Nursing Elites

1. What is a surgical procedure to create an opening in the windpipe to assist with breathing?

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

Correct answer: A

Rationale: Tracheostomy is the correct answer. It is a surgical procedure to create an opening in the windpipe (trachea) to assist with breathing. This procedure is commonly used for patients who require long-term ventilation support. Choice B, Lobectomy, involves the removal of a lobe of the lung and is not related to creating an opening in the windpipe. Choice C, Thoracotomy, is a surgical incision into the chest wall and is not specifically related to creating an opening in the windpipe. Choice D, Pleurodesis, is a procedure to treat recurrent pleural effusions by causing the pleural layers to stick together, and it is not related to creating an opening in the windpipe.

2. What test measures the pressure in the arteries during the contraction and relaxation of the heart?

• A. Blood pressure test
• B. Electrocardiogram (ECG or EKG)
• C. Spirometry
• D. Pulse oximetry

Correct answer: A

Rationale: The correct answer is 'Blood pressure test.' This test measures the pressure in the arteries during the contraction (systolic) and relaxation (diastolic) phases of the heart, providing important information about heart health. Choice B, 'Electrocardiogram (ECG or EKG),' records the heart's electrical activity and is not specifically related to measuring arterial pressure. Choice C, 'Spirometry,' assesses lung function by measuring airflow. Choice D, 'Pulse oximetry,' measures oxygen saturation in the blood, not arterial pressure.

3. Which condition involves the heart muscle becoming abnormally thickened, reducing its ability to pump blood?

• A. Hypertrophic cardiomyopathy
• B. Dilated cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Ischemic cardiomyopathy

Correct answer: A

Rationale: The correct answer is A: Hypertrophic cardiomyopathy. In this condition, the heart muscle thickens, leading to a decreased ability to pump blood effectively. Choice B, Dilated cardiomyopathy, is characterized by the heart chambers enlarging and weakening. Choice C, Restrictive cardiomyopathy, involves the heart muscle becoming rigid and less compliant. Choice D, Ischemic cardiomyopathy, is when the heart muscle is weakened due to reduced blood flow.

4. The nurse is administering enoxaparin (Lovenox) to a client. What is the most important lab value to monitor?

• A. Platelet count
• B. Hemoglobin
• C. White blood cell count
• D. aPTT

Correct answer: A

Rationale: The correct answer is A: Platelet count. When administering enoxaparin, it is crucial to monitor the platelet count because enoxaparin can lead to a rare but serious side effect known as thrombocytopenia, which is a decrease in platelet levels. Monitoring the platelet count helps in detecting this adverse effect early. Choices B, C, and D are incorrect because hemoglobin, white blood cell count, and aPTT are not the most important lab values to monitor specifically for enoxaparin administration.

5. The nurse is giving the client digoxin for heart failure and recognizes that the drug has what type of effect on the heart?

• A. Negative inotropic, negative chronotropic effect
• B. Positive inotropic, negative chronotropic effect
• C. Negative inotropic, positive chronotropic effect
• D. Positive inotropic, positive chronotropic effect

Correct answer: B

Rationale: The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin strengthens the heart muscle, providing a positive inotropic effect, which increases the force of contraction. It also decreases the heart rate, having a negative chronotropic effect. Choice A is incorrect because digoxin has a positive inotropic effect, not a negative inotropic effect. Choice C is incorrect as digoxin does not have a positive chronotropic effect but a negative one. Choice D is incorrect because while digoxin has a positive inotropic effect, it does not have a positive chronotropic effect.

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