Nursing Elites

1. After the AV node, the electrical impulse is then transmitted into the _________, and into the _________.

• A. Purkinje fibers, ventricles
• B. Atria, ventricles
• C. Bundle of His, Purkinje fibers
• D. Ventricles, Purkinje fibers

Correct answer: C

Rationale: The correct answer is C. After the AV node, the electrical impulse is transmitted to the Bundle of His and then to the Purkinje fibers. This sequence is crucial for the coordinated contraction of the ventricles. Choice A (Purkinje fibers, ventricles) is incorrect because the Purkinje fibers come after the Bundle of His in the sequence of electrical conduction. Choice B (Atria, ventricles) is incorrect because the impulse does not go back to the atria after passing through the AV node. Choice D (Ventricles, Purkinje fibers) is incorrect because the impulse first reaches the Bundle of His before spreading to the Purkinje fibers.

2. What test uses high-frequency sound waves to create images of the heart, allowing doctors to assess its structure and function?

• A. Echocardiogram
• B. MRI
• C. CT scan
• D. X-ray

Correct answer: A

Rationale: The correct answer is an echocardiogram. An echocardiogram utilizes high-frequency sound waves (ultrasound) to create images of the heart, enabling doctors to evaluate its structure, function, and detect any abnormalities. MRI (Choice B) uses magnetic fields and radio waves to produce detailed images of the body's structures. CT scan (Choice C) combines X-rays and computer technology to create cross-sectional images of the body. X-ray (Choice D) uses electromagnetic radiation to produce images of the internal structures of the body, but it is not the most suitable for assessing the heart's structure and function.

3. What condition is characterized by the inflammation of the pleura, causing sharp chest pain that worsens with breathing?

• A. Pleurisy
• B. Pericarditis
• C. Endocarditis
• D. Myocarditis

Correct answer: A

Rationale: The correct answer is Pleurisy. Pleurisy is the inflammation of the pleura, the lining surrounding the lungs, which causes sharp chest pain that worsens with breathing. Pericarditis (choice B) is the inflammation of the pericardium, the sac around the heart, which typically causes chest pain that worsens when lying down. Endocarditis (choice C) is the inflammation of the inner lining of the heart chambers and valves, leading to symptoms like fever, fatigue, and abnormal heart sounds. Myocarditis (choice D) is inflammation of the heart muscle, which can cause symptoms such as chest pain, fatigue, and shortness of breath.

4. What procedure involves inserting a needle into the pleural space to remove excess fluid and help the patient breathe more easily?

• A. Thoracentesis
• B. Bronchoscopy
• C. Spirometry
• D. Arterial blood gas (ABG)

Correct answer: A

Rationale: Thoracentesis is the correct answer. It is a procedure where a needle is inserted into the pleural space to remove excess fluid, aiding in easier breathing. Bronchoscopy (Choice B) is a procedure to visualize the airways and diagnose lung problems, not specifically for fluid drainage. Spirometry (Choice C) is a test to measure lung function, not a procedure for fluid removal. Arterial blood gas (ABG) (Choice D) is a blood test to assess oxygen and carbon dioxide levels in the blood, not a procedure for draining fluid from the pleural space.

5. The nurse is giving the client digoxin for heart failure and recognizes that the drug has what type of effect on the heart?

• A. Negative inotropic, negative chronotropic effect
• B. Positive inotropic, negative chronotropic effect
• C. Negative inotropic, positive chronotropic effect
• D. Positive inotropic, positive chronotropic effect

Correct answer: B

Rationale: The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin strengthens the heart muscle, providing a positive inotropic effect, which increases the force of contraction. It also decreases the heart rate, having a negative chronotropic effect. Choice A is incorrect because digoxin has a positive inotropic effect, not a negative inotropic effect. Choice C is incorrect as digoxin does not have a positive chronotropic effect but a negative one. Choice D is incorrect because while digoxin has a positive inotropic effect, it does not have a positive chronotropic effect.

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