Nursing Elites

1. What is a condition where the heart muscle becomes thickened without an obvious cause, leading to a reduction in the heart's ability to pump blood?

• A. Hypertrophic cardiomyopathy
• B. Dilated cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Myocarditis

Correct answer: A

Rationale: Hypertrophic cardiomyopathy is the correct answer. It is a condition characterized by the abnormal thickening of the heart muscle without an obvious cause, which impairs the heart's ability to effectively pump blood. Dilated cardiomyopathy (choice B) involves the enlargement and weakening of the heart chambers, not thickening. Restrictive cardiomyopathy (choice C) refers to the stiffening of the heart muscle, limiting its ability to fill properly. Myocarditis (choice D) is inflammation of the heart muscle usually caused by a viral infection, not thickening.

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. A client on an ACE inhibitor reports a persistent cough. What is the nurse’s best response?

• A. Reassure the client that the cough is a common side effect and is usually not serious.
• B. Instruct the client to report the cough to the healthcare provider as it may require discontinuation of the medication.
• C. Advise the client to use a humidifier at night to relieve the cough.
• D. Suggest the client take an over-the-counter cough suppressant.

Correct answer: B

Rationale: The correct answer is B. A persistent cough in a client on an ACE inhibitor may indicate a serious side effect that requires discontinuation of the medication. Instructing the client to report the cough to the healthcare provider is essential for proper evaluation and management. Choice A is incorrect because simply reassuring the client may delay necessary action. Choice C is incorrect as using a humidifier may not address the underlying cause of the cough. Choice D is incorrect because taking a cough suppressant without healthcare provider guidance may mask symptoms without addressing the cause.

4. Which of the following is a type of heart valve disease where the aortic valve becomes narrowed, restricting blood flow from the heart to the rest of the body?

• A. Aortic stenosis
• B. Mitral stenosis
• C. Tricuspid regurgitation
• D. Pulmonary hypertension

Correct answer: A

Rationale: The correct answer is Aortic stenosis. In aortic stenosis, the aortic valve becomes narrowed, which obstructs the blood flow from the heart to the rest of the body. This condition can lead to symptoms like chest pain, shortness of breath, and fainting. Mitral stenosis (choice B) involves narrowing of the mitral valve, not the aortic valve. Tricuspid regurgitation (choice C) is a condition where the tricuspid valve leaks, causing blood to flow backward in the heart. Pulmonary hypertension (choice D) is high blood pressure in the arteries of the lungs.

5. The client on warfarin has an INR of 3.8. What is the most appropriate action by the nurse?

• A. Administer vitamin K.
• B. Hold the next dose of warfarin.
• C. Increase the dose of warfarin.
• D. Notify the healthcare provider immediately.

Correct answer: A

Rationale: An INR of 3.8 is elevated, indicating an increased risk of bleeding. Administering vitamin K can help reverse the effects of warfarin. Holding the next dose of warfarin would be appropriate if the INR was too high, but not as the first-line action. Increasing the dose of warfarin would worsen the situation by further increasing the INR. Notifying the healthcare provider is important, but immediate action to address the elevated INR is necessary.

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