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 of the following is a chronic lung disease that results in the gradual destruction of the alveoli, causing difficulty breathing and reduced oxygen exchange?

• A. Emphysema
• B. Bronchitis
• C. Pulmonary hypertension
• D. Sarcoidosis

Correct answer: A

Rationale: Emphysema is the correct answer as it is a chronic lung disease characterized by the gradual destruction of the alveoli, which are essential for oxygen exchange. This destruction leads to difficulty breathing and reduced oxygen levels in the blood. Bronchitis is an inflammation of the bronchial tubes, not specifically involving alveoli destruction. Pulmonary hypertension is a condition of high blood pressure in the arteries of the lungs, not directly related to alveoli destruction. Sarcoidosis is a disease characterized by the growth of tiny collections of inflammatory cells in different parts of the body, including the lungs, but it does not primarily involve the destruction of alveoli.

3. What is a condition where blood clots form in the deep veins, usually in the legs, and can travel to the lungs, causing serious complications?

• A. Deep vein thrombosis (DVT)
• B. Pulmonary embolism
• C. Varicose veins
• D. Peripheral artery disease

Correct answer: A

Rationale: The correct answer is A, Deep vein thrombosis (DVT). Deep vein thrombosis occurs when blood clots form in the deep veins, usually in the legs, and these clots can potentially travel to the lungs, leading to a pulmonary embolism. Pulmonary embolism (choice B) is a serious complication that can result from untreated DVT. Varicose veins (choice C) and peripheral artery disease (choice D) are not directly related to the formation of blood clots in deep veins that can lead to pulmonary embolism.

4. What type of medication is used to relax the muscles around the airways and improve breathing in conditions like asthma and COPD?

• A. Bronchodilator
• B. Corticosteroid
• C. Mucolytic
• D. Antihistamine

Correct answer: A

Rationale: Bronchodilators are medications that relax the muscles around the airways, improving airflow and making breathing easier for patients with asthma or COPD. Corticosteroids are anti-inflammatory drugs used to reduce airway inflammation, while mucolytics help in thinning and clearing mucus. Antihistamines are used to treat allergies and not specifically to improve breathing in conditions like asthma or COPD.

5. When administering an ACE inhibitor to a client with heart failure, what is the expected outcome of this medication?

• A. Decreased blood pressure
• B. Increased heart rate
• C. Increased cardiac output
• D. Decreased heart rate

Correct answer: C

Rationale: The correct answer is C: Increased cardiac output. ACE inhibitors are commonly used in heart failure to reduce the workload on the heart by decreasing blood pressure and increasing cardiac output. This ultimately helps improve the heart's efficiency and function. Choice A is incorrect because ACE inhibitors generally lead to a reduction in blood pressure. Choice B is incorrect as ACE inhibitors do not increase heart rate. Choice D is incorrect as ACE inhibitors do not typically decrease heart rate in the context of heart failure.

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