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. The nurse is giving the client digoxin for heart failure and recognizes that the drug has what type of effect on the heart?

• A. Negative inotropic, negative chronotropic effect
• B. Positive inotropic, negative chronotropic effect
• C. Negative inotropic, positive chronotropic effect
• D. Positive inotropic, positive chronotropic effect

Correct answer: B

Rationale: The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin strengthens the heart muscle, providing a positive inotropic effect, which increases the force of contraction. It also decreases the heart rate, having a negative chronotropic effect. Choice A is incorrect because digoxin has a positive inotropic effect, not a negative inotropic effect. Choice C is incorrect as digoxin does not have a positive chronotropic effect but a negative one. Choice D is incorrect because while digoxin has a positive inotropic effect, it does not have a positive chronotropic effect.

3. The client asks about side effects of taking digoxin. How does the nurse respond?

• A. Anorexia can be a side effect of digoxin.
• B. Tachycardia can be a side effect of digoxin.
• C. Constipation can be a side effect of digoxin.
• D. Urinary retention can be a side effect of digoxin.

Correct answer: A

Rationale: The correct answer is A: 'Anorexia can be a side effect of digoxin.' Anorexia, nausea, vomiting, and diarrhea are commonly known side effects of digoxin. Choice B, 'Tachycardia can be a side effect of digoxin,' is incorrect as digoxin is used to treat tachycardia, not cause it. Choice C, 'Constipation can be a side effect of digoxin,' is incorrect as constipation is not a typical side effect of digoxin. Choice D, 'Urinary retention can be a side effect of digoxin,' is also incorrect as urinary retention is not a common side effect associated with digoxin use.

4. Which artery supplies the right atrium, right ventricle, a portion of the septum, SA node, AV node, and inferior portion of the left ventricle?

• A. Right coronary artery
• B. Left circumflex artery
• C. Posterior descending artery
• D. Aortic artery

Correct answer: A

Rationale: The correct answer is the right coronary artery. It supplies essential areas of the heart, including the right atrium, right ventricle, a portion of the septum, SA node, AV node, and the inferior portion of the left ventricle. The left circumflex artery primarily supplies the left atrium and lateral wall of the left ventricle, not the mentioned areas. The posterior descending artery supplies the inferior wall of the left ventricle, not the right side. The aortic artery is a general term and does not specifically refer to an artery that supplies the mentioned areas.

5. Which condition is an infection that inflames the air sacs in one or both lungs, which may fill with fluid?

• A. Pneumonia
• B. Bronchitis
• C. Tuberculosis
• D. Cystic fibrosis

Correct answer: A

Rationale: The correct answer is A, Pneumonia. Pneumonia is an infection that inflames the air sacs in the lungs, which may fill with fluid or pus, causing symptoms like cough, fever, and difficulty breathing. Bronchitis (choice B) is an inflammation of the bronchial tubes, not the air sacs in the lungs. Tuberculosis (choice C) is a bacterial infection that primarily affects the lungs but does not always cause fluid accumulation in the air sacs. Cystic fibrosis (choice D) is a genetic disorder that affects the lungs but does not directly cause inflammation of the air sacs with fluid.

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