Nursing Elites

1. What is the ability of cardiac cells to respond to an impulse by transmitting the impulse along cell membranes?

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

Correct answer: C

Rationale: The correct answer is C, Conductivity. Conductivity refers to the ability of cardiac cells to transmit impulses along cell membranes. Contractility (Choice A) is the ability of cardiac cells to contract in response to an electrical stimulus, not transmit impulses. Automaticity (Choice B) is the ability of cardiac cells to spontaneously generate electrical impulses. Rhythmicity (Choice D) refers to the regular generation of electrical impulses by the heart's pacemaker cells, not the transmission of impulses along cell membranes.

2. What is a chronic condition where the heart muscle becomes weakened and enlarged, reducing its ability to pump blood effectively?

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

Correct answer: A

Rationale: Dilated cardiomyopathy is characterized by the weakening and enlargement of the heart muscle, leading to its reduced ability to pump blood effectively. This condition is different from hypertrophic cardiomyopathy, which involves abnormal thickening of the heart muscle, myocarditis, which is inflammation of the heart muscle, and pericarditis, which is inflammation of the pericardium. Therefore, the correct answer is Dilated cardiomyopathy.

3. The client on spironolactone (Aldactone) has a potassium level of 5.8 mEq/L. What is the nurse’s priority action?

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

Correct answer: A

Rationale: With a potassium level of 5.8 mEq/L, which is high, the priority action for the nurse is to hold the spironolactone. Spironolactone is a potassium-sparing diuretic that can further increase potassium levels. Therefore, it is crucial to prevent exacerbating hyperkalemia by discontinuing the medication. Notifying the healthcare provider is necessary for further guidance and potential adjustments to the treatment plan. Administering a potassium supplement (Choice B) would be contraindicated since the client already has elevated potassium levels. Continuing the spironolactone as ordered (Choice C) can worsen hyperkalemia. Increasing the dose of spironolactone (Choice D) would be unsafe and exacerbate the high potassium levels.

4. The client is on nitroglycerin patches. What should the nurse include in the client’s education?

• A. Rotate the application site with each new patch.
• B. Apply the patch at the same time each day.
• C. Leave the patch on for 24 hours, then remove it for 12 hours before applying a new one.
• D. Apply the patch to the same site each time.

Correct answer: A

Rationale: The correct answer is A: 'Rotate the application site with each new patch.' When educating a client using nitroglycerin patches, it is essential to rotate the application site to prevent skin irritation. Choice B is incorrect because applying the patch at the same time each day is not a critical aspect of patch application. Choice C is incorrect as nitroglycerin patches are usually left on for a specific period, typically 12 to 14 hours, before being replaced. Choice D is incorrect because applying the patch to the same site each time can lead to skin irritation and tolerance development.

5. What is the condition where the arteries in the brain become blocked or narrowed, leading to reduced blood flow and a potential stroke?

• A. Cerebral atherosclerosis
• B. Coronary artery disease
• C. Pulmonary embolism
• D. Peripheral artery disease

Correct answer: A

Rationale: Cerebral atherosclerosis is the correct answer. It is a condition where the arteries in the brain become blocked or narrowed due to plaque buildup, leading to reduced blood flow and an increased risk of stroke. Choice B, Coronary artery disease, specifically affects the arteries supplying blood to the heart, not the brain. Choice C, Pulmonary embolism, involves a blockage in the pulmonary artery that affects blood flow to the lungs, not the brain. Choice D, Peripheral artery disease, refers to a condition where blockages occur in arteries outside of the heart and brain, typically affecting the limbs.

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