Nursing Elites

1. The nurse is caring for a client on warfarin with an INR of 5.2. What is the most appropriate action?

• A. Administer vitamin K as an antidote.
• 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 5.2 is elevated, indicating an increased risk of bleeding. Administering vitamin K can help reverse the effects of warfarin, which is the most appropriate action in this situation. Holding the next dose of warfarin is not enough to address the high INR, and increasing the dose would further elevate the INR level. Monitoring the INR closely is important, but in this case, immediate action is needed to counteract the anticoagulant effects of warfarin.

2. What is a condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle?

• A. Coronary artery disease (CAD)
• B. Atherosclerosis
• C. Stroke
• D. Peripheral artery disease

Correct answer: A

Rationale: The correct answer is A, Coronary artery disease (CAD). CAD is a condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle and an increased risk of heart attack. Choice B, Atherosclerosis, is a related condition involving the buildup of fats, cholesterol, and other substances in and on the artery walls, but it is not specific to the coronary arteries. Choices C and D, Stroke and Peripheral artery disease, respectively, involve different arteries and conditions, not directly related to the narrowing or blockage of the coronary arteries.

3. The nurse is giving nitroglycerin sublingually for chest pain. What is the most important instruction to give to the client?

• A. Place the tablet under the tongue and let it dissolve completely.
• B. Swallow the tablet whole with a glass of water.
• C. Chew the tablet and then swallow it.
• D. Take one tablet every 5 minutes until pain is relieved.

Correct answer: A

Rationale: The correct answer is A. The tablet should be placed under the tongue and allowed to dissolve completely to ensure rapid absorption. This route of administration allows the medication to be quickly absorbed into the bloodstream. Choice B is incorrect because nitroglycerin is meant to be absorbed sublingually, not swallowed. Choice C is incorrect as chewing the tablet can cause the medication to be rapidly absorbed, leading to adverse effects like a drop in blood pressure. Choice D is incorrect because the client should take only one tablet every 5 minutes up to a maximum of three tablets for chest pain relief.

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. What is a condition where the lung's air sacs (alveoli) are damaged and enlarged, leading to breathlessness?

• A. Emphysema
• B. Chronic bronchitis
• C. Asthma
• D. Pulmonary fibrosis

Correct answer: A

Rationale: Emphysema is the correct answer. It is a condition where the air sacs in the lungs are damaged and enlarged, leading to breathlessness. Chronic bronchitis is characterized by inflammation of the bronchial tubes, not the alveoli. Asthma involves airway inflammation and constriction, not alveolar damage. Pulmonary fibrosis is a condition where lung tissue becomes thickened and scarred, different from the alveolar damage seen in emphysema.

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