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. 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.

3. Which term refers to the contraction phase of the heart when blood is ejected from the chambers?

• A. Systole
• B. Diastole
• C. Contractility
• D. Afterload

Correct answer: A

Rationale: The correct answer is A, systole. Systole is the phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. During diastole (choice B), the heart relaxes and fills with blood, contrasting with systole. Contractility (choice C) refers to the ability of the heart to contract effectively. Afterload (choice D) is the pressure the heart must work against to eject blood during systole.

4. A client on a beta blocker has a heart rate of 52 bpm. What is the nurse’s priority action?

• A. Hold the beta blocker and notify the healthcare provider.
• B. Administer the beta blocker as ordered.
• C. Increase the dose of the beta blocker.
• D. Continue to monitor the client and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the beta blocker and notify the healthcare provider. A heart rate of 52 bpm is low, and beta blockers can further decrease the heart rate, potentially causing harm. Therefore, withholding the medication and promptly informing the healthcare provider is crucial for further assessment and possible adjustment of the treatment plan. Administering the beta blocker as ordered (Choice B) can exacerbate the bradycardia. Increasing the dose of the beta blocker (Choice C) would further suppress the heart rate. Continuing to monitor the client and reassessing in 30 minutes (Choice D) might delay necessary interventions and increase the risk of complications in a client with a heart rate of 52 bpm.

5. Which test uses sound waves to create images of the heart, allowing doctors to assess its structure and function?

• A. Echocardiogram
• B. MRI
• C. CT scan
• D. X-ray

Correct answer: A

Rationale: The correct answer is A: Echocardiogram. An echocardiogram is a test that uses sound waves to create images of the heart, enabling doctors to assess its structure and function. This imaging technique is particularly useful in detecting abnormalities such as valve disease. Choices B, C, and D are incorrect because MRI, CT scans, and X-rays use different imaging technologies that do not rely on sound waves to visualize the heart.

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