What term describes a condition where a person experiences difficulty breathing when lying flat and requires multiple pillows to sleep comfortably?
- A. Orthopnea
- B. Dyspnea
- C. Tachypnea
- D. Bradypnea
Correct Answer: A
Rationale: Rationale:
1. Orthopnea refers to difficulty breathing when lying flat, relieved by sitting up.
2. Dyspnea is a general term for difficulty breathing, not specific to lying flat.
3. Tachypnea is rapid breathing, not related to difficulty breathing when lying flat.
4. Bradypnea is slow breathing, not related to difficulty breathing when lying flat.
Thus, the correct answer is A (Orthopnea), as it specifically describes the condition of requiring multiple pillows to sleep comfortably due to difficulty breathing when lying flat.
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The client on warfarin has an INR of 1.2. What is the nurse's priority action?
- A. Increase the dose of warfarin
- B. Administer vitamin K
- C. Monitor for signs of bleeding
- D. Hold the next dose and notify the healthcare provider
Correct Answer: A
Rationale: The correct answer is A: Increase the dose of warfarin. INR of 1.2 indicates subtherapeutic levels. The nurse's priority is to adjust the dose to achieve a therapeutic range (usually 2-3). Increasing the dose is essential to prevent clot formation. Administering vitamin K (B) is not indicated for a low INR. Monitoring for bleeding (C) is important, but not the priority when the INR is subtherapeutic. Holding the next dose and notifying the healthcare provider (D) may be necessary if the INR is too high, not low.
After the AV node, the electrical impulse is then transmitted into the _________, and into the _________.
- A. Purkinje fibers, ventricles
- B. Atria, ventricles
- C. Bundle of His, Purkinje fibers
- D. Ventricles, Purkinje fibers
Correct Answer: C
Rationale: The correct answer is C: Bundle of His, Purkinje fibers. After the AV node, the electrical impulse is transmitted to the Bundle of His, which then branches into the Purkinje fibers to spread the impulse throughout the ventricles. This sequence ensures coordinated and efficient contraction of the heart muscle. Choices A, B, and D are incorrect because they do not follow the physiological pathway of the electrical conduction system of the heart. The Purkinje fibers are responsible for transmitting the impulse to the ventricles, not the atria or vice versa as suggested in the other choices.
A 2400 mg sodium diet is prescribed for the patient with chronic heart failure. The nurse recognizes that additional teaching is necessary when the patient states
- A. I should limit my milk intake to 2 cups a day
- B. I can eat fresh fruits and vegetables without worrying about sodium levels
- C. I can eat most foods as long as I do not add salt when cooking or at the table
- D. I need to read the labels on prepared foods and medicines for their sodium content
Correct Answer: C
Rationale: All foods that are high in sodium should be eliminated in a 2400 mg sodium diet, in addition to the elimination of salt during cooking.
Which of the following structures of the heart is called the pacemaker of the heart?
- A. AV junction
- B. SA node
- C. AV node
- D. Purkinje fibers
Correct Answer: B
Rationale: The sinoatrial (SA) node initiates and regulates the heartbeat, acting as the heart's natural pacemaker.
What procedure uses a catheter to open blocked coronary arteries and improve blood flow to the heart muscle?
- A. Angioplasty
- B. Stent placement
- C. Coronary artery bypass graft (CABG)
- D. Valve replacement
Correct Answer: A
Rationale: The correct answer is A: Angioplasty. Angioplasty involves using a catheter with a balloon to open blocked coronary arteries, improving blood flow to the heart muscle. The balloon is inflated to compress the plaque against the artery walls, restoring blood flow. Stent placement (B) involves inserting a mesh tube to keep the artery open after angioplasty. CABG (C) is a surgical procedure that uses grafts to bypass blocked coronary arteries. Valve replacement (D) is a procedure to replace damaged heart valves, not specifically for opening blocked coronary arteries.