Nursing Elites

1. The client is on enalapril (Vasotec) for hypertension. What side effect is most commonly associated with this medication?

• A. Dry cough
• B. Hypotension
• C. Hyperkalemia
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Dry cough. A dry cough is a common side effect of ACE inhibitors like enalapril. ACE inhibitors can cause the accumulation of bradykinin, leading to irritation of the respiratory tract and resulting in a persistent dry cough. Hypotension (choice B) is a possible side effect of ACE inhibitors but is less common than a dry cough. Hyperkalemia (choice C) is another side effect of ACE inhibitors, but it is not the most commonly associated one. Headache (choice D) is not a common side effect of enalapril compared to a dry cough. Therefore, the most commonly associated side effect with enalapril is a dry cough.

2. What is the ability of cardiac cells to respond to an impulse by contracting?

• A. Excitability
• B. Contractility
• C. Rhythmicity
• D. Conductivity

Correct answer: A

Rationale: Excitability is the correct term that describes the ability of cardiac cells to respond to an impulse by contracting. Excitability refers to the cell's ability to respond to stimuli and generate an action potential. Choice B, Contractility, is incorrect as it refers to the ability of cardiac cells to contract after receiving a stimulus, not the response to the impulse itself. Choice C, Rhythmicity, is incorrect as it pertains to the heart's ability to contract rhythmically without external stimulation. Choice D, Conductivity, is incorrect as it refers to the ability of cardiac cells to transmit an impulse from cell to cell, not the direct response to the impulse by contracting.

3. The nurse is giving nitroglycerin sublingually for chest pain. What is the most important instruction to give to the client?

• A. Place the tablet under the tongue and let it dissolve completely.
• B. Swallow the tablet whole with a glass of water.
• C. Chew the tablet and then swallow it.
• D. Take one tablet every 5 minutes until pain is relieved.

Correct answer: A

Rationale: The correct answer is A. The tablet should be placed under the tongue and allowed to dissolve completely to ensure rapid absorption. This route of administration allows the medication to be quickly absorbed into the bloodstream. Choice B is incorrect because nitroglycerin is meant to be absorbed sublingually, not swallowed. Choice C is incorrect as chewing the tablet can cause the medication to be rapidly absorbed, leading to adverse effects like a drop in blood pressure. Choice D is incorrect because the client should take only one tablet every 5 minutes up to a maximum of three tablets for chest pain relief.

4. What diagnostic procedure uses sound waves to create images of the heart and assess its structure and function?

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

Correct answer: A

Rationale: An echocardiogram is the correct answer because it is a diagnostic procedure that uses sound waves to create images of the heart, enabling doctors to assess its structure and function. This imaging technique is specifically designed for cardiac assessment. MRI (Choice B), CT scan (Choice C), and X-ray (Choice D) are imaging modalities that are not primarily used for detailed evaluation of the heart's structure and function, making them incorrect choices for this question.

5. What is the procedure where a device is used to shock the heart back into a normal rhythm during a life-threatening arrhythmia?

• A. Defibrillation
• B. Cardioversion
• C. Echocardiogram
• D. Ablation

Correct answer: A

Rationale: The correct answer is A, Defibrillation. Defibrillation is the procedure of using a device to deliver an electric shock to the heart during life-threatening arrhythmias like ventricular fibrillation or ventricular tachycardia to restore a normal rhythm. Choice B, Cardioversion, is similar but is typically used for less severe arrhythmias. Choice C, Echocardiogram, is a diagnostic test that uses sound waves to create images of the heart. Choice D, Ablation, is a procedure to treat certain types of arrhythmias by scarring or destroying tissue that triggers abnormal electrical signals.

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