Nursing Elites

1. The nurse is caring for a client on amiodarone. What adverse effect is the nurse most concerned about?

• A. Pulmonary toxicity
• B. Liver toxicity
• C. Thyroid dysfunction
• D. Renal dysfunction

Correct answer: A

Rationale: The correct answer is A, Pulmonary toxicity. Amiodarone is known to cause pulmonary toxicity, which can be serious and even fatal in some cases. This adverse effect includes interstitial pneumonitis, pulmonary fibrosis, and acute respiratory distress syndrome. Monitoring for symptoms such as cough, dyspnea, and fever is crucial. Choices B, Liver toxicity, C, Thyroid dysfunction, and D, Renal dysfunction, are incorrect because while amiodarone can also affect the liver, thyroid, and kidneys, the most concerning adverse effect that requires immediate attention and monitoring is pulmonary toxicity.

2. This heart condition is characterized by decreased cardiac output and tissue perfusion, which can lead to organ failure.

• A. Cardiogenic shock
• B. Myocardial infarction
• C. Endocarditis
• D. Pericarditis

Correct answer: A

Rationale: The correct answer is A: Cardiogenic shock. Cardiogenic shock is a severe condition characterized by the heart's inability to pump enough blood, leading to decreased cardiac output and tissue perfusion, which can result in organ failure. Choice B, Myocardial infarction, specifically refers to a blockage of blood flow to the heart muscle. Choices C and D, Endocarditis and Pericarditis, do not directly involve decreased cardiac output leading to organ failure, making them incorrect in the context of the symptoms described in the question.

3. What is a chronic condition where the blood pressure in the arteries is persistently elevated, increasing the risk of heart disease and stroke?

• A. Hypertension
• B. Hypotension
• C. Hyperlipidemia
• D. Hyperglycemia

Correct answer: A

Rationale: Hypertension, also known as high blood pressure, is a chronic condition characterized by persistently elevated pressure in the arteries. This condition increases the risk of heart disease, stroke, and other health issues. Hypotension (choice B) refers to low blood pressure and is not the correct answer. Hyperlipidemia (choice C) is high levels of fats in the blood, not related to blood pressure. Hyperglycemia (choice D) is high blood sugar levels, not directly related to elevated blood pressure.

4. 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.

5. Which valves close during ventricular systole and open during ventricular diastole?

• A. Semilunar valves
• B. Atrioventricular Valves
• C. Mitral valve
• D. Tricuspid valve

Correct answer: B

Rationale: The correct answer is B: Atrioventricular Valves. The atrioventricular (AV) valves, including the mitral valve and tricuspid valve, close during ventricular systole to prevent backflow of blood from the ventricles into the atria. They open during ventricular diastole to allow blood flow from the atria into the ventricles. Semilunar valves, choice A, are located at the exits of the ventricles and prevent backflow into the ventricles. The mitral valve and tricuspid valve, choices C and D, are specific types of AV valves.

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