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 test measures how much and how quickly you can move air out of your lungs?

• A. Spirometry
• B. Peak flow meter
• C. Lung volume test
• D. Arterial blood gas

Correct answer: A

Rationale: The correct answer is A, Spirometry. Spirometry is a common pulmonary function test that measures lung function by assessing the amount (volume) and speed (flow) of air that can be inhaled and exhaled. This test helps in diagnosing conditions like asthma, chronic obstructive pulmonary disease (COPD), and other lung diseases. Peak flow meter (choice B) measures the maximum speed at which a person can exhale air, mainly used in asthma management. Lung volume test (choice C) evaluates the total amount of air the lungs can hold. Arterial blood gas (choice D) measures the levels of oxygen and carbon dioxide in the blood, providing information on how well the lungs are functioning in gas exchange, but it does not specifically measure the amount and speed of air movement in and out of the lungs like spirometry does.

3. Which term refers to a condition where the blood supply to part of the heart muscle is blocked, often referred to as a heart attack?

• A. Myocardial infarction
• B. Arrhythmia
• C. Stroke
• D. Aneurysm

Correct answer: A

Rationale: The correct answer is A, myocardial infarction. A myocardial infarction, commonly known as a heart attack, occurs when the blood supply to part of the heart muscle is blocked, often by a blood clot. Choices B, C, and D are incorrect because arrhythmia refers to an irregular heartbeat, stroke involves the interruption of blood flow to the brain, and an aneurysm is a bulge in a blood vessel.

4. Which medication is used to prevent blood clots by thinning the blood, reducing the risk of stroke and heart attack?

• A. Anticoagulant
• B. ACE inhibitor
• C. Beta-blocker
• D. Calcium channel blocker

Correct answer: A

Rationale: The correct answer is 'Anticoagulant.' Anticoagulants are medications specifically designed to prevent blood clots by thinning the blood, which effectively reduces the risk of stroke, heart attack, and other cardiovascular events. Choices B, C, and D, which are ACE inhibitors, beta-blockers, and calcium channel blockers, respectively, do not have the primary mechanism of action to prevent blood clot formation. ACE inhibitors, beta-blockers, and calcium channel blockers are commonly used for managing hypertension and other cardiovascular conditions by different mechanisms of action.

5. The client is on nitroglycerin patches. What should the nurse include in the client’s education?

• A. Rotate the application site with each new patch.
• B. Apply the patch at the same time each day.
• C. Leave the patch on for 24 hours, then remove it for 12 hours before applying a new one.
• D. Apply the patch to the same site each time.

Correct answer: A

Rationale: The correct answer is A: 'Rotate the application site with each new patch.' When educating a client using nitroglycerin patches, it is essential to rotate the application site to prevent skin irritation. Choice B is incorrect because applying the patch at the same time each day is not a critical aspect of patch application. Choice C is incorrect as nitroglycerin patches are usually left on for a specific period, typically 12 to 14 hours, before being replaced. Choice D is incorrect because applying the patch to the same site each time can lead to skin irritation and tolerance development.

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