Nursing Elites

1. The healthcare provider is preparing to administer heparin to a client. What lab value should be monitored?

• A. PT/INR
• B. aPTT
• C. Platelet count
• D. Hemoglobin

Correct answer: B

Rationale: The correct lab value that should be monitored when administering heparin is the aPTT (activated partial thromboplastin time). Heparin affects the intrinsic pathway of the coagulation cascade, and aPTT is a sensitive measure to assess the effectiveness of heparin therapy. Monitoring aPTT helps in adjusting the heparin dose to maintain the desired anticoagulant effect. PT/INR is more specific to monitor warfarin therapy, not heparin. Platelet count and hemoglobin levels are important parameters to assess bleeding tendencies and oxygen-carrying capacity but are not directly related to monitoring heparin therapy.

2. Which condition is characterized by the right ventricle of the heart failing due to increased pressure in the lungs, often caused by chronic lung disease?

• A. Cor pulmonale
• B. Pulmonary embolism
• C. Aortic stenosis
• D. Hypertrophic cardiomyopathy

Correct answer: A

Rationale: The correct answer is Cor pulmonale, a condition where the right ventricle of the heart fails due to increased pressure in the lungs, commonly caused by chronic lung diseases like COPD. Pulmonary embolism (choice B) is a blockage in one of the pulmonary arteries in the lungs, usually caused by a blood clot. Aortic stenosis (choice C) is a narrowing of the aortic valve opening that restricts blood flow from the left ventricle to the aorta. Hypertrophic cardiomyopathy (choice D) is a genetic condition where the heart muscle becomes abnormally thick, making it harder for the heart to pump blood.

3. Which of the following is a type of heart attack that occurs when the blood supply to part of the heart muscle is severely reduced or stopped?

• A. Myocardial infarction
• B. Angina
• C. Stroke
• D. Congestive heart failure

Correct answer: A

Rationale: The correct answer is A: Myocardial infarction. Myocardial infarction, commonly known as a heart attack, occurs when the blood supply to part of the heart muscle is severely reduced or stopped, leading to tissue damage or death. Angina (choice B) is chest pain or discomfort that occurs when the heart muscle doesn't get enough oxygen-rich blood. Stroke (choice C) is a condition where the blood supply to the brain is interrupted or reduced. Congestive heart failure (choice D) is a chronic condition where the heart muscle doesn't pump blood as well as it should.

4. 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.

5. This is a branch of the left coronary arteries which supplies the LEFT ATRIUM, posterior lateral surface of the left ventricle.

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

Correct answer: B

Rationale: The correct answer is B, Left circumflex artery. The circumflex artery is a branch of the left coronary artery that supplies blood to the left atrium and the lateral wall of the left ventricle. Choice A, the Right coronary artery, does not supply the mentioned areas. Choice C, the Left anterior descending artery, supplies the anterior wall of the left ventricle. Choice D, the Posterior descending artery, is a branch of the right coronary artery and supplies the inferior wall of the left ventricle and the posterior septum.

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