Nursing Elites

1. What test measures the electrical activity of the heart over a period of time, typically 24 to 48 hours?

• A. Holter monitor
• B. Echocardiogram
• C. Stress test
• D. Arterial blood gas (ABG)

Correct answer: A

Rationale: The correct answer is A, Holter monitor. A Holter monitor is a portable device that records the electrical activity of the heart over a period of 24 to 48 hours. It is used to detect arrhythmias and other heart conditions. Choice B, Echocardiogram, is a test that uses sound waves to create images of the heart's structure and function, not focused on the electrical activity. Choice C, Stress test, evaluates the heart's function under stress but does not monitor electrical activity over an extended period. Choice D, Arterial blood gas (ABG), measures the levels of oxygen and carbon dioxide in the blood, unrelated to measuring the electrical activity of the heart over time.

2. What is a type of medication that helps to prevent blood clots by thinning the blood?

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

Correct answer: A

Rationale: Anticoagulants are medications specifically designed to prevent blood clots by thinning the blood. They work by interfering with the body's blood clotting process. Beta-blockers, ACE inhibitors, and calcium channel blockers are medications used for different purposes such as managing blood pressure, heart conditions, and regulating heart rhythm, respectively. However, they do not have the primary function of preventing blood clots like anticoagulants.

3. What is the ability of cardiac cells to generate an electrical impulse without being stimulated by an external source?

• A. Automaticity
• B. Contractility
• C. Conductivity
• D. Refractoriness

Correct answer: A

Rationale: Automaticity is the correct answer because it refers to the inherent ability of cardiac cells to generate electrical impulses without the need for external stimulation. Contractility (Choice B) is the ability of the heart muscle to contract and generate force, not related to electrical impulse generation. Conductivity (Choice C) refers to the ability of cardiac cells to transmit electrical impulses from cell to cell, not the spontaneous generation of impulses. Refractoriness (Choice D) is the period during which the cardiac cells are recovering and not able to respond to a new stimulus, not the spontaneous generation of impulses.

4. The nurse is caring for a client on heparin. What is the most important lab value to monitor?

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

Correct answer: A

Rationale: The correct answer is A: aPTT. When a client is on heparin therapy, monitoring the aPTT is crucial. The aPTT helps assess the effectiveness of heparin in preventing blood clots and guides dose adjustments as needed. INR (Choice B) is more commonly used to monitor warfarin therapy. Platelet count (Choice C) is important to assess for potential bleeding disorders or thrombocytopenia but is not the primary lab value to monitor for heparin therapy. Hemoglobin (Choice D) is essential for assessing oxygen-carrying capacity but is not the most important lab value to monitor when a client is on heparin.

5. The nurse is caring for a client on digoxin with a heart rate of 48 bpm. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Administer atropine to increase the heart rate.
• D. Increase the dose of digoxin.

Correct answer: A

Rationale: In this scenario, the nurse's priority action should be to hold the digoxin and notify the healthcare provider. A heart rate of 48 bpm is low, and digoxin, being a medication that can further decrease the heart rate, should be withheld. Administering the digoxin as ordered (Choice B) would not be appropriate in this situation as it can exacerbate bradycardia. Atropine (Choice C) is not the initial treatment for this scenario; holding the digoxin is the first action. Increasing the dose of digoxin (Choice D) would be contraindicated due to the client's bradycardia. Therefore, the correct action is to hold the digoxin and inform the healthcare provider for further guidance.

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