Nursing Elites

1. The client is on warfarin and has an INR of 1.5. What is the nurse’s priority action?

• A. Increase the dose of warfarin.
• B. Hold the next dose of warfarin.
• C. Continue the current dose of warfarin.
• D. Monitor the client’s INR closely.

Correct answer: B

Rationale: An INR of 1.5 is below the therapeutic range for a client on warfarin, indicating that the client may be at risk of clot formation. The nurse's priority action should be to hold the next dose of warfarin to prevent further reduction of the INR. Increasing the dose could potentially lead to an increased risk of bleeding, and continuing the current dose may not be sufficient to bring the INR within the therapeutic range. Monitoring the client's INR closely is important but not the priority action in this scenario.

2. What type of medication is used to reduce high blood pressure by relaxing the blood vessels?

• A. Calcium channel blocker
• B. Beta-blocker
• C. ACE inhibitor
• D. Diuretic

Correct answer: A

Rationale: Calcium channel blockers are medications that reduce high blood pressure by relaxing the blood vessels, facilitating easier blood flow through the vessels. Beta-blockers work by reducing the heart rate and the heart's workload. ACE inhibitors help relax blood vessels by blocking the production of a chemical that narrows blood vessels. Diuretics help the body get rid of excess sodium and water to lower blood pressure, but they do not directly relax blood vessels like calcium channel blockers do.

3. The client is receiving digoxin and has a potassium level of 2.8 mEq/L. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Increase the dose of digoxin.
• C. Continue the current dose of digoxin.
• D. Administer potassium supplements.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 2.8 mEq/L indicates hypokalemia, which can increase the risk of digoxin toxicity. Holding the medication and informing the healthcare provider is crucial to prevent adverse effects. Choice B is incorrect because increasing the dose of digoxin would further raise the risk of toxicity. Choice C is incorrect as continuing the current dose could exacerbate the toxicity risk. Choice D is incorrect because administering potassium supplements alone is not sufficient to address the potential digoxin toxicity; the first step should be to hold the digoxin and seek further guidance.

4. This test measures the amount of blood the heart pumps with each beat, often used to assess heart function.

• A. Ejection fraction
• B. Cardiac output
• C. Stroke volume
• D. End-diastolic volume

Correct answer: A

Rationale: The correct answer is A: Ejection fraction. Ejection fraction is a measure of the percentage of blood that is pumped out of the left ventricle with each beat, used to assess heart function. Choice B, Cardiac output, is the total volume of blood pumped by the heart per minute and is not specific to each beat. Choice C, Stroke volume, is the amount of blood ejected by the heart in one contraction but does not specify the percentage of blood pumped out. Choice D, End-diastolic volume, is the volume of blood in the ventricle just before it contracts and does not directly measure the blood pumped with each beat.

5. Which of the following is a type of heart attack that occurs when the blood supply to part of the heart muscle is severely reduced or stopped?

• A. Myocardial infarction
• B. Angina
• C. Stroke
• D. Congestive heart failure

Correct answer: A

Rationale: The correct answer is A: Myocardial infarction. Myocardial infarction, commonly known as a heart attack, occurs when the blood supply to part of the heart muscle is severely reduced or stopped, leading to tissue damage or death. Angina (choice B) is chest pain or discomfort that occurs when the heart muscle doesn't get enough oxygen-rich blood. Stroke (choice C) is a condition where the blood supply to the brain is interrupted or reduced. Congestive heart failure (choice D) is a chronic condition where the heart muscle doesn't pump blood as well as it should.

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