Nursing Elites

1. The nurse is caring for a client on warfarin with an INR of 1.8. What is the most appropriate action?

• A. Increase the dose of warfarin.
• B. Administer vitamin K.
• C. Hold the warfarin and notify the healthcare provider.
• D. Monitor the client’s INR closely.

Correct answer: D

Rationale: An INR of 1.8 is below the therapeutic range for a client on warfarin, indicating the need for monitoring closely to ensure that the INR levels reach the desired therapeutic range. Increasing the dose of warfarin (Choice A) without proper monitoring may lead to an increased risk of bleeding. Administering vitamin K (Choice B) is not typically recommended unless the client is experiencing major bleeding or requires rapid reversal of warfarin's effects. Holding the warfarin and notifying the healthcare provider (Choice C) may be necessary in certain situations, but the immediate action in this case should be to monitor the client's INR closely to guide further management.

2. This is a procedure where a small mesh tube is inserted into an artery to keep it open and improve blood flow.

• A. Stent placement
• B. Angioplasty
• C. Bypass surgery
• D. Coronary artery bypass graft (CABG)

Correct answer: A

Rationale: Stent placement is a procedure where a small mesh tube (stent) is inserted into an artery to keep it open and improve blood flow, often following angioplasty.

3. What is the condition where the lung collapses due to air leaking into the space between the lung and chest wall?

• A. Pneumothorax
• B. Pleural effusion
• C. Pulmonary fibrosis
• D. Lung cancer

Correct answer: A

Rationale: Pneumothorax is the correct answer. It is the collapse of a lung due to air leaking into the space between the lung and chest wall. This condition often requires emergency treatment. Choice B, Pleural effusion, is the buildup of excess fluid between the layers of the pleura outside the lung, not air. Choice C, Pulmonary fibrosis, is a lung disease characterized by scarring and thickening of lung tissue, not related to lung collapse. Choice D, Lung cancer, is the uncontrolled growth of abnormal cells in the lung, not directly causing lung collapse.

4. What is the condition where the blood vessels that supply blood to the legs and feet become narrowed or blocked, causing pain and difficulty walking?

• A. Peripheral artery disease
• B. Raynaud's disease
• C. Varicose veins
• D. Pulmonary embolism

Correct answer: A

Rationale: The correct answer is A, Peripheral artery disease (PAD). PAD is a condition where the blood vessels that supply blood to the legs and feet become narrowed or blocked, leading to decreased blood flow, pain, and difficulty walking, especially during physical activity. Raynaud's disease (choice B) is characterized by vasospasms in the fingers and toes, causing them to turn white or blue. Varicose veins (choice C) are enlarged, twisted veins usually found in the legs. Pulmonary embolism (choice D) is a blockage in one of the pulmonary arteries in the lungs, often caused by a blood clot.

5. Which condition involves the heart muscle becoming abnormally thickened, reducing its ability to pump blood?

• A. Hypertrophic cardiomyopathy
• B. Dilated cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Ischemic cardiomyopathy

Correct answer: A

Rationale: The correct answer is A: Hypertrophic cardiomyopathy. In this condition, the heart muscle thickens, leading to a decreased ability to pump blood effectively. Choice B, Dilated cardiomyopathy, is characterized by the heart chambers enlarging and weakening. Choice C, Restrictive cardiomyopathy, involves the heart muscle becoming rigid and less compliant. Choice D, Ischemic cardiomyopathy, is when the heart muscle is weakened due to reduced blood flow.

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