Nursing Elites

1. Which structure serves as the major chemoreceptor of the heart?

• A. Carotid body
• B. Aortic body
• C. Vagus nerve
• D. SA node

Correct answer: A

Rationale: The correct answer is A, the carotid body. The carotid body is the major chemoreceptor of the heart responsible for detecting changes in blood oxygen, carbon dioxide, and pH levels. This specialized structure helps regulate the cardiovascular system's response to maintain appropriate oxygen levels in the blood. Choices B, C, and D are incorrect as they are not directly involved in chemoreception in the heart. The aortic body is primarily involved in blood pressure regulation, the vagus nerve is a cranial nerve responsible for parasympathetic innervation, and the SA node is known as the heart's natural pacemaker.

2. A client on spironolactone (Aldactone) has a potassium level of 6.0 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: The correct action for a client on spironolactone with a potassium level of 6.0 mEq/L is to hold the medication and notify the healthcare provider. Spironolactone is a potassium-sparing diuretic that can further elevate potassium levels, which are already high. Administering a potassium supplement (Choice B) would exacerbate the hyperkalemia. Continuing the spironolactone as ordered (Choice C) could lead to worsening hyperkalemia. Increasing the dose of spironolactone (Choice D) would be contraindicated in the presence of elevated potassium levels.

3. What type of heart disease is characterized by the heart muscle becoming enlarged and weakened, reducing its ability to pump blood effectively?

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

Correct answer: A

Rationale: The correct answer is A: Dilated cardiomyopathy. Dilated cardiomyopathy is a type of heart disease where the heart muscle becomes enlarged and weakened, reducing its ability to pump blood effectively, which can lead to heart failure. Hypertrophic cardiomyopathy (B) is characterized by abnormal thickening of the heart muscle, not enlargement. Restrictive cardiomyopathy (C) involves the heart muscle becoming stiff and less flexible, limiting its ability to fill with blood properly. Myocarditis (D) is inflammation of the heart muscle, which can affect the heart's function but is different from dilated cardiomyopathy.

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. 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.

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