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Which test measures the electrical activity of the heart and can detect arrhythmias and other heart conditions?
- A. Electrocardiogram (ECG or EKG)
- B. Chest X-ray
- C. MRI
- D. CT scan
Correct Answer: A
Rationale: The correct answer is A: Electrocardiogram (ECG or EKG). An ECG measures the electrical activity of the heart, detecting arrhythmias and other heart conditions by recording the heart's electrical impulses. This test is non-invasive and provides valuable information about the heart's function. Chest X-ray (B) primarily shows the heart's size and shape, not electrical activity. MRI (C) and CT scan (D) are imaging tests that provide detailed anatomical images but do not directly measure heart electrical activity.
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The client is on nitroglycerin patches. What should the nurse include in the client's education?
- A. Rotate the application site with each new patch.
- B. Apply the patch at the same time each day.
- C. Leave the patch on for 24 hours, then remove it for 12 hours before applying a new one.
- D. Apply the patch to the same site each time.
Correct Answer: A
Rationale: The correct answer is A: Rotate the application site with each new patch. This is important to prevent skin irritation and tolerance development. Rotating sites ensures consistent drug absorption and reduces the risk of skin reactions. Applying the patch at the same site each time (choice D) can lead to localized skin irritation. Applying the patch at the same time each day (choice B) is not as crucial as rotating sites. Leaving the patch on for 24 hours and then removing it for 12 hours (choice C) can disrupt the therapeutic effect of the medication.
Which of the following is a rare but serious condition where the pulmonary arteries become narrowed, increasing the blood pressure in the lungs?
- A. Pulmonary hypertension
- B. Pulmonary embolism
- C. Pulmonary fibrosis
- D. Aortic stenosis
Correct Answer: A
Rationale: The correct answer is A: Pulmonary hypertension. This condition is characterized by narrowing of the pulmonary arteries, leading to increased blood pressure in the lungs. Pulmonary embolism (B) is a blockage in one of the pulmonary arteries, not narrowing. Pulmonary fibrosis (C) involves scarring of lung tissue, not artery narrowing. Aortic stenosis (D) is a narrowing of the aortic valve, not the pulmonary arteries. Therefore, the correct choice is A.
You are working in the ED caring for a patient who was just admitted with left anterior chest pain, possible unstable angina or myocardial infarction. Which nursing activity will you accomplish first?
- A. Auscultate heart sounds.
- B. Administer sublingual nitroglycerin.
- C. Insert an IV catheter.
- D. Obtain a brief patient health history.
Correct Answer: B
Rationale: Relieving chest pain is a priority to reduce myocardial oxygen demand and prevent further damage.
What is the ability of cardiac cells to respond to an impulse by transmitting the impulse along cell membranes?
- A. Contractility
- B. Automaticity
- C. Conductivity
- D. Rhythmicity
Correct Answer: C
Rationale: The correct answer is C: Conductivity. Cardiac cells have the ability to transmit impulses along cell membranes, allowing for the coordinated contraction of the heart. Conductivity refers to this specific property of cardiac cells to propagate electrical signals.
Contractility (A) refers to the ability of cardiac muscle cells to generate force during contraction. Automaticity (B) refers to the ability of cardiac cells to spontaneously generate electrical impulses. Rhythmicity (D) refers to the regularity of these electrical impulses in the heart. Conductivity is the most relevant choice as it directly addresses the transmission of impulses along cell membranes in cardiac cells.
The nurse is giving nitroglycerin sublingually for chest pain. What is the most important instruction to give to the client?
- A. Place the tablet under the tongue and let it dissolve completely.
- B. Swallow the tablet whole with a glass of water.
- C. Chew the tablet and then swallow it.
- D. Take one tablet every 5 minutes until pain is relieved.
Correct Answer: A
Rationale: The correct answer is A: Place the tablet under the tongue and let it dissolve completely. Nitroglycerin is absorbed quickly through the oral mucosa, providing rapid relief for chest pain. Placing it under the tongue allows for direct absorption into the bloodstream. Swallowing the tablet whole (B) would delay absorption. Chewing the tablet (C) would cause rapid absorption and possibly lead to a drop in blood pressure. Taking one tablet every 5 minutes (D) is not recommended as it can lead to hypotension. Therefore, option A is the most appropriate instruction for the client.