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 is the condition where the pericardium, the sac surrounding the heart, becomes inflamed, leading to chest pain and other symptoms?

• A. Pericarditis
• B. Myocarditis
• C. Endocarditis
• D. Pulmonary hypertension

Correct answer: A

Rationale: Pericarditis is the correct answer. It is the inflammation of the pericardium, the sac surrounding the heart, which can lead to chest pain and other symptoms. Myocarditis (choice B) is inflammation of the heart muscle, not the pericardium. Endocarditis (choice C) is inflammation of the inner lining of the heart chambers and valves, not the pericardium. Pulmonary hypertension (choice D) is high blood pressure in the arteries of the lungs, not related to pericardial inflammation.

4. The nurse is caring for a heart client on digoxin and notes a potassium level of 2.5. What is the appropriate priority nursing intervention?

• A. Do nothing as this is a normal potassium level.
• B. The potassium level is low so the nurse asks for an order for potassium.
• C. The nurse asks to check the digoxin level as low potassium can increase digoxin toxicity.
• D. The nurse stops the digoxin.

Correct answer: C

Rationale: The correct answer is C. When caring for a client on digoxin with a low potassium level, the priority nursing intervention is to check the digoxin level. Low potassium can increase the risk of digoxin toxicity. Checking the digoxin level will help determine if any adjustments to the medication regimen are needed to prevent potential harm. Choice A is incorrect as a potassium level of 2.5 is low, not normal. Choice B is not the priority as simply giving potassium may not address the underlying issue of potential digoxin toxicity. Choice D is not the initial action to take without assessing the digoxin level first.

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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