Nursing Elites

1. The client on nitroglycerin patches reports dizziness when standing up. What is the nurse’s best response?

• A. Advise the client to rise slowly to prevent dizziness.
• B. Instruct the client to discontinue the nitroglycerin patches.
• C. Encourage the client to rest and avoid physical activity.
• D. Suggest the client take an over-the-counter antiemetic.

Correct answer: A

Rationale: The correct answer is to advise the client to rise slowly to prevent dizziness. Dizziness when standing up can be a sign of orthostatic hypotension, a common side effect of nitroglycerin. Rising slowly can help minimize this symptom. Instructing the client to discontinue the nitroglycerin patches (Choice B) is not appropriate without consulting a healthcare provider as sudden discontinuation can lead to adverse effects. Encouraging the client to rest and avoid physical activity (Choice C) does not address the specific issue of orthostatic hypotension. Suggesting the client take an over-the-counter antiemetic (Choice D) is not indicated for dizziness related to orthostatic hypotension.

2. What is the procedure to remove a sample of tissue from the lung for examination under a microscope?

• A. Lung biopsy
• B. Bronchoscopy
• C. Thoracentesis
• D. Lobectomy

Correct answer: A

Rationale: The correct answer is A, lung biopsy. A lung biopsy involves removing a small sample of lung tissue for examination under a microscope to diagnose lung conditions. Choice B, bronchoscopy, is a procedure where a thin, flexible tube with a light and camera is inserted into the airways to view the lungs. This procedure is more for diagnostic purposes and not specifically for tissue removal. Choice C, thoracentesis, is a procedure to remove fluid from the pleural space around the lungs for diagnostic or therapeutic purposes, not for tissue biopsy. Choice D, lobectomy, is a surgical procedure to remove a lobe of the lung, usually done to treat conditions like lung cancer or severe infections, but it does not involve removing tissue for microscopic examination.

3. What is a chronic condition where the airways in the lungs become damaged and widened, leading to mucus buildup and frequent infections?

• A. Bronchiectasis
• B. Chronic bronchitis
• C. Pneumoconiosis
• D. Asthma

Correct answer: A

Rationale: Bronchiectasis is a chronic condition characterized by the damage and widening of the airways in the lungs, resulting in mucus accumulation and recurrent lung infections. Choice B, chronic bronchitis, involves inflammation of the bronchial tubes and excessive mucus production but does not specifically mention airway damage and widening. Choice C, pneumoconiosis, refers to lung diseases caused by inhalation of mineral dust particles, not airway damage and mucus buildup. Choice D, asthma, is a chronic condition characterized by airway inflammation and narrowing, leading to breathing difficulties, but it does not involve the widening and damage of the airways as seen in bronchiectasis.

4. 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.

5. Which of the following is a chronic condition where the heart muscle is weakened and unable to pump blood effectively, often leading to heart failure?

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

Correct answer: A

Rationale: Dilated cardiomyopathy is characterized by the heart muscle being weakened and unable to pump blood effectively, ultimately resulting in heart failure. Choice B, Hypertrophic cardiomyopathy, involves the heart muscle becoming abnormally thick, reducing the heart's efficiency. Choice C, Restrictive cardiomyopathy, refers to the heart becoming rigid and less able to fill with blood properly. Myocarditis, as in Choice D, is inflammation of the heart muscle usually caused by a viral infection and is different from the chronic weakening seen in dilated cardiomyopathy.

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