Nursing Elites

1. 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.

2. What condition involves a weakened and bulging aorta, the main artery in the body, potentially leading to rupture?

• A. Aortic aneurysm
• B. Arterial stenosis
• C. Pulmonary embolism
• D. Deep vein thrombosis

Correct answer: A

Rationale: An aortic aneurysm is a condition characterized by the weakening and bulging of the aorta, the body's main artery. If left untreated, this bulging may lead to a rupture, causing severe complications. Arterial stenosis refers to the narrowing of an artery, not the weakening and bulging seen in an aortic aneurysm. Pulmonary embolism involves a blockage in the pulmonary artery, which is different from the weakening and bulging in an aortic aneurysm. Deep vein thrombosis is the formation of a blood clot in a deep vein, not related to the condition described in the question.

3. A client on an ACE inhibitor reports a persistent cough. What is the nurse’s best response?

• A. Reassure the client that the cough is a common side effect and is usually not serious.
• B. Instruct the client to report the cough to the healthcare provider as it may require discontinuation of the medication.
• C. Advise the client to use a humidifier at night to relieve the cough.
• D. Suggest the client take an over-the-counter cough suppressant.

Correct answer: B

Rationale: The correct answer is B. A persistent cough in a client on an ACE inhibitor may indicate a serious side effect that requires discontinuation of the medication. Instructing the client to report the cough to the healthcare provider is essential for proper evaluation and management. Choice A is incorrect because simply reassuring the client may delay necessary action. Choice C is incorrect as using a humidifier may not address the underlying cause of the cough. Choice D is incorrect because taking a cough suppressant without healthcare provider guidance may mask symptoms without addressing the cause.

4. Which condition is characterized by the sudden onset of shortness of breath, often occurring at night and associated with heart failure?

• A. Paroxysmal nocturnal dyspnea
• B. Sleep apnea
• C. Orthopnea
• D. Dyspnea

Correct answer: A

Rationale: Paroxysmal nocturnal dyspnea is the correct answer. It is characterized by the sudden onset of shortness of breath during sleep, often associated with heart failure. Choice B, Sleep apnea, involves pauses in breathing during sleep but is not specifically associated with heart failure. Choice C, Orthopnea, is difficulty breathing that occurs when lying down and is relieved by sitting up, not necessarily associated with heart failure. Choice D, Dyspnea, is a general term for difficulty breathing and does not specifically describe the sudden onset at night associated with heart failure as seen in paroxysmal nocturnal dyspnea.

5. When administering an ACE inhibitor to a client with heart failure, what is the expected outcome of this medication?

• A. Decreased blood pressure
• B. Increased heart rate
• C. Increased cardiac output
• D. Decreased heart rate

Correct answer: C

Rationale: The correct answer is C: Increased cardiac output. ACE inhibitors are commonly used in heart failure to reduce the workload on the heart by decreasing blood pressure and increasing cardiac output. This ultimately helps improve the heart's efficiency and function. Choice A is incorrect because ACE inhibitors generally lead to a reduction in blood pressure. Choice B is incorrect as ACE inhibitors do not increase heart rate. Choice D is incorrect as ACE inhibitors do not typically decrease heart rate in the context of heart failure.

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