (choice C) is not appropriate in the setting of severe toxicity where immediate action is required. Giving a potassium supplement (choice D) may be needed eventually, but the priority is to administer Digibind to counteract the toxic effects of digoxin.

4. What is the average cardiac output?

• A. Approximately 4 to 6 L per minute
• B. Approximately 4 to 8 L per minute
• C. Approximately 5 to 8 L per minute
• D. Approximately 3 to 7 L per minute

Correct answer: B

Rationale: The correct answer is B: Approximately 4 to 8 L per minute. Cardiac output is defined as the volume of blood the heart pumps per minute, typically ranging between 4 to 8 liters. Choices A, C, and D provide ranges that are either too narrow or outside the standard average values for cardiac output, making them incorrect.

5. What is a condition where blood clots form in the deep veins, usually in the legs, and can travel to the lungs, causing serious complications?

• A. Deep vein thrombosis (DVT)
• B. Pulmonary embolism
• C. Varicose veins
• D. Peripheral artery disease

Correct answer: A

Rationale: The correct answer is A, Deep vein thrombosis (DVT). Deep vein thrombosis occurs when blood clots form in the deep veins, usually in the legs, and these clots can potentially travel to the lungs, leading to a pulmonary embolism. Pulmonary embolism (choice B) is a serious complication that can result from untreated DVT. Varicose veins (choice C) and peripheral artery disease (choice D) are not directly related to the formation of blood clots in deep veins that can lead to pulmonary embolism.

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