Nursing Elites

1. The nurse is caring for a client on heparin. What is the most important lab value to monitor?

• A. aPTT
• B. INR
• C. Platelet count
• D. Hemoglobin

Correct answer: A

Rationale: The correct answer is A: aPTT. When a client is on heparin therapy, monitoring the aPTT is crucial. The aPTT helps assess the effectiveness of heparin in preventing blood clots and guides dose adjustments as needed. INR (Choice B) is more commonly used to monitor warfarin therapy. Platelet count (Choice C) is important to assess for potential bleeding disorders or thrombocytopenia but is not the primary lab value to monitor for heparin therapy. Hemoglobin (Choice D) is essential for assessing oxygen-carrying capacity but is not the most important lab value to monitor when a client is on heparin.

2. Which type of heart disease involves the stiffening of the heart muscle, reducing its ability to relax and fill with blood?

• A. Restrictive cardiomyopathy
• B. Hypertrophic cardiomyopathy
• C. Dilated cardiomyopathy
• D. Ventricular hypertrophy

Correct answer: A

Rationale: The correct answer is A, restrictive cardiomyopathy. This condition specifically involves the stiffening of the heart muscle, leading to a reduced ability to relax and fill with blood between beats. Choice B, hypertrophic cardiomyopathy, is characterized by abnormal thickening of the heart muscle, not stiffening. Choice C, dilated cardiomyopathy, involves the enlargement and weakening of the heart chambers, not stiffening. Choice D, ventricular hypertrophy, refers to the thickening of the walls of the heart's pumping chambers but does not specifically involve the stiffening that is characteristic of restrictive cardiomyopathy.

3. The client is on hydrochlorothiazide and digoxin. What effect can the nurse expect?

• A. Hydrochlorothiazide increases digoxin levels.
• B. Hydrochlorothiazide decreases digoxin levels.
• C. Hydrochlorothiazide decreases potassium, increasing the risk of digoxin toxicity.
• D. Digoxin can increase the effectiveness of hydrochlorothiazide.

Correct answer: C

Rationale: The correct answer is C. Hydrochlorothiazide is a diuretic that can decrease potassium levels, which in turn can increase the risk of digoxin toxicity. Digoxin typically doesn't impact hydrochlorothiazide levels or effectiveness, making choices A, B, and D incorrect. Choice A stating that hydrochlorothiazide increases digoxin levels is inaccurate. Choice B suggesting that hydrochlorothiazide decreases digoxin levels is also incorrect. Choice D, stating that digoxin can increase the effectiveness of hydrochlorothiazide, is not a typical interaction seen between these medications.

4. Which of the following is a rare genetic disorder that affects the lungs, liver, and skin, causing the buildup of a specific protein that damages organs?

• A. Alpha-1 antitrypsin deficiency
• B. Cystic fibrosis
• C. Wegener's granulomatosis
• D. Marfan syndrome

Correct answer: A

Rationale: The correct answer is Alpha-1 antitrypsin deficiency. This disorder leads to the accumulation of a specific protein that can harm the lungs, liver, and skin. Choice B, Cystic fibrosis, is incorrect because it primarily affects the lungs and digestive system due to a defective gene. Choice C, Wegener's granulomatosis, is an autoimmune disease that involves inflammation of blood vessels, not protein buildup. Choice D, Marfan syndrome, is a connective tissue disorder impacting the heart, blood vessels, bones, and eyes, but not involving protein accumulation that damages organs.

5. The client is on a nitrate for angina. What is the most common side effect the nurse should monitor for?

• A. Headache
• B. Flushing
• C. Dizziness
• D. Nausea

Correct answer: A

Rationale: The correct answer is A, Headache. Nitrates commonly cause headaches as a side effect due to vasodilation. Flushing, dizziness, and nausea are less common side effects associated with nitrates. Flushing is more related to the dilation of blood vessels closer to the skin's surface, dizziness could occur but is not as common as headaches, and nausea is a less typical side effect of nitrates.

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