Nursing Elites

1. Which chronic respiratory condition is characterized by the narrowing and inflammation of the airways, leading to difficulty breathing?

• A. Asthma
• B. COPD
• C. Bronchitis
• D. Pneumonia

Correct answer: A

Rationale: Asthma is the correct answer. It is a chronic respiratory condition where the airways become inflamed and narrowed, leading to episodes of wheezing, breathlessness, chest tightness, and coughing. Asthma is characterized by reversible airflow obstruction, differentiating it from COPD, which involves irreversible airflow limitation. Bronchitis is an inflammation of the bronchial tubes without the same reversible airflow obstruction seen in asthma. Pneumonia is an infection of the lung tissue and does not involve chronic inflammation and narrowing of the airways like asthma.

2. 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.

3. Which valve prevents backflow of blood into the left ventricle from the aorta?

• A. Aortic valve
• B. Mitral valve
• C. Tricuspid valve
• D. Pulmonary valve

Correct answer: A

Rationale: The correct answer is Aortic valve. The aortic valve is positioned between the left ventricle and the aorta. It prevents blood from flowing back into the left ventricle after it has been pumped into the aorta. The mitral valve (Choice B) is located between the left atrium and the left ventricle, the tricuspid valve (Choice C) is between the right atrium and right ventricle, and the pulmonary valve (Choice D) is situated between the right ventricle and the pulmonary artery. Therefore, they are not responsible for preventing backflow from the aorta into the left ventricle.

4. What is the condition where the walls of the heart's ventricles become thickened, reducing the heart's ability to pump blood effectively?

• A. Ventricular hypertrophy
• B. Atrial fibrillation
• C. Restrictive cardiomyopathy
• D. Cardiomyopathy

Correct answer: A

Rationale: Ventricular hypertrophy is the correct answer. In ventricular hypertrophy, the walls of the heart's ventricles become thickened, which decreases the heart's efficiency in pumping blood. Atrial fibrillation (choice B) is an irregular and often rapid heart rate that can lead to poor blood flow. While restrictive cardiomyopathy (choice C) involves the heart muscle becoming rigid and less compliant, it is not specifically characterized by thickening of the ventricular walls. Cardiomyopathy (choice D) is a general term for diseases of the heart muscle, which can present with various symptoms and causes.

5. The nurse is administering digoxin to a client with a heart rate of 45 bpm. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Increase the dose of digoxin.
• D. Monitor the client’s heart rate and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A heart rate of 45 bpm is already low, and digoxin can further decrease the heart rate, leading to serious complications like bradycardia or heart block. Administering the medication can exacerbate the bradycardia, hence it should be withheld. Increasing the dose of digoxin is contraindicated due to the client's low heart rate. Monitoring the heart rate alone without taking immediate action to withhold the medication is not the priority when faced with the risk of further lowering the heart rate.

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