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 nurse is administering digoxin to a client with a heart rate of 45 bpm. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Increase the dose of digoxin.
• D. Monitor the client’s heart rate and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A heart rate of 45 bpm is already low, and digoxin can further decrease the heart rate, leading to serious complications like bradycardia or heart block. Administering the medication can exacerbate the bradycardia, hence it should be withheld. Increasing the dose of digoxin is contraindicated due to the client's low heart rate. Monitoring the heart rate alone without taking immediate action to withhold the medication is not the priority when faced with the risk of further lowering the heart rate.

3. What type of medication is used to reduce inflammation in the airways and prevent asthma attacks?

• A. Corticosteroid
• B. Bronchodilator
• C. Antihistamine
• D. Mucolytic

Correct answer: A

Rationale: The correct answer is A, Corticosteroid. Corticosteroids are medications that work by reducing inflammation in the airways, helping to prevent asthma attacks and manage chronic respiratory conditions. Bronchodilators (choice B) work by relaxing the muscles around the airways to make breathing easier, but they do not primarily target inflammation. Antihistamines (choice C) are used to treat allergic reactions and do not directly target airway inflammation. Mucolytics (choice D) help to break down and thin mucus in the airways but do not reduce inflammation.

4. What is the term used to describe a condition where the blood flow to the brain is temporarily interrupted, often referred to as a 'mini-stroke'?

• A. Transient ischemic attack (TIA)
• B. Stroke
• C. Myocardial infarction
• D. Pulmonary embolism

Correct answer: A

Rationale: The correct answer is A: Transient ischemic attack (TIA). A transient ischemic attack (TIA) is often called a 'mini-stroke' because it is characterized by a temporary interruption of blood flow to the brain, resulting in stroke-like symptoms that typically resolve within a short period. Choice B, 'Stroke,' is incorrect because a stroke involves a more prolonged interruption of blood flow, leading to lasting brain damage. Choices C and D, 'Myocardial infarction' and 'Pulmonary embolism,' are unrelated conditions involving the heart and lungs, respectively, and do not describe a temporary interruption of blood flow to the brain.

5. The client on digoxin has a potassium level of 2.7 mEq/L. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Increase the dose of digoxin.
• D. Administer potassium supplements.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 2.7 mEq/L is considered low and can increase the risk of digoxin toxicity. Holding the medication and informing the healthcare provider is crucial to prevent adverse effects. Administering the digoxin as ordered (Choice B) would put the client at a higher risk for toxicity. Increasing the dose of digoxin (Choice C) is not appropriate when the client's potassium level is low. Administering potassium supplements (Choice D) may be necessary but is not the priority action in this situation.

Similar Questions