Nursing Elites

1. Identify the three layers of the heart:

• A. Endocardium, Myocardium, Epicardium
• B. Epicardium, Pericardium, Endocardium
• C. Myocardium, Endocardium, Pericardium
• D. Pericardium, Myocardium, Endocardium

Correct answer: A

Rationale: The correct answer is A: Endocardium, Myocardium, Epicardium. The heart consists of three main layers: the endocardium, which lines the inner chambers of the heart; the myocardium, the middle layer responsible for the heart's pumping action; and the epicardium, the outermost layer that protects the heart. Choices B, C, and D are incorrect as they do not list the heart's layers in the correct order or combination.

2. The nurse is administering digoxin to a client with a heart rate of 45 bpm. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Increase the dose of digoxin.
• D. Monitor the client’s heart rate and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A heart rate of 45 bpm is already low, and digoxin can further decrease the heart rate, leading to serious complications like bradycardia or heart block. Administering the medication can exacerbate the bradycardia, hence it should be withheld. Increasing the dose of digoxin is contraindicated due to the client's low heart rate. Monitoring the heart rate alone without taking immediate action to withhold the medication is not the priority when faced with the risk of further lowering the heart rate.

3. What is the procedure to remove a sample of tissue from the lung for examination under a microscope?

• A. Lung biopsy
• B. Bronchoscopy
• C. Thoracentesis
• D. Lobectomy

Correct answer: A

Rationale: The correct answer is A, lung biopsy. A lung biopsy involves removing a small sample of lung tissue for examination under a microscope to diagnose lung conditions. Choice B, bronchoscopy, is a procedure where a thin, flexible tube with a light and camera is inserted into the airways to view the lungs. This procedure is more for diagnostic purposes and not specifically for tissue removal. Choice C, thoracentesis, is a procedure to remove fluid from the pleural space around the lungs for diagnostic or therapeutic purposes, not for tissue biopsy. Choice D, lobectomy, is a surgical procedure to remove a lobe of the lung, usually done to treat conditions like lung cancer or severe infections, but it does not involve removing tissue for microscopic examination.

4. When administering an ACE inhibitor to a client with heart failure, what is the expected outcome of this medication?

• A. Decreased blood pressure
• B. Increased heart rate
• C. Increased cardiac output
• D. Decreased heart rate

Correct answer: C

Rationale: The correct answer is C: Increased cardiac output. ACE inhibitors are commonly used in heart failure to reduce the workload on the heart by decreasing blood pressure and increasing cardiac output. This ultimately helps improve the heart's efficiency and function. Choice A is incorrect because ACE inhibitors generally lead to a reduction in blood pressure. Choice B is incorrect as ACE inhibitors do not increase heart rate. Choice D is incorrect as ACE inhibitors do not typically decrease heart rate in the context of heart failure.

5. What type of therapy delivers high concentrations of oxygen to the lungs?

• A. Oxygen therapy
• B. Ventilator therapy
• C. Mechanical ventilation
• D. CPAP therapy

Correct answer: A

Rationale: Oxygen therapy is the correct answer because it specifically refers to a treatment that delivers high concentrations of oxygen to the lungs. This therapy is used for patients who require additional oxygen due to conditions affecting their breathing. Ventilator therapy (B), mechanical ventilation (C), and CPAP therapy (D) involve different mechanisms and purposes than delivering high concentrations of oxygen to the lungs.

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