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 chronic condition is characterized by abnormally thickened heart muscle, making it harder for the heart to pump blood efficiently?

• A. Hypertrophic cardiomyopathy
• B. Dilated cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Ventricular hypertrophy

Correct answer: A

Rationale: Hypertrophic cardiomyopathy is the correct answer. In this condition, the heart muscle becomes abnormally thickened, leading to difficulties in pumping blood efficiently. Dilated cardiomyopathy (choice B) involves the enlargement of the heart chambers, not thickening of the heart muscle. Restrictive cardiomyopathy (choice C) is characterized by stiffening of the heart muscle, impairing its ability to fill properly. Ventricular hypertrophy (choice D) refers to the thickening of the heart's ventricle walls, which can result from various conditions, not solely hypertrophic cardiomyopathy.

3. What is the amount of tension the ventricle must develop during contraction to eject blood from the left ventricle into the aorta?

• A. Afterload
• B. Preload
• C. Automaticity
• D. Ejection fraction

Correct answer: A

Rationale: Afterload is the correct answer because it refers to the pressure or tension that the ventricle must overcome during systole to eject blood into the aorta. Preload, on the other hand, is the degree of stretch of the ventricular muscle at the end of diastole before it contracts. Automaticity is the ability of the heart to generate electrical impulses independently, and ejection fraction is the percentage of blood pumped out of the ventricle with each heartbeat. Therefore, in the context of the question, afterload best describes the amount of tension the ventricle must develop to eject blood into the aorta.

4. What is a condition where the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients?

• A. Stroke
• B. Heart attack
• C. Pulmonary embolism
• D. Pneumonia

Correct answer: A

Rationale: A stroke occurs when the blood supply to part of the brain is interrupted or reduced, leading to brain cell death and potential disability. Choice B, a heart attack, involves a blockage in the blood vessels that supply the heart muscle. Choice C, a pulmonary embolism, is a blockage in one of the pulmonary arteries in the lungs. Choice D, pneumonia, is an infection that inflames the air sacs in one or both lungs.

5. What is a condition where a blood clot forms in a deep vein, usually in the legs, and can lead to serious complications if it travels to the lungs?

• A. Deep vein thrombosis (DVT)
• B. Pulmonary embolism
• C. Varicose veins
• D. Raynaud's disease

Correct answer: A

Rationale: The correct answer is A, Deep vein thrombosis (DVT). Deep vein thrombosis occurs when a blood clot forms in a deep vein, usually in the legs. If the clot dislodges and travels to the lungs, it can lead to a serious condition called a pulmonary embolism. Choice B, pulmonary embolism, is incorrect as it is the consequence of a DVT clot traveling to the lungs, not the initial condition. Choices C and D, varicose veins, and Raynaud's disease, respectively, are unrelated conditions to the formation of blood clots in deep veins.

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