Nursing Elites

1. The client is on digoxin and has severe digoxin toxicity. What is the nursing priority action?

• A. Check the potassium level.
• B. Give Digibind as an antidote.
• C. Change the dosing of digoxin to every other day.
• D. Administer a potassium supplement to decrease digoxin toxicity.

Correct answer: B

Rationale: The correct answer is to give Digibind as an antidote in cases of severe digoxin toxicity. Digibind works by binding to digoxin and preventing it from causing further harm. Checking the potassium level (choice A) is important but not the priority when the client has severe toxicity. Changing the dosing to every other day (choice C) is not appropriate in the setting of severe toxicity where immediate action is required. Giving a potassium supplement (choice D) may be needed eventually, but the priority is to administer Digibind to counteract the toxic effects of digoxin.

2. 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.

3. What is the amount of tension the ventricle must develop during contraction to eject blood from the left ventricle into the aorta?

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

Correct answer: A

Rationale: Afterload is the correct answer because it refers to the pressure or tension that the ventricle must overcome during systole to eject blood into the aorta. Preload, on the other hand, is the degree of stretch of the ventricular muscle at the end of diastole before it contracts. Automaticity is the ability of the heart to generate electrical impulses independently, and ejection fraction is the percentage of blood pumped out of the ventricle with each heartbeat. Therefore, in the context of the question, afterload best describes the amount of tension the ventricle must develop to eject blood into the aorta.

4. This test measures the amount of blood the heart pumps with each beat, often used to assess heart function.

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

Correct answer: A

Rationale: The correct answer is A: Ejection fraction. Ejection fraction is a measure of the percentage of blood that is pumped out of the left ventricle with each beat, used to assess heart function. Choice B, Cardiac output, is the total volume of blood pumped by the heart per minute and is not specific to each beat. Choice C, Stroke volume, is the amount of blood ejected by the heart in one contraction but does not specify the percentage of blood pumped out. Choice D, End-diastolic volume, is the volume of blood in the ventricle just before it contracts and does not directly measure the blood pumped with each beat.

5. Which heart chamber ejects blood into the systemic arterial circulation via the aorta?

• A. Right atrium
• B. Left atrium
• C. Right ventricle
• D. Left ventricle

Correct answer: D

Rationale: The correct answer is D, Left ventricle. The left ventricle pumps oxygenated blood into the systemic circulation via the aorta. This chamber receives oxygen-rich blood from the left atrium and contracts forcefully to propel blood into the aorta, distributing it to the body. The other options, right atrium, left atrium, and right ventricle, do not directly eject blood into the systemic arterial circulation via the aorta. The right atrium receives deoxygenated blood from the body, the left atrium receives oxygenated blood from the lungs, and the right ventricle pumps blood to the lungs for oxygenation.

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