Nursing Elites

1. The client on warfarin has an INR of 3.8. What is the most appropriate action by the nurse?

• A. Administer vitamin K.
• B. Hold the next dose of warfarin.
• C. Increase the dose of warfarin.
• D. Notify the healthcare provider immediately.

Correct answer: A

Rationale: An INR of 3.8 is elevated, indicating an increased risk of bleeding. Administering vitamin K can help reverse the effects of warfarin. Holding the next dose of warfarin would be appropriate if the INR was too high, but not as the first-line action. Increasing the dose of warfarin would worsen the situation by further increasing the INR. Notifying the healthcare provider is important, but immediate action to address the elevated INR is necessary.

2. What is the primary effect of a calcium channel blocker on the heart?

• A. Decreases heart rate
• B. Increases heart rate
• C. Increases blood pressure
• D. Decreases blood pressure

Correct answer: D

Rationale: The correct answer is D: Decreases blood pressure. Calcium channel blockers primarily work by relaxing blood vessels, leading to a decrease in blood pressure. While these medications can have secondary effects on the heart, such as reducing the workload of the heart muscle, the primary effect related to blood pressure regulation. Therefore, choices A, B, and C are incorrect as they do not reflect the primary action of calcium channel blockers on the heart.

3. What test 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 test specifically designed to use sound waves to create images of the heart, allowing healthcare providers to assess both its structure and function, as well as to detect any abnormalities. MRI (Choice B), CT scan (Choice C), and X-ray (Choice D) do not primarily use sound waves for imaging the heart; therefore, they are not the most appropriate choices for this scenario.

4. What procedure is used to visualize the airways and diagnose lung disease?

• A. Bronchoscopy
• B. Thoracentesis
• C. Pulmonary function test
• D. Chest X-ray

Correct answer: A

Rationale: Bronchoscopy is the correct answer because it is a procedure specifically designed to visualize the airways and diagnose lung diseases by allowing doctors to examine the inside of the airways. Thoracentesis involves the removal of fluid from the pleural space around the lungs, not the airways. Pulmonary function tests assess how well the lungs work but do not visualize the airways directly. A chest X-ray provides an image of the lungs and surrounding structures but does not involve direct visualization of the airways.

5. What is a condition where the blood flow to the brain is temporarily blocked, often referred to as a mini-stroke?

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

Correct answer: A

Rationale: A transient ischemic attack (TIA) is the correct answer. A TIA is often referred to as a mini-stroke because it is caused by a temporary blockage of blood flow to the brain. This blockage resolves on its own, typically within minutes to hours, leading to temporary symptoms similar to a stroke. Option B, 'Stroke,' is incorrect because a stroke involves a more prolonged interruption of blood flow to the brain. Option C, 'Aneurysm,' is incorrect as it is a bulge in a blood vessel that can rupture and cause bleeding, not a temporary blockage of blood flow. Option D, 'Myocardial infarction,' is also incorrect as it refers to a heart attack, not a condition involving the brain's blood flow.

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