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. 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. What procedure is used to remove fluid from the pleural space to help a patient breathe more easily?

• A. Thoracentesis
• B. Bronchoscopy
• C. Echocardiogram
• D. CT scan

Correct answer: A

Rationale: Thoracentesis is the correct answer. It is a procedure where a needle is inserted into the pleural space to drain fluid, relieving pressure and helping the patient breathe more easily. Bronchoscopy (choice B) is a procedure used to examine the airways, not to drain fluid. An echocardiogram (choice C) is an imaging test to assess the heart's structure and function, not related to draining pleural fluid. A CT scan (choice D) is a cross-sectional imaging test that provides detailed pictures of the inside of the body, not used for draining pleural fluid.

4. The client asks about side effects of taking digoxin. How does the nurse respond?

• A. Anorexia can be a side effect of digoxin.
• B. Tachycardia can be a side effect of digoxin.
• C. Constipation can be a side effect of digoxin.
• D. Urinary retention can be a side effect of digoxin.

Correct answer: A

Rationale: The correct answer is A: 'Anorexia can be a side effect of digoxin.' Anorexia, nausea, vomiting, and diarrhea are commonly known side effects of digoxin. Choice B, 'Tachycardia can be a side effect of digoxin,' is incorrect as digoxin is used to treat tachycardia, not cause it. Choice C, 'Constipation can be a side effect of digoxin,' is incorrect as constipation is not a typical side effect of digoxin. Choice D, 'Urinary retention can be a side effect of digoxin,' is also incorrect as urinary retention is not a common side effect associated with digoxin use.

5. The client on furosemide (Lasix) is at risk for which electrolyte imbalance?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hyponatremia
• D. Hypernatremia

Correct answer: B

Rationale: The correct answer is B: Hypokalemia. Furosemide is a loop diuretic that can lead to potassium loss, resulting in hypokalemia. This electrolyte imbalance is a significant risk associated with diuretic use. Choices A, C, and D are incorrect. Hyperkalemia (choice A) is not typically associated with furosemide use. Hyponatremia (choice C) and hypernatremia (choice D) are related to sodium levels, not potassium levels affected by furosemide.

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