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 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.

3. Which type of medication helps to reduce blood pressure by relaxing the blood vessels?

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

Correct answer: A

Rationale: The correct answer is A, Calcium channel blocker. Calcium channel blockers work by relaxing the blood vessels, making it easier for the heart to pump blood and reducing blood pressure. Choice B, ACE inhibitor, reduces blood pressure by blocking the production of angiotensin II, a substance that narrows blood vessels. Choice C, Beta-blocker, reduces heart rate and the heart's workload, not directly relaxing blood vessels. Choice D, Diuretic, reduces blood pressure by increasing urine output, reducing the volume of fluid in the blood vessels, rather than directly relaxing them.

4. What diagnostic procedure uses sound waves to create images of the heart and assess its structure and function?

• A. Echocardiogram
• B. MRI
• C. CT scan
• D. X-ray

Correct answer: A

Rationale: An echocardiogram is the correct answer because it is a diagnostic procedure that uses sound waves to create images of the heart, enabling doctors to assess its structure and function. This imaging technique is specifically designed for cardiac assessment. MRI (Choice B), CT scan (Choice C), and X-ray (Choice D) are imaging modalities that are not primarily used for detailed evaluation of the heart's structure and function, making them incorrect choices for this question.

5. Which type of medication helps to reduce the workload on the heart by slowing down the heart rate?

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

Correct answer: A

Rationale: Beta-blockers are medications that work by blocking the action of hormones like adrenaline, thereby reducing the heart rate and the workload on the heart. This makes them effective in managing high blood pressure and various heart conditions. Calcium channel blockers work by relaxing blood vessels and reducing the heart's workload, but they do not primarily slow down the heart rate. Diuretics help the body get rid of excess salt and water by increasing urine production, which can lower blood pressure but not by slowing down the heart rate. ACE inhibitors work by relaxing blood vessels, not by directly affecting heart rate.

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