Nursing Elites

1. Which structure serves as the normal pacemaker of the heart?

• A. SA node
• B. AV node
• C. Purkinje fibers
• D. Atria

Correct answer: A

Rationale: The correct answer is the SA node. The sinoatrial (SA) node is known as the natural pacemaker of the heart as it generates electrical impulses initiating each heartbeat. The SA node is located in the right atrium and sets the rhythm and rate of the heartbeat. The AV node (choice B) is responsible for delaying the electrical impulse to allow the atria to contract before the ventricles. Purkinje fibers (choice C) are specialized cardiac fibers responsible for the rapid conduction of impulses to the myocardial cells, and the atria (choice D) are the upper chambers of the heart involved in receiving blood from the veins.

2. What is an acute respiratory infection that inflames the alveoli in one or both lungs, causing them to fill with fluid or pus?

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

Correct answer: A

Rationale: Pneumonia is the correct answer because it is an acute respiratory infection that inflames the alveoli in one or both lungs, leading to the accumulation of fluid or pus. This condition presents with symptoms like cough, fever, and difficulty breathing. Bronchitis is the inflammation of the bronchial tubes, not the alveoli. Tuberculosis is a bacterial infection that primarily affects the lungs but does not always result in alveolar inflammation. Asthma is a chronic respiratory condition characterized by airway inflammation and narrowing, not alveolar inflammation.

3. What condition involves the heart's electrical system malfunctioning, causing very fast heartbeats originating from the ventricles?

• A. Ventricular tachycardia
• B. Atrial fibrillation
• C. Supraventricular tachycardia
• D. Bradycardia

Correct answer: A

Rationale: Ventricular tachycardia is the correct answer. It is a condition characterized by the heart's electrical system malfunctioning, leading to very fast heartbeats originating from the ventricles. Ventricular tachycardia can be life-threatening as it may progress to ventricular fibrillation, causing cardiac arrest. Atrial fibrillation (choice B) involves rapid, irregular beating of the atria, not the ventricles. Supraventricular tachycardia (choice C) originates above the ventricles and does not involve ventricular malfunction. Bradycardia (choice D) is the opposite of tachycardia, characterized by an abnormally slow heart rate.

4. Where is the impulse from the SA node delayed, enabling atrial contraction to complete before the ventricles are stimulated and contract?

• A. AV node
• B. Bundle of His
• C. SA node
• D. Aorta

Correct answer: A

Rationale: The correct answer is AV node. The AV node is responsible for delaying the impulse from the SA node, allowing the atria to contract before the ventricles. This delay ensures the effective pumping of blood in a coordinated manner. Choices B, C, and D are incorrect because the Bundle of His is responsible for transmitting the impulse to the Purkinje fibers, the SA node is the pacemaker of the heart responsible for initiating the heartbeat, and the aorta is the main artery carrying oxygenated blood from the heart to the body, respectively, none of which are involved in delaying the impulse to allow atrial contraction before ventricular contraction.

5. The nurse is giving nitroglycerin sublingually for chest pain. What is the most important instruction to give to the client?

• A. Place the tablet under the tongue and let it dissolve completely.
• B. Swallow the tablet whole with a glass of water.
• C. Chew the tablet and then swallow it.
• D. Take one tablet every 5 minutes until pain is relieved.

Correct answer: A

Rationale: The correct answer is A. The tablet should be placed under the tongue and allowed to dissolve completely to ensure rapid absorption. This route of administration allows the medication to be quickly absorbed into the bloodstream. Choice B is incorrect because nitroglycerin is meant to be absorbed sublingually, not swallowed. Choice C is incorrect as chewing the tablet can cause the medication to be rapidly absorbed, leading to adverse effects like a drop in blood pressure. Choice D is incorrect because the client should take only one tablet every 5 minutes up to a maximum of three tablets for chest pain relief.

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