Nursing Elites

1. What term refers to the degree of myocardial fiber stretch before contraction, related to the volume of blood distending the ventricles at the end of diastole, and determined by the amount of venous return?

• A. Preload
• B. Afterload
• C. Contractility
• D. Ejection fraction

Correct answer: A

Rationale: The correct answer is A: Preload. Preload is the degree of myocardial fiber stretch before contraction, influenced by the volume of blood returning to the heart. This parameter is related to the amount of blood in the ventricles at the end of diastole. Choice B, Afterload, refers to the pressure or resistance that the ventricles must overcome to eject blood. Choice C, Contractility, is the intrinsic ability of the heart muscle to contract. Choice D, Ejection fraction, is the percentage of blood pumped out of the ventricles with each contraction.

2. What is a condition where the lungs become stiff and scarred, making it difficult to breathe and get enough oxygen into the bloodstream?

• A. Pulmonary fibrosis
• B. Pulmonary edema
• C. Pulmonary embolism
• D. Pulmonary hypertension

Correct answer: A

Rationale: Pulmonary fibrosis is a condition characterized by the stiffening and scarring of the lungs, leading to difficulty breathing and impairing the transfer of oxygen into the bloodstream. Pulmonary edema refers to fluid accumulation in the lungs, causing breathing difficulties due to fluid filling the air sacs. Pulmonary embolism is a blockage in one of the pulmonary arteries in the lungs, often caused by a blood clot. Pulmonary hypertension is high blood pressure in the arteries of the lungs, which can lead to strain on the heart and affect oxygen levels in the blood.

3. Which condition is characterized by the narrowing or blockage of arteries that supply blood to the heart by plaque?

• A. Coronary artery disease (CAD)
• B. Atherosclerosis
• C. Peripheral artery disease
• D. Congestive heart failure

Correct answer: A

Rationale: The correct answer is A, Coronary artery disease (CAD). CAD specifically refers to the condition where the arteries supplying blood to the heart become narrowed or blocked by plaque buildup. Choice B, Atherosclerosis, is a general term for the hardening and narrowing of arteries due to plaque buildup but does not specifically mention the heart. Choice C, Peripheral artery disease, involves narrowing of arteries that supply blood to areas other than the heart. Choice D, Congestive heart failure, is a condition where the heart is unable to pump blood effectively but is not primarily caused by narrowed or blocked arteries.

4. 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.

5. The nurse is caring for a client on digoxin. What is the most important assessment before administering this medication?

• 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 oxygen saturation.

Correct answer: A

Rationale: The correct answer is to check the client’s heart rate before administering digoxin because one of the side effects of digoxin is bradycardia. Monitoring the heart rate is crucial to assess whether the client's heart rate is within the acceptable range before giving the medication. Checking the blood pressure (Choice B), respiratory rate (Choice C), or oxygen saturation (Choice D) are important assessments in general patient care, but they are not specifically related to the administration of digoxin.

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