Nursing Elites

1. Which term refers to the ability of the heart to initiate impulses repetitively and spontaneously?

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

Correct answer: C

Rationale: The correct answer is C: Automaticity. Automaticity is the specific term used to describe the heart's ability to generate impulses repetitively and spontaneously. Contractility (A) refers to the ability of muscle fibers to contract, not the initiation of impulses. Excitability (B) is the ability of cells to respond to stimuli but is not specific to the heart's impulse generation. Rhythmicity (D) is a related term but does not specifically describe the heart's spontaneous impulse initiation.

2. The client is on enalapril (Vasotec) for hypertension. What side effect is most commonly associated with this medication?

• A. Dry cough
• B. Hypotension
• C. Hyperkalemia
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Dry cough. A dry cough is a common side effect of ACE inhibitors like enalapril. ACE inhibitors can cause the accumulation of bradykinin, leading to irritation of the respiratory tract and resulting in a persistent dry cough. Hypotension (choice B) is a possible side effect of ACE inhibitors but is less common than a dry cough. Hyperkalemia (choice C) is another side effect of ACE inhibitors, but it is not the most commonly associated one. Headache (choice D) is not a common side effect of enalapril compared to a dry cough. Therefore, the most commonly associated side effect with enalapril is a dry cough.

3. What is a condition where the airways become inflamed and narrow, making breathing difficult?

• A. Asthma
• B. Bronchitis
• C. Pleurisy
• D. Tuberculosis

Correct answer: A

Rationale: Asthma is the correct answer. It is a condition characterized by inflammation, narrowing, and swelling of the airways, leading to symptoms like wheezing, shortness of breath, and coughing. Bronchitis is the inflammation of the bronchial tubes; Pleurisy is inflammation of the tissues that line the lungs and chest cavity; Tuberculosis is a bacterial infection that mainly affects the lungs.

4. The client on enoxaparin (Lovenox) is scheduled for surgery. What is the nurse’s priority action?

• A. Hold the enoxaparin and notify the healthcare provider.
• B. Administer the enoxaparin as scheduled.
• C. Administer vitamin K before the surgery.
• D. Monitor the client’s INR and proceed with surgery.

Correct answer: A

Rationale: The correct answer is A: Hold the enoxaparin and notify the healthcare provider. Enoxaparin, being an anticoagulant, should be held before surgery to reduce the risk of excessive bleeding during the procedure. It is crucial to inform the healthcare provider to determine the appropriate management plan. Choice B is incorrect because administering enoxaparin before surgery can increase the risk of bleeding. Choice C is incorrect as vitamin K administration is not typically indicated in this situation. Choice D is incorrect because monitoring the client's INR and proceeding with surgery without addressing the enoxaparin can lead to significant bleeding complications.

5. What test measures the electrical activity of the heart and can detect heart rhythm problems?

• A. Electrocardiogram (ECG or EKG)
• B. Chest X-ray
• C. MRI
• D. CT scan

Correct answer: A

Rationale: The correct answer is Electrocardiogram (ECG or EKG). An electrocardiogram is a test that measures the electrical activity of the heart and can detect irregularities in heart rhythm. Choices B, C, and D are incorrect because a chest X-ray, MRI, and CT scan do not specifically measure the electrical activity of the heart or detect heart rhythm problems.

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