Nursing Elites

1. Which neurotransmitter released by the parasympathetic nervous system can decrease heart rate?

• A. Acetylcholine
• B. Norepinephrine
• C. Dopamine
• D. Serotonin

Correct answer: A

Rationale: Acetylcholine is the correct answer. It is a neurotransmitter released by the parasympathetic nervous system that can decrease heart rate. Norepinephrine, dopamine, and serotonin are neurotransmitters that usually have different effects on the body and are not specifically associated with decreasing heart rate. Norepinephrine, for example, is often related to the fight-or-flight response and can increase heart rate.

2. What is a condition where blood clots form in the deep veins, usually in the legs, and can travel to the lungs, causing serious complications?

• A. Deep vein thrombosis (DVT)
• B. Pulmonary embolism
• C. Varicose veins
• D. Peripheral artery disease

Correct answer: A

Rationale: The correct answer is A, Deep vein thrombosis (DVT). Deep vein thrombosis occurs when blood clots form in the deep veins, usually in the legs, and these clots can potentially travel to the lungs, leading to a pulmonary embolism. Pulmonary embolism (choice B) is a serious complication that can result from untreated DVT. Varicose veins (choice C) and peripheral artery disease (choice D) are not directly related to the formation of blood clots in deep veins that can lead to pulmonary embolism.

3. Which structure serves as the normal pacemaker of the heart?

• A. SA node
• B. AV node
• C. Purkinje fibers
• D. Atria

Correct answer: A

Rationale: The correct answer is the SA node. The sinoatrial (SA) node is known as the natural pacemaker of the heart as it generates electrical impulses initiating each heartbeat. The SA node is located in the right atrium and sets the rhythm and rate of the heartbeat. The AV node (choice B) is responsible for delaying the electrical impulse to allow the atria to contract before the ventricles. Purkinje fibers (choice C) are specialized cardiac fibers responsible for the rapid conduction of impulses to the myocardial cells, and the atria (choice D) are the upper chambers of the heart involved in receiving blood from the veins.

4. The client on warfarin has an INR of 1.2. What is the nurse’s priority action?

• A. Increase the dose of warfarin
• B. Administer vitamin K
• C. Monitor for signs of bleeding
• D. Hold the next dose and notify the healthcare provider

Correct answer: A

Rationale: The correct answer is to increase the dose of warfarin. An INR of 1.2 is below the therapeutic range for a client on warfarin, indicating that the dose is subtherapeutic. The priority action in this situation is to adjust the dose to achieve the target therapeutic INR range (usually 2-3) to prevent thromboembolic events. Administering vitamin K is not necessary as the INR is low, and there are no signs of bleeding. Monitoring for signs of bleeding is important but not the priority in this case since the INR is subtherapeutic. Holding the next dose and notifying the healthcare provider would delay the intervention needed to adjust the dose and achieve the therapeutic range.

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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