Nokea
The client is on a calcium channel blocker. What is the expected effect on the heart?
- A. Increased heart rate
- B. Decreased heart rate
- C. Increased blood pressure
- D. Decreased blood pressure
Correct Answer: D
Rationale: The correct answer is D: Decreased blood pressure. Calcium channel blockers inhibit the entry of calcium into cardiac muscle cells, leading to relaxation of blood vessels and decreased cardiac contractility. This results in vasodilation and decreased cardiac output, ultimately lowering blood pressure. Choice A is incorrect as calcium channel blockers typically lead to decreased heart rate due to reduced contractility. Choice B is incorrect as calcium channel blockers do not increase heart rate. Choice C is incorrect as the vasodilatory effect of calcium channel blockers typically leads to decreased blood pressure, not increased.
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Which artery supplies the right atrium, right ventricle, a portion of the septum, SA node, AV node, and inferior portion of the left ventricle?
- A. Right coronary artery
- B. Left circumflex artery
- C. Posterior descending artery
- D. Aortic artery
Correct Answer: A
Rationale: The correct answer is A: Right coronary artery. This artery supplies the mentioned structures as it branches off from the aorta and follows the coronary sulcus to reach the right side of the heart. It provides blood to the right atrium, right ventricle, part of the septum, SA node, AV node, and inferior left ventricle. The Left circumflex artery (B) mainly supplies the left atrium and lateral part of the left ventricle. The Posterior descending artery (C) typically arises from the right coronary artery and supplies the inferior part of the heart. The Aortic artery (D) is not a specific artery that directly supplies the structures mentioned.
The client on digoxin has a potassium level of 3.0 mEq/L. What is the nurse's priority action?
- A. Administer a potassium supplement
- B. Hold the digoxin and notify the healthcare provider
- C. Continue the current digoxin dose
- D. Administer Digibind
Correct Answer: B
Rationale: The correct answer is B: Hold the digoxin and notify the healthcare provider. A potassium level of 3.0 mEq/L can increase the risk of digoxin toxicity as hypokalemia potentiates its effects. Holding the digoxin and informing the healthcare provider allows for further assessment and possible adjustment of the medication regimen. Administering a potassium supplement (A) without adjusting the digoxin dose can still lead to toxicity. Continuing the current digoxin dose (C) without addressing the low potassium level puts the client at risk. Administering Digibind (D) is not necessary at this point as the priority is to address the low potassium level and prevent digoxin toxicity.
What is a chronic condition where the heart is unable to pump blood effectively, leading to fluid buildup in the lungs and other parts of the body?
- A. Heart failure
- B. Myocardial infarction
- C. Pericarditis
- D. Pulmonary edema
Correct Answer: A
Rationale: Step 1: Heart failure is the correct answer because it is a chronic condition where the heart is unable to pump blood effectively.
Step 2: This ineffective pumping leads to fluid buildup in the lungs (pulmonary congestion) and other parts of the body (edema).
Step 3: Myocardial infarction (B) is incorrect as it is an acute condition resulting from a blockage in coronary arteries causing heart muscle damage.
Step 4: Pericarditis (C) is incorrect as it is inflammation of the pericardium, the outer lining of the heart, not directly related to heart pumping efficiency.
Step 5: Pulmonary edema (D) is incorrect as it specifically refers to fluid accumulation in the lungs, not necessarily linked to heart failure.
The client on clopidogrel (Plavix) should be monitored for which adverse effect?
- A. Bleeding
- B. Hypertension
- C. Tachycardia
- D. Bradycardia
Correct Answer: A
Rationale: The correct answer is A: Bleeding. Clopidogrel is an antiplatelet medication that can increase the risk of bleeding due to its mechanism of action in preventing blood clot formation. Monitoring for signs of bleeding such as easy bruising, prolonged bleeding from cuts, blood in urine or stool is crucial.
Incorrect Choices:
B: Hypertension - Clopidogrel does not typically cause hypertension.
C: Tachycardia - Clopidogrel does not affect heart rate in a way that would lead to tachycardia.
D: Bradycardia - Clopidogrel is not associated with causing bradycardia.
In summary, monitoring for bleeding is essential when a client is on clopidogrel due to its antiplatelet effects, while hypertension, tachycardia, and bradycardia are not typically associated adverse effects of this medication.
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: The correct answer is A: Ventricular hypertrophy. Ventricular hypertrophy refers to the thickening of the walls of the heart's ventricles, which can reduce the heart's ability to pump blood effectively. This condition is often a response to conditions like high blood pressure or heart valve disease, leading to increased workload on the heart muscle. Atrial fibrillation (B) is an irregular heart rhythm, not directly related to ventricular thickening. Restrictive cardiomyopathy (C) involves stiffening of the heart muscle, affecting the heart's ability to fill properly. Cardiomyopathy (D) is a general term for diseases of the heart muscle, not specifically describing ventricular thickening.