Nursing Elites

1. 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.

2. Which term refers to the ability of the heart to initiate impulses repetitively and spontaneously?

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

Correct answer: C

Rationale: The correct answer is C: Automaticity. Automaticity is the specific term used to describe the heart's ability to generate impulses repetitively and spontaneously. Contractility (A) refers to the ability of muscle fibers to contract, not the initiation of impulses. Excitability (B) is the ability of cells to respond to stimuli but is not specific to the heart's impulse generation. Rhythmicity (D) is a related term but does not specifically describe the heart's spontaneous impulse initiation.

3. The client on atorvastatin (Lipitor) should be advised to report which of the following symptoms?

• A. Muscle pain
• B. Headache
• C. Nausea
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Muscle pain. Muscle pain can be a sign of rhabdomyolysis, a serious side effect of statins like atorvastatin. Rhabdomyolysis is a condition where muscle fibers break down rapidly and release their contents into the bloodstream, which can lead to kidney damage. Headache, nausea, and dizziness are not commonly associated with atorvastatin use and are less likely to indicate a serious adverse reaction compared to muscle pain.

4. What is a procedure to remove fluid or air from the pleural space to help a patient breathe easier?

• A. Thoracentesis
• B. Bronchoscopy
• C. Chest X-ray
• D. CT scan

Correct answer: A

Rationale: Correct! Thoracentesis is the correct answer. It is a procedure where fluid or air is removed from the pleural space in the chest to help the patient breathe more easily. Bronchoscopy (choice B) is a procedure to visualize the airways, while Chest X-ray (choice C) and CT scan (choice D) are imaging tests and do not involve the removal of fluid or air from the pleural space.

5. Which test measures how well the lungs work by assessing the amount of air the lungs can hold and how quickly air can be exhaled?

• A. Spirometry
• B. Pulse oximetry
• C. Arterial blood gas (ABG)
• D. Chest X-ray

Correct answer: A

Rationale: The correct answer is A, Spirometry. Spirometry is a pulmonary function test that evaluates lung function by measuring the amount of air a person can exhale and how quickly, assisting in the diagnosis of conditions such as asthma and COPD. Choices B, C, and D are incorrect because Pulse oximetry measures oxygen saturation in the blood, Arterial blood gas (ABG) evaluates blood pH, oxygen, and carbon dioxide levels, and a Chest X-ray provides an image of the lungs but does not measure lung function.

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