Nursing Elites

1. What test measures the electrical activity of the heart to detect arrhythmias and other heart conditions?

• A. Electrocardiogram (ECG or EKG)
• B. Chest X-ray
• C. Stress test
• D. Arterial blood gas (ABG)

Correct answer: A

Rationale: An electrocardiogram (ECG or EKG) is used to measure the heart's electrical activity, aiding in the detection of arrhythmias and other heart conditions. Choice B, a chest X-ray, is not used to measure electrical activity but to visualize the structures of the chest. Choice C, a stress test, evaluates the heart's response to exertion and is not primarily focused on measuring electrical activity. Choice D, an arterial blood gas (ABG) test, is used to assess oxygen and carbon dioxide levels in the blood, not the heart's electrical activity.

2. The nurse is caring for a client on digoxin. What is the most important assessment before administering this medication?

• A. Check the client’s heart rate.
• B. Check the client’s blood pressure.
• C. Check the client’s respiratory rate.
• D. Check the client’s oxygen saturation.

Correct answer: A

Rationale: The correct answer is to check the client’s heart rate before administering digoxin because one of the side effects of digoxin is bradycardia. Monitoring the heart rate is crucial to assess whether the client's heart rate is within the acceptable range before giving the medication. Checking the blood pressure (Choice B), respiratory rate (Choice C), or oxygen saturation (Choice D) are important assessments in general patient care, but they are not specifically related to the administration of digoxin.

3. What type of heart disease is characterized by the heart muscle becoming enlarged and weakened, reducing its ability to pump blood effectively?

• A. Dilated cardiomyopathy
• B. Hypertrophic cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Myocarditis

Correct answer: A

Rationale: The correct answer is A: Dilated cardiomyopathy. Dilated cardiomyopathy is a type of heart disease where the heart muscle becomes enlarged and weakened, reducing its ability to pump blood effectively, which can lead to heart failure. Hypertrophic cardiomyopathy (B) is characterized by abnormal thickening of the heart muscle, not enlargement. Restrictive cardiomyopathy (C) involves the heart muscle becoming stiff and less flexible, limiting its ability to fill with blood properly. Myocarditis (D) is inflammation of the heart muscle, which can affect the heart's function but is different from dilated cardiomyopathy.

4. This is a more accurate indicator of tissue perfusion. It represents the cardiac output in terms of liters per minute per square meter of body surface area. Its normal range is 2.4-4 L/min.

• A. Cardiac Index
• B. Stroke volume
• C. Ejection fraction
• D. Cardiac output

Correct answer: A

Rationale: The correct answer is A: Cardiac Index. Cardiac Index is a measure of cardiac output relative to body surface area, providing a more accurate assessment of tissue perfusion. It is calculated by dividing the cardiac output by the body surface area. The normal range for cardiac index is 2.4-4 L/min/m². Choice B, Stroke volume, refers to the amount of blood ejected by the heart in one contraction and is not adjusted for body surface area. Choice C, Ejection fraction, is the percentage of blood pumped out of the heart's ventricles with each contraction, not adjusted for body surface area. Choice D, Cardiac output, is the total volume of blood pumped by the heart per minute, without considering body surface area.

5. What term refers to the degree of myocardial fiber stretch before contraction, related to the volume of blood distending the ventricles at the end of diastole, and determined by the amount of venous return?

• A. Preload
• B. Afterload
• C. Contractility
• D. Ejection fraction

Correct answer: A

Rationale: The correct answer is A: Preload. Preload is the degree of myocardial fiber stretch before contraction, influenced by the volume of blood returning to the heart. This parameter is related to the amount of blood in the ventricles at the end of diastole. Choice B, Afterload, refers to the pressure or resistance that the ventricles must overcome to eject blood. Choice C, Contractility, is the intrinsic ability of the heart muscle to contract. Choice D, Ejection fraction, is the percentage of blood pumped out of the ventricles with each contraction.

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