Nursing Elites

1. What is the ability of cardiac cells to respond to an impulse by contracting?

• A. Excitability
• B. Contractility
• C. Rhythmicity
• D. Conductivity

Correct answer: A

Rationale: Excitability is the correct term that describes the ability of cardiac cells to respond to an impulse by contracting. Excitability refers to the cell's ability to respond to stimuli and generate an action potential. Choice B, Contractility, is incorrect as it refers to the ability of cardiac cells to contract after receiving a stimulus, not the response to the impulse itself. Choice C, Rhythmicity, is incorrect as it pertains to the heart's ability to contract rhythmically without external stimulation. Choice D, Conductivity, is incorrect as it refers to the ability of cardiac cells to transmit an impulse from cell to cell, not the direct response to the impulse by contracting.

2. The client is on digoxin and has severe digoxin toxicity. What is the nursing priority action?

• A. Check the potassium level.
• B. Give Digibind as an antidote.
• C. Change the dosing of digoxin to every other day.
• D. Administer a potassium supplement to decrease digoxin toxicity.

Correct answer: B

Rationale: The correct answer is to give Digibind as an antidote in cases of severe digoxin toxicity. Digibind works by binding to digoxin and preventing it from causing further harm. Checking the potassium level (choice A) is important but not the priority when the client has severe toxicity. Changing the dosing to every other day (choice C) is not appropriate in the setting of severe toxicity where immediate action is required. Giving a potassium supplement (choice D) may be needed eventually, but the priority is to administer Digibind to counteract the toxic effects of digoxin.

3. The nurse is administering digoxin to a client with a heart rate of 45 bpm. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Increase the dose of digoxin.
• D. Monitor the client’s heart rate and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A heart rate of 45 bpm is already low, and digoxin can further decrease the heart rate, leading to serious complications like bradycardia or heart block. Administering the medication can exacerbate the bradycardia, hence it should be withheld. Increasing the dose of digoxin is contraindicated due to the client's low heart rate. Monitoring the heart rate alone without taking immediate action to withhold the medication is not the priority when faced with the risk of further lowering the heart rate.

4. This is a chronic condition where the heart is unable to pump enough blood to meet the body's needs.

• A. Heart failure
• B. Cardiomyopathy
• C. Myocarditis
• D. Pericarditis

Correct answer: A

Rationale: The correct answer is A: Heart failure. Heart failure is a chronic condition characterized by the heart's inability to pump enough blood to meet the body's needs, resulting in symptoms such as fatigue, shortness of breath, and fluid retention. Choice B, Cardiomyopathy, refers to diseases of the heart muscle that can lead to heart failure but is not the specific term for the condition described. Choices C and D, Myocarditis and Pericarditis, respectively, are conditions involving inflammation of the heart muscle or the lining around the heart, which can cause heart failure as a complication but are not the primary condition described in the question.

5. What is the condition where the heart's mitral valve becomes narrowed, restricting blood flow from the left atrium to the left ventricle?

• A. Mitral stenosis
• B. Aortic stenosis
• C. Tricuspid regurgitation
• D. Pulmonary hypertension

Correct answer: A

Rationale: Mitral stenosis is the correct answer. It is a condition characterized by the narrowing of the heart's mitral valve, which hinders the flow of blood from the left atrium to the left ventricle. This obstruction can lead to symptoms such as shortness of breath and fatigue. Aortic stenosis (choice B) is the narrowing of the aortic valve, not the mitral valve. Tricuspid regurgitation (choice C) is the backflow of blood through the tricuspid valve, not narrowing. Pulmonary hypertension (choice D) is increased blood pressure in the pulmonary arteries, not narrowing of the mitral valve.

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