Nursing Elites

1. What is the term for the ability of cardiac cells to respond to a stimulus by initiating a cardiac impulse?

• A. Excitability
• B. Contractility
• C. Rhythmicity
• D. Conductivity

Correct answer: A

Rationale: The correct answer is A, Excitability. Excitability is the ability of cardiac cells to respond to a stimulus by initiating a cardiac impulse. Choice B, Contractility, refers to the ability of cardiac muscle to shorten forcibly. Choice C, Rhythmicity, refers to the cardiac muscle's ability to contract rhythmically. Choice D, Conductivity, refers to the ability of the heart's cells to conduct electrical impulses.

2. The nurse is administering a beta blocker to a client with a heart rate of 58 bpm. What is the nurse’s priority action?

• A. Administer the beta blocker as ordered.
• B. Hold the beta blocker and notify the healthcare provider.
• C. Increase the dose of the beta blocker.
• D. Monitor the client’s heart rate and reassess in 30 minutes.

Correct answer: B

Rationale: The correct answer is B. A heart rate of 58 bpm is considered low, and beta blockers can further decrease the heart rate. Therefore, the nurse's priority action should be to hold the beta blocker and notify the healthcare provider for further assessment. Choice A is incorrect because administering the beta blocker without considering the low heart rate can worsen the condition. Choice C is incorrect as increasing the dose of the beta blocker can lead to further slowing of the heart rate, which is not safe in this situation. Choice D is not the priority action; holding the medication and seeking guidance from the healthcare provider is more crucial.

3. What test evaluates the heart's response to physical stress, often involving exercise on a treadmill while monitoring the heart?

• A. Stress test
• B. Echocardiogram
• C. Holter monitor
• D. CT angiography

Correct answer: A

Rationale: A stress test, also known as an exercise stress test, evaluates the heart's response to physical stress by monitoring its activity during exercise, typically on a treadmill. This test helps assess the heart's performance, detect coronary artery disease, and evaluate the effectiveness of heart treatments. Echocardiogram (choice B) is an ultrasound of the heart that provides detailed images of the heart's structure and function, but it does not involve physical stress like a stress test. Holter monitor (choice C) is a device for continuously monitoring the heart's rhythm and rate over a period (usually 24-48 hours), not during exercise. CT angiography (choice D) is a diagnostic test that uses X-rays to visualize blood vessels but does not involve physical stress like a stress test.

4. What is a condition where the heart is unable to pump blood effectively, leading to a buildup of fluid in the lungs and other parts of the body?

• A. Heart failure
• B. Cardiomyopathy
• C. Myocardial infarction
• D. Pulmonary edema

Correct answer: A

Rationale: The correct answer is A: Heart failure. Heart failure occurs when the heart is unable to pump blood effectively, resulting in a buildup of fluid in the lungs and other parts of the body. Choice B, Cardiomyopathy, refers to diseases of the heart muscle, not specifically the inability to pump blood effectively. Choice C, Myocardial infarction, is a heart attack caused by a blocked blood supply to the heart muscle, not directly related to the heart's pumping efficiency. Choice D, Pulmonary edema, is a condition characterized by fluid accumulation in the lungs, often a consequence of heart failure but not the primary condition described in the question.

5. The client on amiodarone reports shortness of breath. What is the nurse’s best response?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect.
• C. Instruct the client to monitor their symptoms at home.
• D. Suggest the client reduce physical activity.

Correct answer: A

Rationale: When a client on amiodarone reports shortness of breath, it can be indicative of pulmonary toxicity, a severe side effect associated with this medication. The nurse's priority is to notify the healthcare provider immediately to assess the situation and determine the appropriate course of action. Choice B is incorrect because shortness of breath with amiodarone should not be dismissed as a common side effect. Instructing the client to monitor symptoms at home (Choice C) may delay necessary intervention. Suggesting the client reduce physical activity (Choice D) does not address the potential serious nature of the symptom and the need for prompt evaluation.

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