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 condition involves the enlargement and weakening of the left ventricle of the heart, leading to reduced pumping ability?

• A. Dilated cardiomyopathy
• B. Hypertrophic cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Pericarditis

Correct answer: A

Rationale: The correct answer is A: Dilated cardiomyopathy. Dilated cardiomyopathy is characterized by the enlargement and weakening of the left ventricle of the heart, which results in a reduced ability to pump blood effectively. Choice B, Hypertrophic cardiomyopathy, involves thickening of the heart muscle, not enlargement. Choice C, Restrictive cardiomyopathy, is characterized by stiffening of the heart muscle, not enlargement. Choice D, Pericarditis, refers to inflammation of the pericardium, the lining surrounding the heart, and does not involve enlargement and weakening of the left ventricle.

3. What is the term for a condition where the lung collapses due to air leaking into the space between the lung and the chest wall?

• A. Pneumothorax
• B. Pleural effusion
• C. Atelectasis
• D. Pulmonary fibrosis

Correct answer: A

Rationale: Pneumothorax is the correct answer for this question. Pneumothorax is the collapse of a lung caused by the presence of air in the pleural space between the lung and chest wall. This condition can lead to chest pain, shortness of breath, and may require emergency treatment such as chest tube insertion to remove the air. Pleural effusion is the accumulation of fluid in the pleural space, not air. Atelectasis is the collapse or closure of a lung resulting in reduced or absent gas exchange. Pulmonary fibrosis is a condition characterized by scarring and thickening of lung tissue, not related to air leaking into the pleural space.

4. What is a condition where the arteries that supply blood to the heart muscle become hardened and narrowed due to the buildup of plaque?

• A. Atherosclerosis
• B. Aneurysm
• C. Arrhythmia
• D. Peripheral artery disease

Correct answer: A

Rationale: Atherosclerosis is the correct answer. It is a condition characterized by the hardening and narrowing of arteries supplying blood to the heart due to plaque buildup. This condition increases the risk of heart attacks. Choice B, aneurysm, refers to a balloon-like bulge in an artery, not the hardening and narrowing of arteries. Choice C, arrhythmia, is an irregular heartbeat and not related to arterial hardening. Choice D, peripheral artery disease, involves the narrowing of arteries that supply blood to the limbs, not specifically to the heart.

5. What is the approximate stroke volume of the heart?

• A. Approximately 60 mL of blood per beat
• B. Approximately 70 mL of blood per beat
• C. Approximately 80 mL of blood per beat
• D. Approximately 90 mL of blood per beat

Correct answer: B

Rationale: The correct answer is B: Approximately 70 mL of blood per beat. The stroke volume of the heart is typically around 70 mL, indicating the volume of blood ejected from the left ventricle with each contraction. Choices A, C, and D are incorrect as they do not represent the standard approximate stroke volume of the heart, which is around 70 mL per beat.

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