Nursing Elites

1. The client is on enoxaparin (Lovenox) for DVT prophylaxis. What is the most important lab value to monitor?

• A. Platelet count
• B. PT/INR
• C. aPTT
• D. Hemoglobin

Correct answer: A

Rationale: The correct answer is A: Platelet count. When a client is on enoxaparin (Lovenox), monitoring the platelet count is crucial as enoxaparin can lead to a rare but serious side effect known as heparin-induced thrombocytopenia (HIT), causing a decrease in platelet count. Monitoring the platelet count helps detect this adverse reaction early. Choices B, C, and D are incorrect because enoxaparin therapy does not directly affect PT/INR, aPTT, or hemoglobin levels.

2. The client on furosemide (Lasix) has a potassium level of 3.1 mEq/L. What is the nurse’s priority action?

• A. Administer a potassium supplement.
• B. Hold the furosemide and notify the healthcare provider.
• C. Continue the current dose of furosemide.
• D. Administer Digibind.

Correct answer: A

Rationale: The correct answer is to administer a potassium supplement. A potassium level of 3.1 mEq/L indicates hypokalemia, which can lead to serious complications like cardiac dysrhythmias. Therefore, the priority action is to address the low potassium level by administering a potassium supplement. Holding the furosemide (Choice B) may be necessary in the long term to prevent further potassium loss, but the immediate need is to correct the low potassium level. Continuing the current dose of furosemide (Choice C) without addressing the low potassium level can worsen hypokalemia. Administering Digibind (Choice D) is not indicated for low potassium levels; Digibind is used to treat digoxin toxicity.

3. In cases of myocardial infarction leading to shock, which medication is appropriate to counteract shock?

• A. Atropine
• B. Dopamine
• C. Digoxin
• D. Adenosine

Correct answer: B

Rationale: In cases of myocardial infarction leading to shock, dopamine is the drug of choice. Dopamine helps increase blood pressure and improve blood flow to vital organs, making it beneficial in managing shock. Atropine is mainly used for symptomatic bradycardia, not for shock. Digoxin is a cardiac glycoside used in heart failure and atrial fibrillation, not for managing shock. Adenosine is typically used for diagnosing and treating supraventricular tachycardias, not for shock associated with myocardial infarction.

4. Which condition involves the enlargement and weakening of the left ventricle of the heart, leading to reduced pumping ability?

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

Correct answer: A

Rationale: The correct answer is A: Dilated cardiomyopathy. Dilated cardiomyopathy is characterized by the enlargement and weakening of the left ventricle of the heart, which results in a reduced ability to pump blood effectively. Choice B, Hypertrophic cardiomyopathy, involves thickening of the heart muscle, not enlargement. Choice C, Restrictive cardiomyopathy, is characterized by stiffening of the heart muscle, not enlargement. Choice D, Pericarditis, refers to inflammation of the pericardium, the lining surrounding the heart, and does not involve enlargement and weakening of the left ventricle.

5. What procedure involves using a balloon to open a narrowed or blocked blood vessel, often followed by the placement of a stent?

• A. Angioplasty
• B. Valve replacement
• C. Coronary artery bypass graft (CABG)
• D. Endarterectomy

Correct answer: A

Rationale: The correct answer is A, Angioplasty. Angioplasty is a procedure that uses a balloon to open a narrowed or blocked blood vessel, often followed by the placement of a stent to maintain vessel patency. Choice B, Valve replacement, involves replacing damaged heart valves, not treating narrowed blood vessels. Choice C, Coronary artery bypass graft (CABG), is a procedure to bypass blocked coronary arteries, not directly open them using a balloon. Choice D, Endarterectomy, is a surgical procedure to remove plaque from the inner lining of an artery, not involving the use of a balloon and stent to open a vessel.

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