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 condition is characterized by the inflammation of the heart's outer lining, often causing chest pain and other symptoms?

• A. Pericarditis
• B. Endocarditis
• C. Myocarditis
• D. Valvular heart disease

Correct answer: A

Rationale: Pericarditis is the correct answer because it is the inflammation of the pericardium, the outer lining of the heart. This condition commonly presents with symptoms like chest pain. Endocarditis (choice B) is the inflammation of the inner lining of the heart chambers and valves. Myocarditis (choice C) is the inflammation of the heart muscle itself. Valvular heart disease (choice D) refers to various conditions affecting the heart valves, not specifically the outer lining of the heart.

3. The healthcare provider is monitoring a client receiving lidocaine IV. What side effect is the healthcare provider most concerned about?

• A. Severe headache
• B. Nausea and vomiting
• C. Seizures
• D. Tremors

Correct answer: C

Rationale: Seizures are the most concerning side effect of lidocaine IV administration due to its potential to indicate lidocaine toxicity, which can lead to serious complications such as cardiovascular collapse. Headache, nausea, and tremors are not typically associated with lidocaine IV and are less concerning compared to seizures in this context.

4. Which of the following is a type of heart attack that occurs when the blood supply to part of the heart muscle is severely reduced or stopped?

• A. Myocardial infarction
• B. Angina
• C. Stroke
• D. Congestive heart failure

Correct answer: A

Rationale: The correct answer is A: Myocardial infarction. Myocardial infarction, commonly known as a heart attack, occurs when the blood supply to part of the heart muscle is severely reduced or stopped, leading to tissue damage or death. Angina (choice B) is chest pain or discomfort that occurs when the heart muscle doesn't get enough oxygen-rich blood. Stroke (choice C) is a condition where the blood supply to the brain is interrupted or reduced. Congestive heart failure (choice D) is a chronic condition where the heart muscle doesn't pump blood as well as it should.

5. What condition is characterized by the inflammation of the pleura, causing sharp chest pain that worsens with breathing?

• A. Pleurisy
• B. Pericarditis
• C. Endocarditis
• D. Myocarditis

Correct answer: A

Rationale: The correct answer is Pleurisy. Pleurisy is the inflammation of the pleura, the lining surrounding the lungs, which causes sharp chest pain that worsens with breathing. Pericarditis (choice B) is the inflammation of the pericardium, the sac around the heart, which typically causes chest pain that worsens when lying down. Endocarditis (choice C) is the inflammation of the inner lining of the heart chambers and valves, leading to symptoms like fever, fatigue, and abnormal heart sounds. Myocarditis (choice D) is inflammation of the heart muscle, which can cause symptoms such as chest pain, fatigue, and shortness of breath.

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