Nursing Elites

1. This term refers to a change in the inotropic state of the muscle without a change in myocardial fiber length.

• A. Contractility
• B. Excitability
• C. Refractoriness
• D. Automaticity

Correct answer: A

Rationale: The correct answer is A: Contractility. Contractility specifically refers to the change in the force of contraction of the heart muscle without changing its length. In this scenario, the focus is on the change in the inotropic state of the muscle, which directly relates to contractility. Choice B, Excitability, refers to the ability of a cell to respond to a stimulus, not specifically related to changes in contractile force. Choice C, Refractoriness, pertains to the period during which a cell is unresponsive to a new stimulus. Choice D, Automaticity, refers to the ability of cardiac cells to spontaneously generate electrical impulses.

2. Which condition is characterized by an inability to effectively pump blood, leading to fluid buildup and swelling in the body?

• A. Heart failure
• B. Cardiomyopathy
• C. Angina
• D. Myocarditis

Correct answer: A

Rationale: Heart failure is the correct answer. It is a condition where the heart is unable to pump blood effectively, resulting in fluid accumulation and swelling in the body. Cardiomyopathy is a disease of the heart muscle that affects its ability to pump blood but is not the specific condition described in the question. Angina is chest pain or discomfort caused by reduced blood flow to the heart, not directly related to fluid buildup and swelling. Myocarditis is inflammation of the heart muscle and does not necessarily involve the inability to pump blood effectively.

3. What is a surgical procedure to create an opening in the windpipe to assist with breathing?

• A. Tracheostomy
• B. Lobectomy
• C. Thoracotomy
• D. Pleurodesis

Correct answer: A

Rationale: Tracheostomy is the correct answer. It is a surgical procedure to create an opening in the windpipe (trachea) to assist with breathing. This procedure is commonly used for patients who require long-term ventilation support. Choice B, Lobectomy, involves the removal of a lobe of the lung and is not related to creating an opening in the windpipe. Choice C, Thoracotomy, is a surgical incision into the chest wall and is not specifically related to creating an opening in the windpipe. Choice D, Pleurodesis, is a procedure to treat recurrent pleural effusions by causing the pleural layers to stick together, and it is not related to creating an opening in the windpipe.

4. Which of the following is a central vasodilator and peripheral vasoconstrictor?

• A. Sympathetic nervous system
• B. Parasympathetic nervous system
• C. Norepinephrine
• D. Acetylcholine

Correct answer: A

Rationale: The correct answer is the Sympathetic nervous system. The sympathetic nervous system is a branch of the autonomic nervous system that is responsible for the fight-or-flight response. It causes vasodilation in central vessels to increase blood flow to vital organs during stress or exercise, while inducing vasoconstriction in peripheral vessels to redirect blood to essential areas. Norepinephrine and acetylcholine are neurotransmitters associated with the sympathetic and parasympathetic nervous systems, respectively, but they are not themselves central vasodilators and peripheral vasoconstrictors.

5. The client is on enalapril (Vasotec) for hypertension. What side effect is most commonly associated with this medication?

• A. Dry cough
• B. Hypotension
• C. Hyperkalemia
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Dry cough. A dry cough is a common side effect of ACE inhibitors like enalapril. ACE inhibitors can cause the accumulation of bradykinin, leading to irritation of the respiratory tract and resulting in a persistent dry cough. Hypotension (choice B) is a possible side effect of ACE inhibitors but is less common than a dry cough. Hyperkalemia (choice C) is another side effect of ACE inhibitors, but it is not the most commonly associated one. Headache (choice D) is not a common side effect of enalapril compared to a dry cough. Therefore, the most commonly associated side effect with enalapril is a dry cough.

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