Nursing Elites

1. Which artery supplies the right atrium, right ventricle, a portion of the septum, SA node, AV node, and inferior portion of the left ventricle?

• A. Right coronary artery
• B. Left circumflex artery
• C. Posterior descending artery
• D. Aortic artery

Correct answer: A

Rationale: The correct answer is the right coronary artery. It supplies essential areas of the heart, including the right atrium, right ventricle, a portion of the septum, SA node, AV node, and the inferior portion of the left ventricle. The left circumflex artery primarily supplies the left atrium and lateral wall of the left ventricle, not the mentioned areas. The posterior descending artery supplies the inferior wall of the left ventricle, not the right side. The aortic artery is a general term and does not specifically refer to an artery that supplies the mentioned areas.

2. Which order should the nurse question?

• A. The addition of a loop diuretic with digoxin.
• B. The addition of a beta blocker with digoxin.
• C. A digoxin dose of 0.125 mg per day.
• D. The addition of an ACE inhibitor with digoxin.

Correct answer: B

Rationale: The correct answer is B because adding a beta blocker to digoxin can potentiate the bradycardic effect of digoxin, leading to serious complications such as heart block. This combination requires caution as it can significantly slow down the heart rate. Choices A, C, and D are not the best options to question in this scenario. Loop diuretics are commonly used with digoxin, a digoxin dose of 0.125 mg per day is within the typical range, and ACE inhibitors are often prescribed alongside digoxin for managing heart conditions.

3. Which term conceptualizes that the greater the myocardial fiber stretch, within physiologic limits, the more forceful the ventricular contraction, thereby increasing stroke volume?

• A. Frank-Starling’s Law
• B. Automaticity
• C. Contractility
• D. Excitability

Correct answer: A

Rationale: The correct answer is A, Frank-Starling’s Law. This law explains that within physiologic limits, the greater the stretch of myocardial fibers, the more forceful the ventricular contraction, leading to an increased stroke volume. Choice B, Automaticity, refers to the ability of cardiac cells to spontaneously generate electrical impulses. Choice C, Contractility, represents the intrinsic ability of the heart muscle to contract. Choice D, Excitability, refers to the ability of cardiac cells to respond to electrical stimuli.

4. This is a test that measures the oxygen saturation level in the blood, often used to assess respiratory function.

• A. Pulse oximetry
• B. Spirometry
• C. Arterial blood gas (ABG)
• D. Lung function test

Correct answer: A

Rationale: The correct answer is A, Pulse oximetry. Pulse oximetry is a non-invasive test that measures the oxygen saturation level in the blood, helping to assess respiratory and cardiovascular function. Choice B, Spirometry, measures lung function by assessing airflow and volume. Choice C, Arterial blood gas (ABG), evaluates the acidity, oxygen, and carbon dioxide levels in the blood. Choice D, Lung function test, is a broad term that may include various tests to assess lung health, but specifically measuring oxygen saturation is done through pulse oximetry.

5. The nurse is caring for a client on warfarin with an INR of 5.2. What is the most appropriate action?

• A. Administer vitamin K as an antidote.
• B. Hold the next dose of warfarin.
• C. Increase the dose of warfarin.
• D. Monitor the client’s INR closely.

Correct answer: A

Rationale: An INR of 5.2 is elevated, indicating an increased risk of bleeding. Administering vitamin K can help reverse the effects of warfarin, which is the most appropriate action in this situation. Holding the next dose of warfarin is not enough to address the high INR, and increasing the dose would further elevate the INR level. Monitoring the INR closely is important, but in this case, immediate action is needed to counteract the anticoagulant effects of warfarin.

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