Nursing Elites

1. What is a condition where the right side of the heart fails due to increased pressure in the pulmonary arteries, often caused by chronic lung disease?

• A. Cor pulmonale
• B. Heart failure
• C. Pulmonary embolism
• D. Myocarditis

Correct answer: A

Rationale: Cor pulmonale is the correct answer. It is a condition where the right side of the heart fails due to increased pressure in the pulmonary arteries, often caused by chronic lung disease such as COPD. Pulmonary embolism (choice C) is a blockage in one of the pulmonary arteries in your lungs. Myocarditis (choice D) is inflammation of the heart muscle. While heart failure (choice B) is a broad term that can involve the failure of either the right or left side of the heart.

2. What is a condition characterized by the presence of air or gas in the pleural space, leading to the collapse of the lung?

• A. Pneumothorax
• B. Pulmonary embolism
• C. Pleural effusion
• D. Atelectasis

Correct answer: A

Rationale: The correct answer is Pneumothorax. Pneumothorax occurs when air or gas accumulates in the pleural space, causing the lung to collapse. This condition can result in symptoms such as chest pain and difficulty breathing. Pulmonary embolism (choice B) is a blockage in one of the pulmonary arteries in the lungs, usually caused by a blood clot. Pleural effusion (choice C) is the accumulation of excess fluid in the pleural space, not air or gas. Atelectasis (choice D) refers to the collapse or closure of a lung resulting in reduced or absent gas exchange.

3. A client on spironolactone (Aldactone) has a potassium level of 6.0 mEq/L. What is the nurse’s priority action?

• A. Hold the spironolactone and notify the healthcare provider.
• B. Administer a potassium supplement.
• C. Continue the spironolactone as ordered.
• D. Increase the dose of spironolactone.

Correct answer: A

Rationale: The correct action for a client on spironolactone with a potassium level of 6.0 mEq/L is to hold the medication and notify the healthcare provider. Spironolactone is a potassium-sparing diuretic that can further elevate potassium levels, which are already high. Administering a potassium supplement (Choice B) would exacerbate the hyperkalemia. Continuing the spironolactone as ordered (Choice C) could lead to worsening hyperkalemia. Increasing the dose of spironolactone (Choice D) would be contraindicated in the presence of elevated potassium levels.

4. The client has a prescription for sublingual nitroglycerin. What is the nurse's instruction for how to take this medication during an episode of chest pain?

• A. Take one tablet every 5 minutes, up to three tablets.
• B. Take one tablet every hour until the pain subsides.
• C. Take two tablets immediately if chest pain occurs.
• D. Take one tablet with a full glass of water.

Correct answer: A

Rationale: The correct answer is A. The standard instruction for sublingual nitroglycerin during an episode of chest pain is to take one tablet every 5 minutes, up to three tablets. If the pain persists after taking three tablets, the client should seek emergency help. Choice B is incorrect because taking one tablet every hour is not the appropriate dosing for acute chest pain. Choice C is incorrect as taking two tablets immediately is not in line with the recommended dosing instructions. Choice D is incorrect because sublingual nitroglycerin should be placed under the tongue, not swallowed with water.

5. Which of the following is a central vasoconstrictor and peripheral vasodilator?

• A. Parasympathetic nervous system
• B. Sympathetic nervous system
• C. Dopamine
• D. Epinephrine

Correct answer: D

Rationale: The correct answer is D, Epinephrine. Epinephrine acts as a central vasoconstrictor and peripheral vasodilator. It increases heart rate and blood flow to muscles, helping to prepare the body for a 'fight or flight' response. Parasympathetic nervous system (choice A) does not cause vasoconstriction but rather vasodilation. The sympathetic nervous system (choice B) is primarily responsible for the fight or flight response, causing vasoconstriction. Dopamine (choice C) primarily acts as a neurotransmitter and hormone, not directly causing central vasoconstriction and peripheral vasodilation.

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