Nursing Elites

1. What test measures the electrical activity of the heart over a 24- or 48-hour period?

• A. Holter monitor
• B. Electrocardiogram
• C. Stress test
• D. Chest X-ray

Correct answer: A

Rationale: The correct answer is A, Holter monitor. A Holter monitor is a portable device that continuously records the heart's electrical activity over 24 to 48 hours, aiding in the diagnosis of arrhythmias and other heart conditions. Choice B, an Electrocardiogram, provides a snapshot of the heart's electrical activity at a specific point in time, not over an extended period like a Holter monitor. Choice C, a Stress test, measures how the heart responds to physical activity and is not used for continuous monitoring of electrical activity. Choice D, a Chest X-ray, is used to visualize the structures of the chest, not to measure the heart's electrical activity.

2. Which medication is used to lower high blood pressure and reduce the risk of heart attacks and strokes?

• A. ACE inhibitor
• B. Beta-blocker
• C. Diuretic
• D. Calcium channel blocker

Correct answer: A

Rationale: The correct answer is an ACE inhibitor. ACE inhibitors are medications specifically designed to lower high blood pressure and reduce the risk of heart attacks, strokes, and other cardiovascular events. Beta-blockers, diuretics, and calcium channel blockers are also used to treat high blood pressure, but ACE inhibitors are particularly effective in reducing the risk of heart attacks and strokes.

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

• A. Sympathetic nervous system
• B. Parasympathetic nervous system
• C. Norepinephrine
• D. Acetylcholine

Correct answer: A

Rationale: The correct answer is the Sympathetic nervous system. The sympathetic nervous system is a branch of the autonomic nervous system that is responsible for the fight-or-flight response. It causes vasodilation in central vessels to increase blood flow to vital organs during stress or exercise, while inducing vasoconstriction in peripheral vessels to redirect blood to essential areas. Norepinephrine and acetylcholine are neurotransmitters associated with the sympathetic and parasympathetic nervous systems, respectively, but they are not themselves central vasodilators and peripheral vasoconstrictors.

4. The client on nitroglycerin patches reports dizziness when standing up. What is the nurse’s best response?

• A. Advise the client to rise slowly to prevent dizziness.
• B. Instruct the client to discontinue the nitroglycerin patches.
• C. Encourage the client to rest and avoid physical activity.
• D. Suggest the client take an over-the-counter antiemetic.

Correct answer: A

Rationale: The correct answer is to advise the client to rise slowly to prevent dizziness. Dizziness when standing up can be a sign of orthostatic hypotension, a common side effect of nitroglycerin. Rising slowly can help minimize this symptom. Instructing the client to discontinue the nitroglycerin patches (Choice B) is not appropriate without consulting a healthcare provider as sudden discontinuation can lead to adverse effects. Encouraging the client to rest and avoid physical activity (Choice C) does not address the specific issue of orthostatic hypotension. Suggesting the client take an over-the-counter antiemetic (Choice D) is not indicated for dizziness related to orthostatic hypotension.

5. The nurse is administering a calcium channel blocker. What is the primary effect of this medication on the cardiovascular system?

• A. Decreases heart rate
• B. Increases heart rate
• C. Increases blood pressure
• D. Decreases blood pressure

Correct answer: D

Rationale: The correct answer is D: Decreases blood pressure. Calcium channel blockers primarily work by relaxing the blood vessels, leading to a decrease in blood pressure. Choice A, 'Decreases heart rate,' is incorrect because calcium channel blockers do not significantly affect heart rate. Choice B, 'Increases heart rate,' is incorrect as calcium channel blockers do not have a primary effect of increasing heart rate. Choice C, 'Increases blood pressure,' is incorrect as the primary effect of calcium channel blockers is to decrease blood pressure by vasodilation.

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