Nursing Elites

1. What term refers to the degree of myocardial fiber stretch before contraction, related to the volume of blood distending the ventricles at the end of diastole, and determined by the amount of venous return?

• A. Preload
• B. Afterload
• C. Contractility
• D. Ejection fraction

Correct answer: A

Rationale: The correct answer is A: Preload. Preload is the degree of myocardial fiber stretch before contraction, influenced by the volume of blood returning to the heart. This parameter is related to the amount of blood in the ventricles at the end of diastole. Choice B, Afterload, refers to the pressure or resistance that the ventricles must overcome to eject blood. Choice C, Contractility, is the intrinsic ability of the heart muscle to contract. Choice D, Ejection fraction, is the percentage of blood pumped out of the ventricles with each contraction.

2. What is the approximate stroke volume of the heart?

• A. Approximately 60 mL of blood per beat
• B. Approximately 70 mL of blood per beat
• C. Approximately 80 mL of blood per beat
• D. Approximately 90 mL of blood per beat

Correct answer: B

Rationale: The correct answer is B: Approximately 70 mL of blood per beat. The stroke volume of the heart is typically around 70 mL, indicating the volume of blood ejected from the left ventricle with each contraction. Choices A, C, and D are incorrect as they do not represent the standard approximate stroke volume of the heart, which is around 70 mL per beat.

3. What is a condition where the lungs become stiff and scarred, making it difficult to breathe and get enough oxygen into the bloodstream?

• A. Pulmonary fibrosis
• B. Pulmonary edema
• C. Pulmonary embolism
• D. Pulmonary hypertension

Correct answer: A

Rationale: Pulmonary fibrosis is a condition characterized by the stiffening and scarring of the lungs, leading to difficulty breathing and impairing the transfer of oxygen into the bloodstream. Pulmonary edema refers to fluid accumulation in the lungs, causing breathing difficulties due to fluid filling the air sacs. Pulmonary embolism is a blockage in one of the pulmonary arteries in the lungs, often caused by a blood clot. Pulmonary hypertension is high blood pressure in the arteries of the lungs, which can lead to strain on the heart and affect oxygen levels in the blood.

4. 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.

5. The client on spironolactone should avoid which of the following?

• A. Foods high in potassium
• B. Foods high in sodium
• C. Foods high in calcium
• D. Foods high in chloride

Correct answer: A

Rationale: The correct answer is A: Foods high in potassium. Spironolactone is a potassium-sparing diuretic, meaning it helps the body retain potassium and excrete sodium. Consuming foods high in potassium while on spironolactone can lead to an excess of potassium in the body, potentially causing hyperkalemia. Choices B, C, and D are incorrect because spironolactone does not directly interact with sodium, calcium, or chloride in a way that would require specific dietary restrictions related to these minerals.

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