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. Which term describes a type of abnormal heart rhythm characterized by rapid and irregular beating of the atria?

• A. Atrial fibrillation
• B. Ventricular fibrillation
• C. Atrial flutter
• D. Sinus tachycardia

Correct answer: A

Rationale: The correct answer is Atrial fibrillation. Atrial fibrillation is indeed a type of abnormal heart rhythm characterized by rapid and irregular beating of the atria. This condition can increase the risk of stroke and heart failure. Choice B, Ventricular fibrillation, is incorrect because it refers to a life-threatening arrhythmia that occurs in the ventricles, not the atria. Choice C, Atrial flutter, is incorrect as it describes a different type of atrial arrhythmia characterized by a regular but fast heartbeat. Choice D, Sinus tachycardia, is incorrect because it is a normal increase in heart rate originating from the sinus node, not an abnormal rhythm.

3. What is a surgical procedure to remove one of the lobes of the lungs, often performed to treat lung cancer?

• A. Lobectomy
• B. Pneumonectomy
• C. Thoracotomy
• D. Tracheostomy

Correct answer: A

Rationale: A lobectomy is the correct answer. This surgical procedure involves removing one of the lobes of the lungs, commonly done to treat lung cancer or other serious lung ailments. Choice B, pneumonectomy, involves the complete removal of a lung, not just a lobe. Choice C, thoracotomy, is a surgical incision into the chest wall and is not specific to removing a lung lobe. Choice D, tracheostomy, is the creation of an opening in the windpipe to assist with breathing and is unrelated to lung lobe removal.

4. What procedure uses a catheter to open blocked coronary arteries and improve blood flow to the heart muscle?

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

Correct answer: A

Rationale: The correct answer is A, Angioplasty. Angioplasty is a procedure where a catheter is used to open blocked coronary arteries and may involve the insertion of a stent to improve blood flow to the heart muscle. Stent placement (B) is a related procedure but specifically refers to the insertion of a stent. Coronary artery bypass graft (CABG) (C) is a surgical procedure that uses blood vessels to bypass blocked coronary arteries. Valve replacement (D) is a different procedure that involves replacing a heart valve, not opening blocked coronary arteries.

5. What is the condition where a blood clot blocks an artery in the lungs, causing shortness of breath, chest pain, and other symptoms?

• A. Pulmonary embolism
• B. Pneumothorax
• C. Pleural effusion
• D. Aneurysm

Correct answer: A

Rationale: The correct answer is Pulmonary embolism. Pulmonary embolism occurs when a blood clot blocks an artery in the lungs, leading to symptoms like shortness of breath and chest pain. This condition is life-threatening and requires prompt treatment. Choices B, C, and D are incorrect as they refer to different medical conditions: Pneumothorax is a collapsed lung, Pleural effusion is an abnormal accumulation of fluid around the lungs, and an Aneurysm is a bulge in a blood vessel.

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