Nursing Elites

1. What is a surgical procedure where a blood vessel is grafted to bypass a blocked coronary artery, improving blood flow to the heart muscle?

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

Correct answer: A

Rationale: The correct answer is A: Coronary artery bypass graft (CABG). CABG involves grafting a blood vessel to bypass a blocked coronary artery, enhancing blood flow to the heart muscle. This procedure helps reduce the risk of heart attack by restoring proper blood circulation to the heart. Choice B, valve replacement, is a different surgical procedure that involves replacing damaged or dysfunctional heart valves. Choice C, angioplasty, is a minimally invasive procedure that uses a balloon to open narrowed or blocked blood vessels. Choice D, endarterectomy, is the surgical removal of plaque from the lining of an artery to improve blood flow.

2. Which of the following is a rare but serious condition where the pulmonary arteries become narrowed, increasing the blood pressure in the lungs?

• A. Pulmonary hypertension
• B. Pulmonary embolism
• C. Pulmonary fibrosis
• D. Aortic stenosis

Correct answer: A

Rationale: The correct answer is A, Pulmonary hypertension. Pulmonary hypertension is a rare but serious condition characterized by high blood pressure in the arteries of the lungs, which can lead to heart failure. Pulmonary embolism (choice B) involves a blockage in one of the pulmonary arteries in the lungs. Pulmonary fibrosis (choice C) is a lung disease that causes lung tissue scarring. Aortic stenosis (choice D) is a condition where the aortic valve narrows, affecting blood flow from the heart.

3. 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.

4. Which medication is used to prevent blood clots by thinning the blood, reducing the risk of stroke and heart attack?

• A. Anticoagulant
• B. ACE inhibitor
• C. Beta-blocker
• D. Calcium channel blocker

Correct answer: A

Rationale: The correct answer is 'Anticoagulant.' Anticoagulants are medications specifically designed to prevent blood clots by thinning the blood, which effectively reduces the risk of stroke, heart attack, and other cardiovascular events. Choices B, C, and D, which are ACE inhibitors, beta-blockers, and calcium channel blockers, respectively, do not have the primary mechanism of action to prevent blood clot formation. ACE inhibitors, beta-blockers, and calcium channel blockers are commonly used for managing hypertension and other cardiovascular conditions by different mechanisms of action.

5. Where is the impulse from the SA node delayed, enabling atrial contraction to complete before the ventricles are stimulated and contract?

• A. AV node
• B. Bundle of His
• C. SA node
• D. Aorta

Correct answer: A

Rationale: The correct answer is AV node. The AV node is responsible for delaying the impulse from the SA node, allowing the atria to contract before the ventricles. This delay ensures the effective pumping of blood in a coordinated manner. Choices B, C, and D are incorrect because the Bundle of His is responsible for transmitting the impulse to the Purkinje fibers, the SA node is the pacemaker of the heart responsible for initiating the heartbeat, and the aorta is the main artery carrying oxygenated blood from the heart to the body, respectively, none of which are involved in delaying the impulse to allow atrial contraction before ventricular contraction.

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