Nursing Elites

1. During which process does coronary artery blood flow to the myocardium occur during diastole, when coronary vascular resistance is reduced?

• A. Coronary perfusion pressure
• B. Coronary vascular resistance
• C. Diastolic filling
• D. Ventricular ejection

Correct answer: A

Rationale: The correct answer is A: Coronary perfusion pressure. Coronary perfusion pressure refers to the process of coronary artery blood flow to the myocardium during diastole when coronary vascular resistance is reduced. This process ensures that the myocardium receives sufficient oxygen and nutrients for proper functioning. Choice B, Coronary vascular resistance, is the opposite of what is described in the question. During coronary perfusion, resistance is reduced to enhance blood flow. Choices C and D, Diastolic filling and Ventricular ejection, do not directly relate to the process of coronary artery blood flow during diastole.

2. What is a chronic condition where the heart muscle becomes weakened and enlarged, reducing its ability to pump blood effectively?

• A. Dilated cardiomyopathy
• B. Hypertrophic cardiomyopathy
• C. Myocarditis
• D. Pericarditis

Correct answer: A

Rationale: Dilated cardiomyopathy is characterized by the weakening and enlargement of the heart muscle, leading to its reduced ability to pump blood effectively. This condition is different from hypertrophic cardiomyopathy, which involves abnormal thickening of the heart muscle, myocarditis, which is inflammation of the heart muscle, and pericarditis, which is inflammation of the pericardium. Therefore, the correct answer is Dilated cardiomyopathy.

3. What is the narrowing of the arteries due to the buildup of plaque, which can lead to heart attacks and strokes?

• A. Coronary artery disease
• B. Peripheral artery disease
• C. Aortic stenosis
• D. Mitral valve prolapse

Correct answer: A

Rationale: Coronary artery disease is the correct answer. It is the narrowing or blockage of the coronary arteries due to plaque buildup, which can lead to heart attacks and other cardiovascular issues. Choice B, Peripheral artery disease, involves the narrowing of arteries in the limbs, not specifically the coronary arteries. Choice C, Aortic stenosis, refers to the narrowing of the aortic valve opening, not the arteries. Choice D, Mitral valve prolapse, is a condition where the valve between the left atrium and left ventricle doesn't close properly, unrelated to arterial narrowing.

4. Which heart chamber receives oxygenated blood from the four pulmonary veins and serves as a reservoir during ventricular systole?

• A. Right atrium
• B. Left atrium
• C. Right ventricle
• D. Left ventricle

Correct answer: B

Rationale: The correct answer is B, Left atrium. The left atrium receives oxygenated blood from the lungs via the four pulmonary veins and acts as a holding chamber before the blood is pumped into the left ventricle. Choice A, Right atrium, is incorrect as it receives deoxygenated blood from the body via the vena cava. Choices C and D, Right ventricle and Left ventricle, are incorrect as they receive blood from the atria, not the pulmonary veins.

5. The client on warfarin has an INR of 5.5. What is the priority nursing action?

• A. Administer vitamin K as an antidote.
• B. Hold the next dose of warfarin.
• C. Increase the dose of warfarin.
• D. Administer fresh frozen plasma.

Correct answer: A

Rationale: An INR of 5.5 is significantly elevated, indicating an increased risk of bleeding. The priority nursing action in this situation is to administer vitamin K as an antidote to reverse the effects of warfarin and lower the INR. Holding the next dose of warfarin (choice B) is important but not as immediate as administering vitamin K. Increasing the dose of warfarin (choice C) would further elevate the INR, worsening the bleeding risk. Administering fresh frozen plasma (choice D) is not the first-line treatment for high INR due to warfarin.

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