Nursing Elites

1. What is a surgical procedure to redirect blood flow around a blocked or narrowed artery, often involving the use of a graft from another part of the body?

• A. Coronary artery bypass graft (CABG)
• B. Valve replacement
• C. Aneurysm repair
• D. Atherectomy

Correct answer: A

Rationale: The correct answer is A: Coronary artery bypass graft (CABG). This surgical procedure is used to redirect blood flow around a blocked or narrowed artery by using a graft from another part of the body. Choices B, C, and D are incorrect because valve replacement involves replacing heart valves, aneurysm repair addresses the treatment of aneurysms, and atherectomy is a procedure to remove plaque from blood vessels, none of which match the description provided in the question.

2. Which of the following conditions is characterized by inflammation of the heart muscle, often due to a viral infection, leading to impaired heart function?

• A. Myocarditis
• B. Endocarditis
• C. Pericarditis
• D. Cardiomyopathy

Correct answer: A

Rationale: The correct answer is A, Myocarditis. Myocarditis is an inflammation of the heart muscle, typically caused by a viral infection. It can impair the heart's ability to pump blood efficiently, potentially leading to other complications. Endocarditis (choice B) is an inflammation of the inner lining of the heart chambers and valves. Pericarditis (choice C) is inflammation of the pericardium, the outer lining of the heart. Cardiomyopathy (choice D) is a disease of the heart muscle that affects the heart's ability to pump blood.

3. What is a condition where a blood clot forms in a deep vein, usually in the legs, and can lead to serious complications if it travels to the lungs?

• A. Deep vein thrombosis (DVT)
• B. Pulmonary embolism
• C. Varicose veins
• D. Raynaud's disease

Correct answer: A

Rationale: The correct answer is A, Deep vein thrombosis (DVT). Deep vein thrombosis occurs when a blood clot forms in a deep vein, usually in the legs. If the clot dislodges and travels to the lungs, it can lead to a serious condition called a pulmonary embolism. Choice B, pulmonary embolism, is incorrect as it is the consequence of a DVT clot traveling to the lungs, not the initial condition. Choices C and D, varicose veins, and Raynaud's disease, respectively, are unrelated conditions to the formation of blood clots in deep veins.

4. A client on an ACE inhibitor reports a persistent cough. What is the nurse’s best response?

• A. Reassure the client that the cough is a common side effect and is usually not serious.
• B. Instruct the client to report the cough to the healthcare provider as it may require discontinuation of the medication.
• C. Advise the client to use a humidifier at night to relieve the cough.
• D. Suggest the client take an over-the-counter cough suppressant.

Correct answer: B

Rationale: The correct answer is B. A persistent cough in a client on an ACE inhibitor may indicate a serious side effect that requires discontinuation of the medication. Instructing the client to report the cough to the healthcare provider is essential for proper evaluation and management. Choice A is incorrect because simply reassuring the client may delay necessary action. Choice C is incorrect as using a humidifier may not address the underlying cause of the cough. Choice D is incorrect because taking a cough suppressant without healthcare provider guidance may mask symptoms without addressing the cause.

5. Which order should the nurse question?

• A. The addition of a loop diuretic with digoxin.
• B. The addition of a beta blocker with digoxin.
• C. A digoxin dose of 0.125 mg per day.
• D. The addition of an ACE inhibitor with digoxin.

Correct answer: B

Rationale: The correct answer is B because adding a beta blocker to digoxin can potentiate the bradycardic effect of digoxin, leading to serious complications such as heart block. This combination requires caution as it can significantly slow down the heart rate. Choices A, C, and D are not the best options to question in this scenario. Loop diuretics are commonly used with digoxin, a digoxin dose of 0.125 mg per day is within the typical range, and ACE inhibitors are often prescribed alongside digoxin for managing heart conditions.

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