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 a device that delivers a fine spray of medication into the airways?

• A. Nebulizer
• B. Inhaler
• C. Oxygen concentrator
• D. Peak flow meter

Correct answer: A

Rationale: A nebulizer is a device that converts liquid medication into a fine mist, allowing it to be inhaled directly into the lungs. This makes it the correct answer to the question. Choice B, an inhaler, delivers medication in a different form - as a pressurized dose that needs to be inhaled. Choice C, an oxygen concentrator, is used to deliver oxygen to patients with breathing difficulties but does not deliver medication. Choice D, a peak flow meter, is used to measure how fast air can be blown out of the lungs and is not involved in delivering medication.

3. What is a condition where the heart's mitral valve does not close properly, causing blood to leak backward into the left atrium?

• A. Mitral valve prolapse
• B. Aortic stenosis
• C. Mitral stenosis
• D. Tricuspid regurgitation

Correct answer: A

Rationale: Mitral valve prolapse is the correct answer. It occurs when the mitral valve does not close properly, leading to blood leaking backward into the left atrium. This condition can manifest with symptoms such as palpitations and chest pain. Choices B, C, and D are incorrect because aortic stenosis involves narrowing of the aortic valve, mitral stenosis is the narrowing of the mitral valve, and tricuspid regurgitation is when blood leaks backward through the tricuspid valve.

4. The nurse is giving the client digoxin for heart failure and recognizes that the drug has what type of effect on the heart?

• A. Negative inotropic, negative chronotropic effect
• B. Positive inotropic, negative chronotropic effect
• C. Negative inotropic, positive chronotropic effect
• D. Positive inotropic, positive chronotropic effect

Correct answer: B

Rationale: The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin strengthens the heart muscle, providing a positive inotropic effect, which increases the force of contraction. It also decreases the heart rate, having a negative chronotropic effect. Choice A is incorrect because digoxin has a positive inotropic effect, not a negative inotropic effect. Choice C is incorrect as digoxin does not have a positive chronotropic effect but a negative one. Choice D is incorrect because while digoxin has a positive inotropic effect, it does not have a positive chronotropic effect.

5. What procedure involves inserting a needle into the pleural space to remove excess fluid and help the patient breathe more easily?

• A. Thoracentesis
• B. Bronchoscopy
• C. Spirometry
• D. Arterial blood gas (ABG)

Correct answer: A

Rationale: Thoracentesis is the correct answer. It is a procedure where a needle is inserted into the pleural space to remove excess fluid, aiding in easier breathing. Bronchoscopy (Choice B) is a procedure to visualize the airways and diagnose lung problems, not specifically for fluid drainage. Spirometry (Choice C) is a test to measure lung function, not a procedure for fluid removal. Arterial blood gas (ABG) (Choice D) is a blood test to assess oxygen and carbon dioxide levels in the blood, not a procedure for draining fluid from the pleural space.

Similar Questions