Nursing Elites

1. What is a type of heart disease that involves the thickening or stiffening of the heart muscle, reducing its ability to pump blood?

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

Correct answer: A

Rationale: Hypertrophic cardiomyopathy is a type of heart disease characterized by the thickening or stiffening of the heart muscle, leading to a reduced ability to pump blood. This condition is different from dilated cardiomyopathy (choice B), which involves the enlargement and weakening of the heart chambers. Restrictive cardiomyopathy (choice C) is characterized by the stiffening of the heart muscle, affecting its ability to fill with blood properly. Arrhythmia (choice D) refers to abnormal heart rhythms and is not specifically related to thickening or stiffening of the heart muscle, as seen in hypertrophic cardiomyopathy.

2. The client on amiodarone develops symptoms of hypothyroidism. What is the nurse’s best response?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect of amiodarone.
• C. Monitor the client’s thyroid function tests regularly.
• D. Discontinue the amiodarone immediately.

Correct answer: C

Rationale: When a client on amiodarone develops symptoms of hypothyroidism, the nurse's best response is to monitor the client's thyroid function tests regularly. Amiodarone can affect thyroid function, so monitoring is essential to assess the impact and adjust treatment if necessary. Notifying the healthcare provider immediately (Choice A) may be necessary in some cases but the priority is to monitor first. Reassuring the client (Choice B) is not sufficient as monitoring is crucial. Discontinuing amiodarone (Choice D) abruptly without healthcare provider guidance can lead to serious consequences.

3. The client is on digoxin and has severe digoxin toxicity. What is the nursing priority action?

• A. Check the potassium level.
• B. Give Digibind as an antidote.
• C. Change the dosing of digoxin to every other day.
• D. Administer a potassium supplement to decrease digoxin toxicity.

Correct answer: B

Rationale: The correct answer is to give Digibind as an antidote in cases of severe digoxin toxicity. Digibind works by binding to digoxin and preventing it from causing further harm. Checking the potassium level (choice A) is important but not the priority when the client has severe toxicity. Changing the dosing to every other day (choice C) is not appropriate in the setting of severe toxicity where immediate action is required. Giving a potassium supplement (choice D) may be needed eventually, but the priority is to administer Digibind to counteract the toxic effects of digoxin.

4. What is the amount of blood the heart pumps through the circulatory system in a minute?

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

Correct answer: A

Rationale: The correct answer is A: Cardiac output. Cardiac output is the volume of blood pumped by the heart per minute. It is calculated by multiplying the stroke volume (the amount of blood pumped out of the heart in each beat) by the heart rate (number of heartbeats per minute). This question specifically asks for the total amount of blood pumped through the circulatory system in a minute, which is represented by cardiac output. Choices B, C, and D are incorrect because stroke volume refers to the amount of blood pumped out of the heart in each beat, end-diastolic volume is the volume of blood in the heart at the end of diastole, and ejection fraction is the percentage of blood pumped out of the heart with each contraction, not the total amount pumped per minute.

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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