Nursing Elites

1. Which structure serves as the normal pacemaker of the heart?

• A. SA node
• B. AV node
• C. Purkinje fibers
• D. Atria

Correct answer: A

Rationale: The correct answer is the SA node. The sinoatrial (SA) node is known as the natural pacemaker of the heart as it generates electrical impulses initiating each heartbeat. The SA node is located in the right atrium and sets the rhythm and rate of the heartbeat. The AV node (choice B) is responsible for delaying the electrical impulse to allow the atria to contract before the ventricles. Purkinje fibers (choice C) are specialized cardiac fibers responsible for the rapid conduction of impulses to the myocardial cells, and the atria (choice D) are the upper chambers of the heart involved in receiving blood from the veins.

2. What is the condition where the walls of the heart's ventricles become thickened, reducing the heart's ability to pump blood effectively?

• A. Ventricular hypertrophy
• B. Atrial fibrillation
• C. Restrictive cardiomyopathy
• D. Cardiomyopathy

Correct answer: A

Rationale: Ventricular hypertrophy is the correct answer. In ventricular hypertrophy, the walls of the heart's ventricles become thickened, which decreases the heart's efficiency in pumping blood. Atrial fibrillation (choice B) is an irregular and often rapid heart rate that can lead to poor blood flow. While restrictive cardiomyopathy (choice C) involves the heart muscle becoming rigid and less compliant, it is not specifically characterized by thickening of the ventricular walls. Cardiomyopathy (choice D) is a general term for diseases of the heart muscle, which can present with various symptoms and causes.

3. The nurse is administering nitroglycerin IV to a client with chest pain. What is the most important parameter to monitor?

• A. Blood pressure
• B. Heart rate
• C. Oxygen saturation
• D. Respiratory rate

Correct answer: A

Rationale: The correct answer is A: Blood pressure. When administering nitroglycerin IV to a client with chest pain, monitoring blood pressure is crucial as nitroglycerin can cause significant hypotension. While heart rate, oxygen saturation, and respiratory rate are important parameters to assess, blood pressure takes precedence in this scenario due to the potential hypotensive effects of nitroglycerin.

4. What is a severe allergic reaction that can cause difficulty breathing and shock?

• A. Anaphylaxis
• B. Asthma attack
• C. Bronchospasm
• D. Hypersensitivity

Correct answer: A

Rationale: Anaphylaxis is the correct answer. It is a severe, potentially life-threatening allergic reaction that can lead to difficulty breathing, low blood pressure, and loss of consciousness. An asthma attack is a separate condition characterized by narrowed airways and difficulty breathing, but it is not necessarily related to an allergic reaction like anaphylaxis. Bronchospasm refers to the sudden constriction of muscles in the bronchi, leading to breathing difficulties, and is not specific to allergic reactions. Hypersensitivity is a general term for an exaggerated immune response to a substance, which may or may not manifest as severe allergic reactions like anaphylaxis.

5. The nurse is administering an ACE inhibitor to a client. What is the most common side effect?

• A. Cough
• B. Dizziness
• C. Hypotension
• D. Hyperkalemia

Correct answer: A

Rationale: The correct answer is A: Cough. Cough is a well-known side effect of ACE inhibitors due to an increase in bradykinin levels. This irritating cough can be bothersome to clients and should be monitored. Choice B, Dizziness, is not the most common side effect of ACE inhibitors. While ACE inhibitors can cause hypotension (Choice C), cough is more prevalent. Hyperkalemia (Choice D) is a possible side effect of ACE inhibitors but is less common compared to cough.

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