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 the condition where the pericardium, the sac surrounding the heart, becomes inflamed, leading to chest pain and other symptoms?

• A. Pericarditis
• B. Myocarditis
• C. Endocarditis
• D. Pulmonary hypertension

Correct answer: A

Rationale: Pericarditis is the correct answer. It is the inflammation of the pericardium, the sac surrounding the heart, which can lead to chest pain and other symptoms. Myocarditis (choice B) is inflammation of the heart muscle, not the pericardium. Endocarditis (choice C) is inflammation of the inner lining of the heart chambers and valves, not the pericardium. Pulmonary hypertension (choice D) is high blood pressure in the arteries of the lungs, not related to pericardial inflammation.

3. Which condition is characterized by the weakening and rupture of the walls of the alveoli in the lungs, reducing the surface area available for gas exchange?

• A. Emphysema
• B. Bronchitis
• C. Atelectasis
• D. Pulmonary fibrosis

Correct answer: A

Rationale: The correct answer is A, Emphysema. Emphysema is a lung condition where the walls of the alveoli become weak and rupture, reducing the surface area available for gas exchange. This leads to shortness of breath. Choice B, Bronchitis, is characterized by inflammation of the bronchial tubes, not the alveoli. Choice C, Atelectasis, involves the collapse of a part or entire lung, not the weakening and rupture of alveolar walls. Choice D, Pulmonary fibrosis, is a condition where lung tissue becomes thickened and stiff, not involving the weakening and rupture of alveoli walls.

4. 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.

5. Which condition is characterized by the sudden onset of shortness of breath, often occurring at night and associated with heart failure?

• A. Paroxysmal nocturnal dyspnea
• B. Sleep apnea
• C. Orthopnea
• D. Dyspnea

Correct answer: A

Rationale: Paroxysmal nocturnal dyspnea is the correct answer. It is characterized by the sudden onset of shortness of breath during sleep, often associated with heart failure. Choice B, Sleep apnea, involves pauses in breathing during sleep but is not specifically associated with heart failure. Choice C, Orthopnea, is difficulty breathing that occurs when lying down and is relieved by sitting up, not necessarily associated with heart failure. Choice D, Dyspnea, is a general term for difficulty breathing and does not specifically describe the sudden onset at night associated with heart failure as seen in paroxysmal nocturnal dyspnea.

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