Nursing Elites

1. What is a condition where the heart beats too fast, reducing its ability to pump blood effectively?

• A. Tachycardia
• B. Bradycardia
• C. Arrhythmia
• D. Ventricular fibrillation

Correct answer: A

Rationale: Tachycardia is the correct answer because it is a condition characterized by a fast heart rate, which can decrease the heart's efficiency in pumping blood. Bradycardia, on the other hand, refers to a slow heart rate, which is the opposite of what is described in the question. Arrhythmia is a general term for any irregularity in the heart's rhythm, not necessarily specifically related to a fast heart rate. Ventricular fibrillation is a life-threatening arrhythmia where the heart's lower chambers quiver instead of pumping blood effectively, but it is not specifically characterized by a fast heart rate.

2. What test evaluates the heart's response to physical stress, often involving exercise on a treadmill while monitoring the heart?

• A. Stress test
• B. Echocardiogram
• C. Holter monitor
• D. CT angiography

Correct answer: A

Rationale: A stress test, also known as an exercise stress test, evaluates the heart's response to physical stress by monitoring its activity during exercise, typically on a treadmill. This test helps assess the heart's performance, detect coronary artery disease, and evaluate the effectiveness of heart treatments. Echocardiogram (choice B) is an ultrasound of the heart that provides detailed images of the heart's structure and function, but it does not involve physical stress like a stress test. Holter monitor (choice C) is a device for continuously monitoring the heart's rhythm and rate over a period (usually 24-48 hours), not during exercise. CT angiography (choice D) is a diagnostic test that uses X-rays to visualize blood vessels but does not involve physical stress like a stress test.

3. What is a surgical procedure to create an opening in the windpipe to assist with breathing?

• A. Tracheostomy
• B. Lobectomy
• C. Thoracotomy
• D. Pleurodesis

Correct answer: A

Rationale: Tracheostomy is the correct answer. It is a surgical procedure to create an opening in the windpipe (trachea) to assist with breathing. This procedure is commonly used for patients who require long-term ventilation support. Choice B, Lobectomy, involves the removal of a lobe of the lung and is not related to creating an opening in the windpipe. Choice C, Thoracotomy, is a surgical incision into the chest wall and is not specifically related to creating an opening in the windpipe. Choice D, Pleurodesis, is a procedure to treat recurrent pleural effusions by causing the pleural layers to stick together, and it is not related to creating an opening in the windpipe.

4. What is the term for the amount of blood ejected by the left ventricle into the aorta per beat, determined by preload, contractility, and afterload?

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

Correct answer: A

Rationale: The correct answer is A: Stroke volume. Stroke volume refers to the volume of blood ejected by the left ventricle during each heartbeat. This is determined by preload (the degree of stretch of the cardiac muscle fibers at the end of diastole), contractility (the force of myocardial contraction), and afterload (the pressure or resistance that the ventricle must overcome to eject blood). Choice B, Cardiac output, is the volume of blood pumped by the heart per minute and is calculated by multiplying the heart rate by the stroke volume. Choice C, End-diastolic volume, is the volume of blood in the ventricle at the end of diastole before contraction. Choice D, Ejection fraction, is the proportion of blood pumped out of the ventricle with each contraction, calculated by dividing the stroke volume by the end-diastolic volume.

5. The client on furosemide (Lasix) has a potassium level of 3.1 mEq/L. What is the nurse’s priority action?

• A. Administer a potassium supplement.
• B. Hold the furosemide and notify the healthcare provider.
• C. Continue the current dose of furosemide.
• D. Administer Digibind.

Correct answer: A

Rationale: The correct answer is to administer a potassium supplement. A potassium level of 3.1 mEq/L indicates hypokalemia, which can lead to serious complications like cardiac dysrhythmias. Therefore, the priority action is to address the low potassium level by administering a potassium supplement. Holding the furosemide (Choice B) may be necessary in the long term to prevent further potassium loss, but the immediate need is to correct the low potassium level. Continuing the current dose of furosemide (Choice C) without addressing the low potassium level can worsen hypokalemia. Administering Digibind (Choice D) is not indicated for low potassium levels; Digibind is used to treat digoxin toxicity.

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