Nursing Elites

1. The client on warfarin has an INR of 4.5. 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. Monitor the client’s INR closely.

Correct answer: A

Rationale: An INR of 4.5 is elevated, indicating an increased risk of bleeding due to excessive anticoagulation. The most appropriate action for the nurse in this scenario is to administer vitamin K. Vitamin K helps reverse the anticoagulant effects of warfarin, thus lowering the INR and reducing the risk of bleeding. Holding the next dose of warfarin (choice B) is not sufficient to address the immediate high INR level. Increasing the dose of warfarin (choice C) would further elevate the INR, worsening the risk of bleeding. While monitoring the client's INR closely (choice D) is important, immediate action is required to address the critically high INR level, making the administration of vitamin K the priority intervention.

2. Which condition is characterized by an inability to effectively pump blood, leading to fluid buildup and swelling in the body?

• A. Heart failure
• B. Cardiomyopathy
• C. Angina
• D. Myocarditis

Correct answer: A

Rationale: Heart failure is the correct answer. It is a condition where the heart is unable to pump blood effectively, resulting in fluid accumulation and swelling in the body. Cardiomyopathy is a disease of the heart muscle that affects its ability to pump blood but is not the specific condition described in the question. Angina is chest pain or discomfort caused by reduced blood flow to the heart, not directly related to fluid buildup and swelling. Myocarditis is inflammation of the heart muscle and does not necessarily involve the inability to pump blood effectively.

3. What is a chronic condition where the airways in the lungs become damaged and widened, leading to mucus buildup and frequent infections?

• A. Bronchiectasis
• B. Chronic bronchitis
• C. Pneumoconiosis
• D. Asthma

Correct answer: A

Rationale: Bronchiectasis is a chronic condition characterized by the damage and widening of the airways in the lungs, resulting in mucus accumulation and recurrent lung infections. Choice B, chronic bronchitis, involves inflammation of the bronchial tubes and excessive mucus production but does not specifically mention airway damage and widening. Choice C, pneumoconiosis, refers to lung diseases caused by inhalation of mineral dust particles, not airway damage and mucus buildup. Choice D, asthma, is a chronic condition characterized by airway inflammation and narrowing, leading to breathing difficulties, but it does not involve the widening and damage of the airways as seen in bronchiectasis.

4. Which artery supplies the anterior wall of the left ventricle, the anterior interventricular septum, the anterior papillary muscles, and apex of the heart?

• A. Left anterior descending artery
• B. Left circumflex artery
• C. Posterior descending artery
• D. Aortic artery

Correct answer: A

Rationale: The correct answer is the Left anterior descending artery. This artery supplies the anterior wall of the left ventricle, the anterior interventricular septum, the anterior papillary muscles, and apex of the heart. The Left circumflex artery (choice B) supplies the lateral and posterior walls of the left ventricle, the posterior descending artery (choice C) supplies the inferior part of the heart, and the aortic artery (choice D) is not a specific coronary artery.

5. The client is given an alpha agonist. What might it be used for?

• A. For hemostasis
• B. To dilate the arteries
• C. To dilate the veins
• D. To decrease afterload

Correct answer: A

Rationale: Alpha agonists are used for hemostasis to help control bleeding by constricting blood vessels, leading to decreased blood flow to the area. Choices B, C, and D are incorrect as alpha agonists do not typically dilate arteries, dilate veins, or decrease afterload.

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