Nursing Elites

1. What is the abnormal accumulation of fluid in the pleural space, often associated with infections or malignancies?

• A. Pleural effusion
• B. Pneumothorax
• C. Pulmonary edema
• D. Atelectasis

Correct answer: A

Rationale: The correct answer is A, pleural effusion. Pleural effusion is the accumulation of excess fluid between the layers of the pleura outside the lungs, often caused by infections, cancer, or other diseases. Pneumothorax (choice B) is the presence of air in the pleural space, not fluid. Pulmonary edema (choice C) is the accumulation of fluid in the lungs' air sacs and tissue, not in the pleural space. Atelectasis (choice D) is the collapse or closure of a lung resulting in reduced or absent gas exchange.

2. The nurse is caring for a heart client on digoxin and notes a potassium level of 2.5. What is the appropriate priority nursing intervention?

• A. Do nothing as this is a normal potassium level.
• B. The potassium level is low so the nurse asks for an order for potassium.
• C. The nurse asks to check the digoxin level as low potassium can increase digoxin toxicity.
• D. The nurse stops the digoxin.

Correct answer: C

Rationale: The correct answer is C. When caring for a client on digoxin with a low potassium level, the priority nursing intervention is to check the digoxin level. Low potassium can increase the risk of digoxin toxicity. Checking the digoxin level will help determine if any adjustments to the medication regimen are needed to prevent potential harm. Choice A is incorrect as a potassium level of 2.5 is low, not normal. Choice B is not the priority as simply giving potassium may not address the underlying issue of potential digoxin toxicity. Choice D is not the initial action to take without assessing the digoxin level first.

3. What term describes the phenomenon wherein decreased BP causes a reflex SNS response with increased pulse, increased contractility, and vasoconstriction; and increased BP causes reflex vagal responses resulting in decreased heart rate and passive vasodilation in the systemic arterioles?

• A. Baroreflex
• B. Cheyne-Stokes breathing
• C. Frank-Starling Law
• D. Starling reflex

Correct answer: A

Rationale: The correct answer is A: Baroreflex. The Baroreflex is a mechanism by which the body maintains blood pressure homeostasis through reflexive adjustments in heart rate and vascular tone. Choice B, Cheyne-Stokes breathing, is a pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing. Choices C and D, Frank-Starling Law and Starling reflex, are related to the intrinsic ability of the heart to adjust its output based on venous return, not specifically regulating blood pressure through reflex adjustments in heart rate and vascular tone as seen in the described phenomenon.

4. Where is the impulse from the SA node delayed, enabling atrial contraction to complete before the ventricles are stimulated and contract?

• A. AV node
• B. Bundle of His
• C. SA node
• D. Aorta

Correct answer: A

Rationale: The correct answer is AV node. The AV node is responsible for delaying the impulse from the SA node, allowing the atria to contract before the ventricles. This delay ensures the effective pumping of blood in a coordinated manner. Choices B, C, and D are incorrect because the Bundle of His is responsible for transmitting the impulse to the Purkinje fibers, the SA node is the pacemaker of the heart responsible for initiating the heartbeat, and the aorta is the main artery carrying oxygenated blood from the heart to the body, respectively, none of which are involved in delaying the impulse to allow atrial contraction before ventricular contraction.

5. Which valve opens during ventricular systole and closes during ventricular diastole?

• A. Aortic valve
• B. Pulmonary valve
• C. Mitral valve
• D. Tricuspid valve

Correct answer: B

Rationale: The correct answer is B: Pulmonary valve. The pulmonary valve opens during ventricular systole to allow blood to flow from the right ventricle into the pulmonary artery. The aortic valve opens during ventricular systole to allow blood to flow from the left ventricle into the aorta. The mitral valve and tricuspid valve are atrioventricular valves that open during ventricular diastole to allow blood to flow from the atria into the ventricles.

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