Nursing Elites

1. Which type of medication helps to reduce the workload on the heart by slowing down the heart rate?

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

Correct answer: A

Rationale: Beta-blockers are medications that work by blocking the action of hormones like adrenaline, thereby reducing the heart rate and the workload on the heart. This makes them effective in managing high blood pressure and various heart conditions. Calcium channel blockers work by relaxing blood vessels and reducing the heart's workload, but they do not primarily slow down the heart rate. Diuretics help the body get rid of excess salt and water by increasing urine production, which can lower blood pressure but not by slowing down the heart rate. ACE inhibitors work by relaxing blood vessels, not by directly affecting heart rate.

2. Which type of lung cancer begins in the cells lining the bronchi and bronchioles?

• A. Adenocarcinoma
• B. Small cell lung cancer
• C. Squamous cell carcinoma
• D. Mesothelioma

Correct answer: A

Rationale: Adenocarcinoma is the correct answer because it is a type of lung cancer that originates in the cells lining the bronchi and bronchioles. Adenocarcinoma is one of the most common types of lung cancer, often found in non-smokers and more frequently in women. Small cell lung cancer (Choice B) typically starts in the bronchi, but it is characterized by its rapid growth and tendency to spread quickly. Squamous cell carcinoma (Choice C) usually begins in the squamous cells lining the bronchi and is strongly associated with smoking. Mesothelioma (Choice D) is a cancer that affects the lining of certain organs like the lungs, often caused by asbestos exposure, but it does not specifically start in the cells lining the bronchi and bronchioles.

3. Which of the following is a central vasodilator and peripheral vasoconstrictor?

• A. Sympathetic nervous system
• B. Parasympathetic nervous system
• C. Norepinephrine
• D. Acetylcholine

Correct answer: A

Rationale: The correct answer is the Sympathetic nervous system. The sympathetic nervous system is a branch of the autonomic nervous system that is responsible for the fight-or-flight response. It causes vasodilation in central vessels to increase blood flow to vital organs during stress or exercise, while inducing vasoconstriction in peripheral vessels to redirect blood to essential areas. Norepinephrine and acetylcholine are neurotransmitters associated with the sympathetic and parasympathetic nervous systems, respectively, but they are not themselves central vasodilators and peripheral vasoconstrictors.

4. 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.

5. Which order should the nurse question?

• A. The addition of a loop diuretic with digoxin.
• B. The addition of a beta blocker with digoxin.
• C. A digoxin dose of 0.125 mg per day.
• D. The addition of an ACE inhibitor with digoxin.

Correct answer: B

Rationale: The correct answer is B because adding a beta blocker to digoxin can potentiate the bradycardic effect of digoxin, leading to serious complications such as heart block. This combination requires caution as it can significantly slow down the heart rate. Choices A, C, and D are not the best options to question in this scenario. Loop diuretics are commonly used with digoxin, a digoxin dose of 0.125 mg per day is within the typical range, and ACE inhibitors are often prescribed alongside digoxin for managing heart conditions.

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