Nursing Elites

1. The client is prescribed warfarin. What should the client be taught about this medication?

• A. Avoid foods high in vitamin K.
• B. Take the medication with food to prevent stomach upset.
• C. Take the medication at the same time every day.
• D. Increase the dose if a dose is missed.

Correct answer: A

Rationale: The correct answer is A: Avoid foods high in vitamin K. Warfarin is an anticoagulant medication, and vitamin K can counteract its effects. Therefore, it is important for clients taking warfarin to avoid foods high in vitamin K to maintain the medication's effectiveness. Choice B is incorrect because warfarin should be taken consistently as prescribed, regardless of food intake. Choice C is incorrect because while consistency in timing is important, it is not specific to the effectiveness of warfarin. Choice D is incorrect because clients should never increase the dose of warfarin on their own, especially to make up for a missed dose, as it can lead to serious bleeding risks.

2. A client on a beta blocker has a heart rate of 52 bpm. What is the nurse’s priority action?

• A. Hold the beta blocker and notify the healthcare provider.
• B. Administer the beta blocker as ordered.
• C. Increase the dose of the beta blocker.
• D. Continue to monitor the client and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the beta blocker and notify the healthcare provider. A heart rate of 52 bpm is low, and beta blockers can further decrease the heart rate, potentially causing harm. Therefore, withholding the medication and promptly informing the healthcare provider is crucial for further assessment and possible adjustment of the treatment plan. Administering the beta blocker as ordered (Choice B) can exacerbate the bradycardia. Increasing the dose of the beta blocker (Choice C) would further suppress the heart rate. Continuing to monitor the client and reassessing in 30 minutes (Choice D) might delay necessary interventions and increase the risk of complications in a client with a heart rate of 52 bpm.

3. What test uses sound waves to create pictures of the heart, allowing doctors to see how well the heart is functioning?

• A. Echocardiogram
• B. MRI
• C. CT scan
• D. X-ray

Correct answer: A

Rationale: The correct answer is an echocardiogram. This test utilizes sound waves to generate images of the heart, enabling doctors to evaluate both the function and structure of the heart. Choice B, MRI, uses magnetic fields and radio waves to produce detailed images of the body's organs and structures, not specifically focused on the heart. Choice C, CT scan, employs X-rays to create detailed cross-sectional images of the body, not primarily for the heart. Choice D, X-ray, uses electromagnetic radiation to produce images of internal structures, but it does not provide the detailed pictures of the heart's function that an echocardiogram does.

4. Which condition involves the tearing of the aorta, leading to severe pain and internal bleeding?

• A. Aortic dissection
• B. Aneurysm
• C. Stroke
• D. Myocardial infarction

Correct answer: A

Rationale: The correct answer is Aortic dissection. Aortic dissection is a life-threatening condition where the inner layer of the aorta tears, causing severe chest or back pain and internal bleeding, requiring immediate medical attention. Choice B, aneurysm, involves a bulging or weakening of a blood vessel wall, which is different from a tear in the aorta. Choices C and D, stroke and myocardial infarction, do not directly involve the tearing of the aorta and are distinct conditions.

5. The nurse is administering an ACE inhibitor to a client. What is the most common side effect?

• A. Cough
• B. Dizziness
• C. Hypotension
• D. Hyperkalemia

Correct answer: A

Rationale: The correct answer is A: Cough. Cough is a well-known side effect of ACE inhibitors due to an increase in bradykinin levels. This irritating cough can be bothersome to clients and should be monitored. Choice B, Dizziness, is not the most common side effect of ACE inhibitors. While ACE inhibitors can cause hypotension (Choice C), cough is more prevalent. Hyperkalemia (Choice D) is a possible side effect of ACE inhibitors but is less common compared to cough.

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