Nursing Elites

1. The client on warfarin has an INR of 1.2. What is the nurse’s priority action?

• A. Increase the dose of warfarin
• B. Administer vitamin K
• C. Monitor for signs of bleeding
• D. Hold the next dose and notify the healthcare provider

Correct answer: A

Rationale: The correct answer is to increase the dose of warfarin. An INR of 1.2 is below the therapeutic range for a client on warfarin, indicating that the dose is subtherapeutic. The priority action in this situation is to adjust the dose to achieve the target therapeutic INR range (usually 2-3) to prevent thromboembolic events. Administering vitamin K is not necessary as the INR is low, and there are no signs of bleeding. Monitoring for signs of bleeding is important but not the priority in this case since the INR is subtherapeutic. Holding the next dose and notifying the healthcare provider would delay the intervention needed to adjust the dose and achieve the therapeutic range.

2. What is a condition where the heart muscle becomes thickened without an obvious cause, leading to a reduction in the heart's ability to pump blood?

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

Correct answer: A

Rationale: Hypertrophic cardiomyopathy is the correct answer. It is a condition characterized by the abnormal thickening of the heart muscle without an obvious cause, which impairs the heart's ability to effectively pump blood. Dilated cardiomyopathy (choice B) involves the enlargement and weakening of the heart chambers, not thickening. Restrictive cardiomyopathy (choice C) refers to the stiffening of the heart muscle, limiting its ability to fill properly. Myocarditis (choice D) is inflammation of the heart muscle usually caused by a viral infection, not thickening.

3. Which condition is characterized by the narrowing or blockage of arteries that supply blood to the heart by plaque?

• A. Coronary artery disease (CAD)
• B. Atherosclerosis
• C. Peripheral artery disease
• D. Congestive heart failure

Correct answer: A

Rationale: The correct answer is A, Coronary artery disease (CAD). CAD specifically refers to the condition where the arteries supplying blood to the heart become narrowed or blocked by plaque buildup. Choice B, Atherosclerosis, is a general term for the hardening and narrowing of arteries due to plaque buildup but does not specifically mention the heart. Choice C, Peripheral artery disease, involves narrowing of arteries that supply blood to areas other than the heart. Choice D, Congestive heart failure, is a condition where the heart is unable to pump blood effectively but is not primarily caused by narrowed or blocked arteries.

4. The client asks about side effects of taking digoxin. How does the nurse respond?

• A. Anorexia can be a side effect of digoxin.
• B. Tachycardia can be a side effect of digoxin.
• C. Constipation can be a side effect of digoxin.
• D. Urinary retention can be a side effect of digoxin.

Correct answer: A

Rationale: The correct answer is A: 'Anorexia can be a side effect of digoxin.' Anorexia, nausea, vomiting, and diarrhea are commonly known side effects of digoxin. Choice B, 'Tachycardia can be a side effect of digoxin,' is incorrect as digoxin is used to treat tachycardia, not cause it. Choice C, 'Constipation can be a side effect of digoxin,' is incorrect as constipation is not a typical side effect of digoxin. Choice D, 'Urinary retention can be a side effect of digoxin,' is also incorrect as urinary retention is not a common side effect associated with digoxin use.

5. The client on warfarin has an INR of 4.5. What is the most appropriate action by the nurse?

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

Correct answer: A

Rationale: An INR of 4.5 is elevated, indicating an increased risk of bleeding due to excessive anticoagulation. The most appropriate action for the nurse in this scenario is to administer vitamin K. Vitamin K helps reverse the anticoagulant effects of warfarin, thus lowering the INR and reducing the risk of bleeding. Holding the next dose of warfarin (choice B) is not sufficient to address the immediate high INR level. Increasing the dose of warfarin (choice C) would further elevate the INR, worsening the risk of bleeding. While monitoring the client's INR closely (choice D) is important, immediate action is required to address the critically high INR level, making the administration of vitamin K the priority intervention.

Similar Questions