Nursing Elites

1. The nurse is caring for a client on amiodarone who develops a cough. What is the most appropriate action?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect.
• C. Continue the amiodarone and monitor the client’s symptoms.
• D. Discontinue the amiodarone immediately.

Correct answer: A

Rationale: The correct action when a client on amiodarone develops a cough, which can be a sign of pulmonary toxicity, a serious side effect of amiodarone, is to notify the healthcare provider immediately. This is crucial because pulmonary toxicity can lead to severe complications if not addressed promptly. Choices B and C are incorrect as they do not address the potential severity of the situation and may delay necessary intervention. Choice D of discontinuing amiodarone immediately without consulting the healthcare provider can be risky, as sudden discontinuation of the medication may have adverse effects on the client's condition.

2. What is the condition where the lungs become filled with fluid, often due to heart failure, making it difficult to breathe?

• A. Pulmonary edema
• B. Pleural effusion
• C. Pulmonary hypertension
• D. Pneumothorax

Correct answer: A

Rationale: Pulmonary edema is the correct answer. It occurs when fluid fills the lungs, usually due to heart failure, leading to breathing difficulties. Pleural effusion is the accumulation of fluid around the lungs, not inside. Pulmonary hypertension is high blood pressure in the arteries of the lungs, and pneumothorax is the presence of air between the lung and chest wall.

3. What is the term that describes the inability of cardiac cells to respond to a new stimulus while they are still in contraction from a previous stimulus?

• A. Refractoriness
• B. Excitability
• C. Contractility
• D. Automaticity

Correct answer: A

Rationale: Refractoriness is the correct term to describe the inability of cardiac cells to respond to a new stimulus while they are still in contraction from a previous stimulus. This period is essential for the heart to complete its contraction and relaxation phases without interference. Excitability refers to the ability of cells to respond to stimuli, not the inability to respond. Contractility is the force of cardiac muscle contraction, and automaticity is the ability of cardiac cells to generate electrical impulses spontaneously, which are not relevant to the described scenario.

4. Which artery supplies the anterior wall of the left ventricle, the anterior interventricular septum, the anterior papillary muscles, and apex of the heart?

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

Correct answer: A

Rationale: The correct answer is the Left anterior descending artery. This artery supplies the anterior wall of the left ventricle, the anterior interventricular septum, the anterior papillary muscles, and apex of the heart. The Left circumflex artery (choice B) supplies the lateral and posterior walls of the left ventricle, the posterior descending artery (choice C) supplies the inferior part of the heart, and the aortic artery (choice D) is not a specific coronary artery.

5. What is the procedure where a catheter is used to open a blocked or narrowed coronary artery, often involving the placement of a stent?

• A. Angioplasty
• B. Valve replacement
• C. Stent placement
• D. Coronary artery bypass graft (CABG)

Correct answer: A

Rationale: The correct answer is Angioplasty. Angioplasty is a procedure where a catheter is used to open a blocked or narrowed coronary artery, often involving the placement of a stent to keep the artery open and improve blood flow to the heart. Choice B, Valve replacement, is incorrect as it involves replacing a heart valve, not opening a blocked artery. Choice C, Stent placement, is similar to angioplasty but not as specific, as it does not involve the catheter-based procedure. Choice D, Coronary artery bypass graft (CABG), is a different procedure where blocked arteries are bypassed using a blood vessel from another part of the body.

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