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. Which type of lung cancer begins in the cells lining the bronchi and bronchioles?

• A. Adenocarcinoma
• B. Small cell lung cancer
• C. Squamous cell carcinoma
• D. Mesothelioma

Correct answer: A

Rationale: Adenocarcinoma is the correct answer because it is a type of lung cancer that originates in the cells lining the bronchi and bronchioles. Adenocarcinoma is one of the most common types of lung cancer, often found in non-smokers and more frequently in women. Small cell lung cancer (Choice B) typically starts in the bronchi, but it is characterized by its rapid growth and tendency to spread quickly. Squamous cell carcinoma (Choice C) usually begins in the squamous cells lining the bronchi and is strongly associated with smoking. Mesothelioma (Choice D) is a cancer that affects the lining of certain organs like the lungs, often caused by asbestos exposure, but it does not specifically start in the cells lining the bronchi and bronchioles.

3. Which type of heart valve disease occurs when the mitral valve does not close properly, allowing blood to flow backward into the left atrium?

• A. Mitral regurgitation
• B. Aortic stenosis
• C. Tricuspid regurgitation
• D. Pulmonary hypertension

Correct answer: A

Rationale: Mitral regurgitation is the correct answer. It occurs when the mitral valve does not close properly, allowing blood to flow backward into the left atrium. This condition can lead to symptoms such as fatigue, shortness of breath, and if left untreated, it can progress to heart failure. Aortic stenosis (choice B) is a different heart valve condition characterized by narrowing of the aortic valve, restricting blood flow from the heart. Tricuspid regurgitation (choice C) involves the tricuspid valve not closing properly, leading to blood flowing back into the right atrium. Pulmonary hypertension (choice D) is a condition characterized by high blood pressure in the arteries of the lungs.

4. 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.

5. The client is receiving digoxin and complains of nausea. What is the nurse’s priority action?

• A. Check the client’s digoxin level.
• B. Continue the current dose of digoxin.
• C. Administer an antiemetic for nausea.
• D. Discontinue the digoxin immediately.

Correct answer: A

Rationale: The correct answer is to check the client’s digoxin level (Choice A). Nausea can be a sign of digoxin toxicity, so assessing the digoxin level is crucial to determine if the medication dosage needs adjustment. Continuing the current dose of digoxin (Choice B) may worsen the symptoms if toxicity is present. Administering an antiemetic (Choice C) may provide temporary relief but does not address the underlying issue of digoxin toxicity. Discontinuing digoxin immediately (Choice D) without assessing the digoxin level can be harmful if the medication is within the therapeutic range.

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