Nursing Elites

1. The client on atorvastatin (Lipitor) should be advised to report which of the following symptoms?

• A. Muscle pain
• B. Headache
• C. Nausea
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Muscle pain. Muscle pain can be a sign of rhabdomyolysis, a serious side effect of statins like atorvastatin. Rhabdomyolysis is a condition where muscle fibers break down rapidly and release their contents into the bloodstream, which can lead to kidney damage. Headache, nausea, and dizziness are not commonly associated with atorvastatin use and are less likely to indicate a serious adverse reaction compared to muscle pain.

2. What test measures the electrical activity of the heart over a period of time, typically 24 to 48 hours?

• A. Holter monitor
• B. Echocardiogram
• C. Stress test
• D. Arterial blood gas (ABG)

Correct answer: A

Rationale: The correct answer is A, Holter monitor. A Holter monitor is a portable device that records the electrical activity of the heart over a period of 24 to 48 hours. It is used to detect arrhythmias and other heart conditions. Choice B, Echocardiogram, is a test that uses sound waves to create images of the heart's structure and function, not focused on the electrical activity. Choice C, Stress test, evaluates the heart's function under stress but does not monitor electrical activity over an extended period. Choice D, Arterial blood gas (ABG), measures the levels of oxygen and carbon dioxide in the blood, unrelated to measuring the electrical activity of the heart over time.

3. The nurse is caring for a client on warfarin with an INR of 1.8. What is the most appropriate action?

• A. Increase the dose of warfarin.
• B. Administer vitamin K.
• C. Hold the warfarin and notify the healthcare provider.
• D. Monitor the client’s INR closely.

Correct answer: D

Rationale: An INR of 1.8 is below the therapeutic range for a client on warfarin, indicating the need for monitoring closely to ensure that the INR levels reach the desired therapeutic range. Increasing the dose of warfarin (Choice A) without proper monitoring may lead to an increased risk of bleeding. Administering vitamin K (Choice B) is not typically recommended unless the client is experiencing major bleeding or requires rapid reversal of warfarin's effects. Holding the warfarin and notifying the healthcare provider (Choice C) may be necessary in certain situations, but the immediate action in this case should be to monitor the client's INR closely to guide further management.

4. What is a condition where the arteries that supply blood to the heart muscle become hardened and narrowed due to the buildup of plaque?

• A. Atherosclerosis
• B. Aneurysm
• C. Arrhythmia
• D. Peripheral artery disease

Correct answer: A

Rationale: Atherosclerosis is the correct answer. It is a condition characterized by the hardening and narrowing of arteries supplying blood to the heart due to plaque buildup. This condition increases the risk of heart attacks. Choice B, aneurysm, refers to a balloon-like bulge in an artery, not the hardening and narrowing of arteries. Choice C, arrhythmia, is an irregular heartbeat and not related to arterial hardening. Choice D, peripheral artery disease, involves the narrowing of arteries that supply blood to the limbs, not specifically to the heart.

5. 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 electrocardiogram is a test that measures the electrical activity of the heart and can detect arrhythmias and other heart conditions by recording the heart's electrical impulses. Choices B, C, and D are incorrect because a chest X-ray is used to visualize the structures in the chest, an MRI (Magnetic Resonance Imaging) is used to provide detailed images of organs and tissues, and a CT scan (Computed Tomography) is a type of imaging that uses X-rays to create detailed cross-sectional images of the body.

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