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 a condition where the alveoli are gradually destroyed, leading to shortness of breath and reduced oxygen exchange?

• A. Emphysema
• B. Pulmonary fibrosis
• C. Pulmonary edema
• D. Lung cancer

Correct answer: A

Rationale: The correct answer is A: Emphysema. Emphysema is a chronic lung condition where the alveoli (air sacs) in the lungs are damaged, reducing the surface area available for gas exchange. This destruction leads to symptoms like shortness of breath and reduced oxygen exchange. Choice B, pulmonary fibrosis, involves scarring and thickening of the lung tissue, not destruction of alveoli. Choice C, pulmonary edema, is the accumulation of fluid in the lungs, not destruction of alveoli. Choice D, lung cancer, is the uncontrolled growth of abnormal cells in the lungs, not destruction of alveoli.

3. The client is on hydrochlorothiazide and digoxin. What effect can the nurse expect?

• A. Hydrochlorothiazide increases digoxin levels.
• B. Hydrochlorothiazide decreases digoxin levels.
• C. Hydrochlorothiazide decreases potassium, increasing the risk of digoxin toxicity.
• D. Digoxin can increase the effectiveness of hydrochlorothiazide.

Correct answer: C

Rationale: The correct answer is C. Hydrochlorothiazide is a diuretic that can decrease potassium levels, which in turn can increase the risk of digoxin toxicity. Digoxin typically doesn't impact hydrochlorothiazide levels or effectiveness, making choices A, B, and D incorrect. Choice A stating that hydrochlorothiazide increases digoxin levels is inaccurate. Choice B suggesting that hydrochlorothiazide decreases digoxin levels is also incorrect. Choice D, stating that digoxin can increase the effectiveness of hydrochlorothiazide, is not a typical interaction seen between these medications.

4. The nurse is caring for a client on digoxin. What is the most important assessment before administering this medication?

• A. Check the client’s heart rate.
• B. Check the client’s blood pressure.
• C. Check the client’s respiratory rate.
• D. Check the client’s oxygen saturation.

Correct answer: A

Rationale: The correct answer is to check the client’s heart rate before administering digoxin because one of the side effects of digoxin is bradycardia. Monitoring the heart rate is crucial to assess whether the client's heart rate is within the acceptable range before giving the medication. Checking the blood pressure (Choice B), respiratory rate (Choice C), or oxygen saturation (Choice D) are important assessments in general patient care, but they are not specifically related to the administration of digoxin.

5. What test uses sound waves to create images of the heart and assess its structure and function?

• A. Echocardiogram
• B. MRI
• C. CT scan
• D. X-ray

Correct answer: A

Rationale: An echocardiogram is the correct answer because it is a test specifically designed to use sound waves to create images of the heart, allowing healthcare providers to assess both its structure and function, as well as to detect any abnormalities. MRI (Choice B), CT scan (Choice C), and X-ray (Choice D) do not primarily use sound waves for imaging the heart; therefore, they are not the most appropriate choices for this scenario.

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