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 term for the amount of blood ejected by the left ventricle into the aorta per beat, determined by preload, contractility, and afterload?

• A. Stroke volume
• B. Cardiac output
• C. End-diastolic volume
• D. Ejection fraction

Correct answer: A

Rationale: The correct answer is A: Stroke volume. Stroke volume refers to the volume of blood ejected by the left ventricle during each heartbeat. This is determined by preload (the degree of stretch of the cardiac muscle fibers at the end of diastole), contractility (the force of myocardial contraction), and afterload (the pressure or resistance that the ventricle must overcome to eject blood). Choice B, Cardiac output, is the volume of blood pumped by the heart per minute and is calculated by multiplying the heart rate by the stroke volume. Choice C, End-diastolic volume, is the volume of blood in the ventricle at the end of diastole before contraction. Choice D, Ejection fraction, is the proportion of blood pumped out of the ventricle with each contraction, calculated by dividing the stroke volume by the end-diastolic volume.

3. The client is on spironolactone (Aldactone). What is the most important dietary instruction?

• A. Avoid foods high in potassium.
• B. Increase intake of foods high in potassium.
• C. Avoid foods high in sodium.
• D. Increase intake of foods high in sodium.

Correct answer: A

Rationale: The correct answer is to avoid foods high in potassium. Spironolactone is a potassium-sparing diuretic, meaning it helps the body retain potassium and can lead to hyperkalemia if too much potassium is consumed. Choices B, C, and D are incorrect because increasing intake of potassium-rich foods can worsen hyperkalemia, while avoiding foods high in sodium is not the primary concern when taking spironolactone.

4. The client on amiodarone develops pulmonary fibrosis. What action should the nurse take?

• A. Notify the healthcare provider immediately.
• B. Continue the medication and monitor lung function.
• C. Discontinue the medication and start oxygen therapy.
• D. Reduce the dose and monitor respiratory status.

Correct answer: A

Rationale: When a client on amiodarone develops pulmonary fibrosis, a serious side effect, the immediate action the nurse should take is to notify the healthcare provider. This is crucial because pulmonary fibrosis can lead to severe respiratory compromise and requires prompt evaluation and management by the healthcare provider. Continuing the medication (choice B) can worsen the condition, and delaying action by reducing the dose and monitoring respiratory status (choice D) may not be appropriate given the seriousness of pulmonary fibrosis. Discontinuing the medication and starting oxygen therapy (choice C) may be necessary, but the priority is to notify the healthcare provider first for further assessment and guidance.

5. What is a condition where the heart's electrical impulses are blocked or delayed, leading to a slower or irregular heartbeat?

• A. Heart block
• B. Atrial fibrillation
• C. Tachycardia
• D. Bradycardia

Correct answer: A

Rationale: Heart block is the correct answer. It is a condition where the electrical impulses in the heart are blocked or delayed, resulting in a slower or irregular heartbeat. This can lead to symptoms like dizziness, fainting, or other issues. Atrial fibrillation (B) is characterized by rapid, irregular heartbeats. Tachycardia (C) is a condition where the heart rate is too fast. Bradycardia (D) is the opposite of tachycardia, where the heart rate is too slow.

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