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. 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.

3. 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.

4. What is a chronic condition where the bronchial tubes in the lungs become inflamed and narrowed, often caused by smoking?

• A. Chronic bronchitis
• B. Emphysema
• C. Asthma
• D. Tuberculosis

Correct answer: A

Rationale: Chronic bronchitis is the correct answer because it is a long-term condition characterized by inflammation and narrowing of the bronchial tubes in the lungs, commonly triggered by smoking. Emphysema involves damage to the air sacs in the lungs, not specifically the bronchial tubes. Asthma is a condition of reversible airway obstruction usually due to allergies or other triggers, not solely smoking. Tuberculosis is a bacterial infection that primarily affects the lungs but is not directly related to inflammation and narrowing of the bronchial tubes.

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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