Nursing Elites

1. This test measures the amount of blood the heart pumps with each beat, often used to assess heart function.

• A. Ejection fraction
• B. Cardiac output
• C. Stroke volume
• D. End-diastolic volume

Correct answer: A

Rationale: The correct answer is A: Ejection fraction. Ejection fraction is a measure of the percentage of blood that is pumped out of the left ventricle with each beat, used to assess heart function. Choice B, Cardiac output, is the total volume of blood pumped by the heart per minute and is not specific to each beat. Choice C, Stroke volume, is the amount of blood ejected by the heart in one contraction but does not specify the percentage of blood pumped out. Choice D, End-diastolic volume, is the volume of blood in the ventricle just before it contracts and does not directly measure the blood pumped with each beat.

2. After the AV node, the electrical impulse is then transmitted into the _________, and into the _________.

• A. Purkinje fibers, ventricles
• B. Atria, ventricles
• C. Bundle of His, Purkinje fibers
• D. Ventricles, Purkinje fibers

Correct answer: C

Rationale: The correct answer is C. After the AV node, the electrical impulse is transmitted to the Bundle of His and then to the Purkinje fibers. This sequence is crucial for the coordinated contraction of the ventricles. Choice A (Purkinje fibers, ventricles) is incorrect because the Purkinje fibers come after the Bundle of His in the sequence of electrical conduction. Choice B (Atria, ventricles) is incorrect because the impulse does not go back to the atria after passing through the AV node. Choice D (Ventricles, Purkinje fibers) is incorrect because the impulse first reaches the Bundle of His before spreading to the Purkinje fibers.

3. The client on spironolactone (Aldactone) has a potassium level of 5.8 mEq/L. What is the nurse’s priority action?

• A. Hold the spironolactone and notify the healthcare provider.
• B. Administer a potassium supplement.
• C. Continue the spironolactone as ordered.
• D. Increase the dose of spironolactone.

Correct answer: A

Rationale: With a potassium level of 5.8 mEq/L, which is high, the priority action for the nurse is to hold the spironolactone. Spironolactone is a potassium-sparing diuretic that can further increase potassium levels. Therefore, it is crucial to prevent exacerbating hyperkalemia by discontinuing the medication. Notifying the healthcare provider is necessary for further guidance and potential adjustments to the treatment plan. Administering a potassium supplement (Choice B) would be contraindicated since the client already has elevated potassium levels. Continuing the spironolactone as ordered (Choice C) can worsen hyperkalemia. Increasing the dose of spironolactone (Choice D) would be unsafe and exacerbate the high potassium levels.

4. 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.

5. The client on warfarin has an INR of 3.8. What is the most appropriate action by the nurse?

• A. Administer vitamin K.
• B. Hold the next dose of warfarin.
• C. Increase the dose of warfarin.
• D. Notify the healthcare provider immediately.

Correct answer: A

Rationale: An INR of 3.8 is elevated, indicating an increased risk of bleeding. Administering vitamin K can help reverse the effects of warfarin. Holding the next dose of warfarin would be appropriate if the INR was too high, but not as the first-line action. Increasing the dose of warfarin would worsen the situation by further increasing the INR. Notifying the healthcare provider is important, but immediate action to address the elevated INR is necessary.

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