Nursing Elites

1. Which of the following is a chronic condition where the heart muscle is weakened and unable to pump blood effectively, often leading to heart failure?

• A. Dilated cardiomyopathy
• B. Hypertrophic cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Myocarditis

Correct answer: A

Rationale: Dilated cardiomyopathy is characterized by the heart muscle being weakened and unable to pump blood effectively, ultimately resulting in heart failure. Choice B, Hypertrophic cardiomyopathy, involves the heart muscle becoming abnormally thick, reducing the heart's efficiency. Choice C, Restrictive cardiomyopathy, refers to the heart becoming rigid and less able to fill with blood properly. Myocarditis, as in Choice D, is inflammation of the heart muscle usually caused by a viral infection and is different from the chronic weakening seen in dilated cardiomyopathy.

2. The client on warfarin has an INR of 4.5. What is the most appropriate action by the nurse?

• A. Administer vitamin K.
• 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 4.5 is elevated, indicating an increased risk of bleeding due to excessive anticoagulation. The most appropriate action for the nurse in this scenario is to administer vitamin K. Vitamin K helps reverse the anticoagulant effects of warfarin, thus lowering the INR and reducing the risk of bleeding. Holding the next dose of warfarin (choice B) is not sufficient to address the immediate high INR level. Increasing the dose of warfarin (choice C) would further elevate the INR, worsening the risk of bleeding. While monitoring the client's INR closely (choice D) is important, immediate action is required to address the critically high INR level, making the administration of vitamin K the priority intervention.

3. What is a chronic inflammatory disease that affects the small airways in the lungs, leading to episodes of wheezing, breathlessness, and coughing?

• A. Asthma
• B. COPD
• C. Bronchitis
• D. Lung cancer

Correct answer: A

Rationale: Asthma is the correct answer. It is a chronic inflammatory disease that affects the small airways in the lungs, leading to symptoms like wheezing, breathlessness, and coughing. Asthma is commonly triggered by allergens, exercise, respiratory infections, and other factors. Choice B, COPD (Chronic Obstructive Pulmonary Disease), is characterized by airflow limitation and is often caused by smoking. Choice C, Bronchitis, is an inflammation of the bronchial tubes and can be acute or chronic. Choice D, Lung cancer, is a disease characterized by uncontrolled cell growth in lung tissues and is commonly associated with smoking or environmental factors.

4. Which of the following is a genetic disorder that causes thick, sticky mucus to build up in the lungs and digestive system, leading to severe respiratory and digestive problems?

• A. Cystic fibrosis
• B. Pulmonary fibrosis
• C. Pulmonary edema
• D. Bronchiectasis

Correct answer: A

Rationale: The correct answer is A, cystic fibrosis. Cystic fibrosis is a genetic disorder characterized by the buildup of thick, sticky mucus in the lungs and digestive system, resulting in severe respiratory and digestive issues. Choice B, pulmonary fibrosis, involves scarring and thickening of lung tissue, not excessive mucus production. Choice C, pulmonary edema, refers to fluid accumulation in the lungs, not mucus buildup. Choice D, bronchiectasis, is a condition where the airways in the lungs are damaged and widened, leading to chronic cough and sputum production, but it does not specifically involve the thick, sticky mucus characteristic of cystic fibrosis.

5. The client has a prescription for sublingual nitroglycerin. What is the nurse's instruction for how to take this medication during an episode of chest pain?

• A. Take one tablet every 5 minutes, up to three tablets.
• B. Take one tablet every hour until the pain subsides.
• C. Take two tablets immediately if chest pain occurs.
• D. Take one tablet with a full glass of water.

Correct answer: A

Rationale: The correct answer is A. The standard instruction for sublingual nitroglycerin during an episode of chest pain is to take one tablet every 5 minutes, up to three tablets. If the pain persists after taking three tablets, the client should seek emergency help. Choice B is incorrect because taking one tablet every hour is not the appropriate dosing for acute chest pain. Choice C is incorrect as taking two tablets immediately is not in line with the recommended dosing instructions. Choice D is incorrect because sublingual nitroglycerin should be placed under the tongue, not swallowed with water.

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