Nursing Elites

1. Which test uses sound waves to create images of the heart, allowing doctors to assess its structure and function?

• A. Echocardiogram
• B. MRI
• C. CT scan
• D. X-ray

Correct answer: A

Rationale: The correct answer is A: Echocardiogram. An echocardiogram is a test that uses sound waves to create images of the heart, enabling doctors to assess its structure and function. This imaging technique is particularly useful in detecting abnormalities such as valve disease. Choices B, C, and D are incorrect because MRI, CT scans, and X-rays use different imaging technologies that do not rely on sound waves to visualize the heart.

2. 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.

3. The client on spironolactone (Aldactone) has a potassium level of 5.6 mEq/L. What is the nurse’s priority action?

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

Correct answer: A

Rationale: The correct answer is A: Hold the spironolactone and notify the healthcare provider. A potassium level of 5.6 mEq/L is high, indicating hyperkalemia. Spironolactone is a potassium-sparing diuretic that can further elevate potassium levels. Therefore, the priority action is to withhold the medication to prevent exacerbating hyperkalemia and notify the healthcare provider for further management. Option B is incorrect because administering potassium supplements would worsen the hyperkalemia. Option C is incorrect as continuing spironolactone can lead to a further increase in potassium levels. Option D is incorrect as increasing the dose of spironolactone would be inappropriate in the presence of elevated potassium levels.

4. What condition is characterized by narrowed or blocked arteries in the legs or arms, leading to pain and mobility issues?

• A. Peripheral artery disease
• B. Atherosclerosis
• C. Raynaud's disease
• D. Varicose veins

Correct answer: A

Rationale: The correct answer is A: Peripheral artery disease (PAD). PAD is a condition where the arteries in the legs or arms become narrowed or blocked, leading to pain and mobility issues. Choice B, Atherosclerosis, refers to the buildup of fats, cholesterol, and other substances in and on the artery walls, not specifically the narrowing or blockage in the extremities. Choice C, Raynaud's disease, is characterized by reduced blood flow to the extremities, leading to coldness, numbness, and color changes in the skin, but it is not primarily about narrowed or blocked arteries. Choice D, Varicose veins, involves enlarged, twisted veins usually in the legs, but it is not related to narrowed or blocked arteries causing pain and mobility issues.

5. 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.

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