Nursing Elites

1. Which neurotransmitter is released by the sympathetic nervous system (SNS) to increase heart rate and the force of contraction of the heart?

• A. Norepinephrine
• B. Epinephrine
• C. Dopamine
• D. Acetylcholine

Correct answer: A

Rationale: The correct answer is Norepinephrine. Norepinephrine is the neurotransmitter released by the sympathetic nervous system that increases heart rate and the force of contraction. Epinephrine, though similar, is more involved in the fight-or-flight response and has a broader range of effects on various organs. Dopamine is not primarily responsible for increasing heart rate and contractility. Acetylcholine is a neurotransmitter that predominantly acts on the parasympathetic nervous system to decrease heart rate and contractility.

2. What condition is characterized by the inflammation of the heart's outer lining, often causing chest pain and other symptoms?

• A. Pericarditis
• B. Endocarditis
• C. Myocarditis
• D. Valvular heart disease

Correct answer: A

Rationale: Pericarditis is the correct answer because it is the inflammation of the pericardium, the outer lining of the heart. This condition commonly presents with symptoms like chest pain. Endocarditis (choice B) is the inflammation of the inner lining of the heart chambers and valves. Myocarditis (choice C) is the inflammation of the heart muscle itself. Valvular heart disease (choice D) refers to various conditions affecting the heart valves, not specifically the outer lining of the heart.

3. The nurse is preparing to administer a beta blocker to a client with hypertension. What is the priority assessment?

• A. Check the client's heart rate.
• B. Check the client's blood pressure.
• C. Check the client's respiratory rate.
• D. Check the client's temperature.

Correct answer: B

Rationale: The correct answer is to check the client's blood pressure. Before administering a beta blocker to a client with hypertension, assessing the blood pressure is crucial because beta blockers can cause hypotension, potentially leading to adverse effects. Checking the heart rate may also be important but is secondary to monitoring the blood pressure in this scenario. Respiratory rate and temperature assessments are not directly related to assessing the client's response to a beta blocker in hypertension management, making choices C and D less relevant.

4. The client on spironolactone (Aldactone) has a potassium level of 5.8 mEq/L. What is the nurse’s priority action?

• A. Hold the spironolactone and notify the healthcare provider.
• B. Administer a potassium supplement.
• C. Continue the spironolactone as ordered.
• D. Increase the dose of spironolactone.

Correct answer: A

Rationale: With a potassium level of 5.8 mEq/L, which is high, the priority action for the nurse is to hold the spironolactone. Spironolactone is a potassium-sparing diuretic that can further increase potassium levels. Therefore, it is crucial to prevent exacerbating hyperkalemia by discontinuing the medication. Notifying the healthcare provider is necessary for further guidance and potential adjustments to the treatment plan. Administering a potassium supplement (Choice B) would be contraindicated since the client already has elevated potassium levels. Continuing the spironolactone as ordered (Choice C) can worsen hyperkalemia. Increasing the dose of spironolactone (Choice D) would be unsafe and exacerbate the high potassium levels.

5. Which condition is characterized by chronic inflammation of the airways resulting in excess mucus production, leading to frequent coughing and breathing difficulties?

• A. Chronic bronchitis
• B. Asthma
• C. Pneumonia
• D. COPD

Correct answer: A

Rationale: The correct answer is A, Chronic bronchitis. Chronic bronchitis involves long-term inflammation of the bronchi, leading to excessive mucus production, frequent coughing, and breathing difficulties. Asthma (B) is characterized by reversible airway obstruction and bronchospasms. Pneumonia (C) is an infection of the lungs caused by bacteria, viruses, or fungi. COPD (D) is a term used to describe chronic lung diseases that cause airflow blockage and breathing-related problems.

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