Nursing Elites

1. Which fibers distribute the electrical impulse to the ventricles, causing them to contract?

• A. Purkinje fibers
• B. SA node
• C. AV node
• D. Bundle of His

Correct answer: A

Rationale: The correct answer is Purkinje fibers. Purkinje fibers are specialized conducting fibers that distribute the electrical impulse to the ventricles, leading to their contraction. The SA node (sinoatrial node) is responsible for initiating the electrical impulse in the heart, the AV node (atrioventricular node) delays the impulse to allow for proper atrial contraction before ventricular contraction, and the Bundle of His transmits the impulse from the AV node to the ventricles. Therefore, choices B, C, and D are not the correct options for fibers directly distributing the impulse to the ventricles.

2. The client on nitroglycerin patches reports dizziness when standing up. What is the nurse’s best response?

• A. Advise the client to rise slowly to prevent dizziness.
• B. Instruct the client to discontinue the nitroglycerin patches.
• C. Encourage the client to rest and avoid physical activity.
• D. Suggest the client take an over-the-counter antiemetic.

Correct answer: A

Rationale: The correct answer is to advise the client to rise slowly to prevent dizziness. Dizziness when standing up can be a sign of orthostatic hypotension, a common side effect of nitroglycerin. Rising slowly can help minimize this symptom. Instructing the client to discontinue the nitroglycerin patches (Choice B) is not appropriate without consulting a healthcare provider as sudden discontinuation can lead to adverse effects. Encouraging the client to rest and avoid physical activity (Choice C) does not address the specific issue of orthostatic hypotension. Suggesting the client take an over-the-counter antiemetic (Choice D) is not indicated for dizziness related to orthostatic hypotension.

3. Which medication is used to lower high blood pressure and reduce the risk of heart attacks and strokes?

• A. ACE inhibitor
• B. Beta-blocker
• C. Diuretic
• D. Calcium channel blocker

Correct answer: A

Rationale: The correct answer is an ACE inhibitor. ACE inhibitors are medications specifically designed to lower high blood pressure and reduce the risk of heart attacks, strokes, and other cardiovascular events. Beta-blockers, diuretics, and calcium channel blockers are also used to treat high blood pressure, but ACE inhibitors are particularly effective in reducing the risk of heart attacks and strokes.

4. Which condition occurs when the heart muscle is damaged due to a lack of oxygen, often resulting from a heart attack?

• A. Myocardial infarction
• B. Angina
• C. Pericarditis
• D. Pulmonary embolism

Correct answer: A

Rationale: The correct answer is A: Myocardial infarction. Myocardial infarction, commonly known as a heart attack, is the condition where the heart muscle is damaged due to a lack of oxygen, typically caused by a blocked coronary artery. Angina (choice B) is chest pain or discomfort that occurs when the heart muscle doesn't receive enough oxygen-rich blood. Pericarditis (choice C) is the inflammation of the pericardium, the thin sac-like membrane surrounding the heart. Pulmonary embolism (choice D) is a blockage in one of the pulmonary arteries in the lungs, often caused by a blood clot.

5. 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.

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