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 type of pneumonia that is contracted by inhaling contaminated water droplets?

• A. Legionnaires' disease
• B. Tuberculosis
• C. Asbestosis
• D. Histoplasmosis

Correct answer: A

Rationale: The correct answer is Legionnaires' disease. Legionnaires' disease is a severe form of pneumonia caused by inhaling water droplets contaminated with Legionella bacteria. This bacterium thrives in water systems such as air conditioning units, hot tubs, and water fountains. Choices B, C, and D are incorrect because Tuberculosis is caused by Mycobacterium tuberculosis, Asbestosis is caused by asbestos fibers, and Histoplasmosis is caused by a fungus found in bird and bat droppings.

3. What is a chronic condition where the heart is unable to pump blood efficiently, leading to fluid buildup in the lungs and other parts of the body?

• A. Heart failure
• B. Cardiomyopathy
• C. Pericarditis
• D. Aortic stenosis

Correct answer: A

Rationale: Heart failure is the correct answer. It is a chronic condition characterized by the heart's inability to pump blood efficiently, resulting in symptoms like fluid buildup in the lungs and other parts of the body, shortness of breath, fatigue, and fluid retention. Cardiomyopathy (choice B) refers to diseases of the heart muscle, but it is a broader category that includes various conditions affecting the heart muscle. Pericarditis (choice C) is the inflammation of the pericardium, the sac surrounding the heart, and aortic stenosis (choice D) is a condition where the aortic valve narrows, restricting blood flow from the heart.

4. What is the term for inflammation of the bronchial tubes, often leading to a persistent cough and mucus production?

• A. Bronchitis
• B. Asthma
• C. Pneumonia
• D. Cystic fibrosis

Correct answer: A

Rationale: The correct answer is 'Bronchitis.' Bronchitis refers to the inflammation of the bronchial tubes, which can be acute or chronic, leading to symptoms like coughing and increased mucus production. Choice B, 'Asthma,' is a chronic condition characterized by inflammation and narrowing of the airways, often causing wheezing and shortness of breath. Choice C, 'Pneumonia,' is an infection that inflames air sacs in one or both lungs, leading to symptoms like fever, cough, and difficulty breathing. Choice D, 'Cystic fibrosis,' is a genetic disorder that affects the lungs and digestive system, causing mucus buildup and respiratory issues.

5. What structures hold up the AV valves and are anchored to the ventricular wall by the papillary muscles?

• A. Chordae tendineae
• B. Papillary muscles
• C. Semilunar valves
• D. Aortic valve

Correct answer: A

Rationale: The correct answer is A: Chordae tendineae. Chordae tendineae are fibrous cords that connect the AV valves to the papillary muscles, preventing the valves from inverting during ventricular contraction. Papillary muscles (choice B) anchor the chordae tendineae to the ventricular wall but do not hold up the AV valves directly. Semilunar valves (choice C) are located between the ventricles and the major arteries and are not involved in holding up the AV valves. The aortic valve (choice D) is one of the semilunar valves and is not responsible for holding up the AV valves.

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