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. The client on nitroglycerin complains of a headache. How does the nurse explain this?

• A. This is a normal side effect of nitroglycerin.
• B. This is an allergic reaction to nitroglycerin.
• C. This is an indication of overdose.
• D. This is a sign of heart failure.

Correct answer: A

Rationale: The correct answer is A: 'This is a normal side effect of nitroglycerin.' Headaches are a common side effect of nitroglycerin due to vasodilation. Choice B is incorrect because allergic reactions to nitroglycerin typically present with symptoms like rash, itching, or shortness of breath. Choice C is incorrect as an overdose of nitroglycerin would likely present with symptoms beyond just a headache. Choice D is incorrect because headaches related to nitroglycerin are not indicative of heart failure.

3. What is a blood clot that forms in a vein, often in the legs, and can cause serious complications if it travels to the lungs?

• A. Deep vein thrombosis (DVT)
• B. Pulmonary embolism
• C. Varicose veins
• D. Atherosclerosis

Correct answer: A

Rationale: The correct answer is Deep vein thrombosis (DVT). DVT is a blood clot that forms in a deep vein, typically in the legs, and can lead to serious complications if it breaks loose and travels to the lungs, causing a pulmonary embolism. Varicose veins (choice C) are enlarged, twisted veins usually found in the legs but are not related to blood clots. Atherosclerosis (choice D) is a condition where arteries become narrowed and hardened due to a buildup of plaque, not directly related to blood clots.

4. What is a condition where the heart's mitral valve does not close properly, causing blood to leak backward into the left atrium?

• A. Mitral valve prolapse
• B. Aortic stenosis
• C. Mitral stenosis
• D. Tricuspid regurgitation

Correct answer: A

Rationale: Mitral valve prolapse is the correct answer. It occurs when the mitral valve does not close properly, leading to blood leaking backward into the left atrium. This condition can manifest with symptoms such as palpitations and chest pain. Choices B, C, and D are incorrect because aortic stenosis involves narrowing of the aortic valve, mitral stenosis is the narrowing of the mitral valve, and tricuspid regurgitation is when blood leaks backward through the tricuspid valve.

5. Which medication is used to prevent blood clots by thinning the blood, reducing the risk of stroke and heart attack?

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

Correct answer: A

Rationale: The correct answer is 'Anticoagulant.' Anticoagulants are medications specifically designed to prevent blood clots by thinning the blood, which effectively reduces the risk of stroke, heart attack, and other cardiovascular events. Choices B, C, and D, which are ACE inhibitors, beta-blockers, and calcium channel blockers, respectively, do not have the primary mechanism of action to prevent blood clot formation. ACE inhibitors, beta-blockers, and calcium channel blockers are commonly used for managing hypertension and other cardiovascular conditions by different mechanisms of action.

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