Nursing Elites

1. What test evaluates the heart's response to physical stress, often involving exercise on a treadmill while monitoring the heart?

• A. Stress test
• B. Echocardiogram
• C. Holter monitor
• D. CT angiography

Correct answer: A

Rationale: A stress test, also known as an exercise stress test, evaluates the heart's response to physical stress by monitoring its activity during exercise, typically on a treadmill. This test helps assess the heart's performance, detect coronary artery disease, and evaluate the effectiveness of heart treatments. Echocardiogram (choice B) is an ultrasound of the heart that provides detailed images of the heart's structure and function, but it does not involve physical stress like a stress test. Holter monitor (choice C) is a device for continuously monitoring the heart's rhythm and rate over a period (usually 24-48 hours), not during exercise. CT angiography (choice D) is a diagnostic test that uses X-rays to visualize blood vessels but does not involve physical stress like a stress test.

2. What is the procedure to remove a sample of tissue from the lung for examination under a microscope?

• A. Lung biopsy
• B. Bronchoscopy
• C. Thoracentesis
• D. Lobectomy

Correct answer: A

Rationale: The correct answer is A, lung biopsy. A lung biopsy involves removing a small sample of lung tissue for examination under a microscope to diagnose lung conditions. Choice B, bronchoscopy, is a procedure where a thin, flexible tube with a light and camera is inserted into the airways to view the lungs. This procedure is more for diagnostic purposes and not specifically for tissue removal. Choice C, thoracentesis, is a procedure to remove fluid from the pleural space around the lungs for diagnostic or therapeutic purposes, not for tissue biopsy. Choice D, lobectomy, is a surgical procedure to remove a lobe of the lung, usually done to treat conditions like lung cancer or severe infections, but it does not involve removing tissue for microscopic examination.

3. When administering enoxaparin (Lovenox) to a client for DVT prophylaxis, what is the most important lab value to monitor?

• A. Platelet count
• B. PT/INR
• C. aPTT
• D. Hemoglobin

Correct answer: A

Rationale: The correct answer is A: Platelet count. When administering enoxaparin (Lovenox) for DVT prophylaxis, it is crucial to monitor the platelet count as enoxaparin can lead to thrombocytopenia, a decrease in platelet levels. Monitoring the platelet count helps in early detection of this potential adverse effect. Choices B, C, and D are incorrect because PT/INR, aPTT, and hemoglobin levels are not the most important lab values to monitor specifically for enoxaparin administration and DVT prophylaxis.

4. The nurse is administering digoxin to a client with a heart rate of 45 bpm. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Increase the dose of digoxin.
• D. Monitor the client’s heart rate and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A heart rate of 45 bpm is already low, and digoxin can further decrease the heart rate, leading to serious complications like bradycardia or heart block. Administering the medication can exacerbate the bradycardia, hence it should be withheld. Increasing the dose of digoxin is contraindicated due to the client's low heart rate. Monitoring the heart rate alone without taking immediate action to withhold the medication is not the priority when faced with the risk of further lowering the heart rate.

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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