Nursing Elites

1. What is a severe and often sudden allergic reaction that can lead to breathing difficulties and anaphylactic shock?

• A. Anaphylaxis
• B. Allergic rhinitis
• C. Bronchospasm
• D. Asthma attack

Correct answer: A

Rationale: Anaphylaxis is the correct answer. It is a severe allergic reaction that can result in difficulty breathing, a drop in blood pressure, and even anaphylactic shock if not treated promptly. Choice B, allergic rhinitis, is characterized by symptoms such as a runny or stuffy nose, sneezing, and itching. Choice C, bronchospasm, refers to the sudden constriction of the muscles in the walls of the bronchioles, leading to breathing difficulties. Choice D, asthma attack, involves the inflammation and narrowing of the airways, resulting in symptoms like wheezing, coughing, and chest tightness.

2. After the AV node, the electrical impulse is then transmitted into the _________, and into the _________.

• A. Purkinje fibers, ventricles
• B. Atria, ventricles
• C. Bundle of His, Purkinje fibers
• D. Ventricles, Purkinje fibers

Correct answer: C

Rationale: The correct answer is C. After the AV node, the electrical impulse is transmitted to the Bundle of His and then to the Purkinje fibers. This sequence is crucial for the coordinated contraction of the ventricles. Choice A (Purkinje fibers, ventricles) is incorrect because the Purkinje fibers come after the Bundle of His in the sequence of electrical conduction. Choice B (Atria, ventricles) is incorrect because the impulse does not go back to the atria after passing through the AV node. Choice D (Ventricles, Purkinje fibers) is incorrect because the impulse first reaches the Bundle of His before spreading to the Purkinje fibers.

3. Which condition involves the tearing of the aorta, leading to severe pain and internal bleeding?

• A. Aortic dissection
• B. Aneurysm
• C. Stroke
• D. Myocardial infarction

Correct answer: A

Rationale: The correct answer is Aortic dissection. Aortic dissection is a life-threatening condition where the inner layer of the aorta tears, causing severe chest or back pain and internal bleeding, requiring immediate medical attention. Choice B, aneurysm, involves a bulging or weakening of a blood vessel wall, which is different from a tear in the aorta. Choices C and D, stroke and myocardial infarction, do not directly involve the tearing of the aorta and are distinct conditions.

4. Which procedure is used to restore a normal heart rhythm in patients with arrhythmias, typically using electrical shocks?

• A. Cardioversion
• B. Defibrillation
• C. Ablation
• D. Angioplasty

Correct answer: A

Rationale: The correct answer is A: Cardioversion. Cardioversion is the procedure used to restore a normal heart rhythm in patients with arrhythmias by delivering controlled electrical shocks to the heart. Choice B, Defibrillation, is incorrect because defibrillation is used to treat life-threatening arrhythmias by delivering an unsynchronized high-energy shock to the heart. Choice C, Ablation, is incorrect as it involves destroying abnormal tissue that causes arrhythmias, not necessarily restoring normal heart rhythm. Choice D, Angioplasty, is unrelated to heart rhythm restoration and is a procedure to open blocked or narrowed blood vessels.

5. 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.

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