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 receiving digoxin and has a potassium level of 2.8 mEq/L. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Increase the dose of digoxin.
• C. Continue the current dose of digoxin.
• D. Administer potassium supplements.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 2.8 mEq/L indicates hypokalemia, which can increase the risk of digoxin toxicity. Holding the medication and informing the healthcare provider is crucial to prevent adverse effects. Choice B is incorrect because increasing the dose of digoxin would further raise the risk of toxicity. Choice C is incorrect as continuing the current dose could exacerbate the toxicity risk. Choice D is incorrect because administering potassium supplements alone is not sufficient to address the potential digoxin toxicity; the first step should be to hold the digoxin and seek further guidance.

3. Which condition involves the body's immune system attacking the lungs and kidneys, causing severe respiratory and renal damage?

• A. Goodpasture syndrome
• B. Sarcoidosis
• C. Wegener's granulomatosis
• D. Interstitial lung disease

Correct answer: A

Rationale: Goodpasture syndrome is the correct answer. It is an autoimmune disease characterized by the immune system attacking the lungs and kidneys, leading to bleeding in the lungs and kidney failure. Sarcoidosis primarily affects the lungs and lymph nodes, not the kidneys. Wegener's granulomatosis affects the lungs, sinuses, and kidneys, but it is characterized by inflammation of blood vessels. Interstitial lung disease involves scarring of the lung tissue, not direct immune system attacks on the lungs and kidneys.

4. What type of medication is used to reduce high blood pressure by relaxing the blood vessels?

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

Correct answer: A

Rationale: Calcium channel blockers are medications that reduce high blood pressure by relaxing the blood vessels, facilitating easier blood flow through the vessels. Beta-blockers work by reducing the heart rate and the heart's workload. ACE inhibitors help relax blood vessels by blocking the production of a chemical that narrows blood vessels. Diuretics help the body get rid of excess sodium and water to lower blood pressure, but they do not directly relax blood vessels like calcium channel blockers do.

5. For what reason might the nurse be given an order to administer milrinone (Primacor)?

• A. For congestive heart failure
• B. For hypertension
• C. For cardiac arrhythmias
• D. For bradycardia

Correct answer: A

Rationale: Milrinone is commonly prescribed for congestive heart failure to help improve cardiac function and alleviate symptoms. Choices B, C, and D are incorrect as milrinone is not typically used for hypertension, cardiac arrhythmias, or bradycardia. It is specifically indicated for congestive heart failure for short-term management.

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