Nursing Elites

1. What term describes a condition where a person experiences difficulty breathing when lying flat and requires multiple pillows to sleep comfortably?

• A. Orthopnea
• B. Dyspnea
• C. Tachypnea
• D. Bradypnea

Correct answer: A

Rationale: The correct answer is A, Orthopnea. Orthopnea is a condition where a person finds it hard to breathe while lying flat and needs to use multiple pillows to sleep comfortably. This position helps relieve the discomfort by allowing better lung expansion. Choice B, Dyspnea, refers to difficulty breathing in general, not specifically related to lying flat. Choice C, Tachypnea, is rapid breathing and is not directly related to difficulty breathing while lying down. Choice D, Bradypnea, is slow breathing and does not describe the condition of having trouble breathing when lying flat.

2. The client on warfarin has an INR of 5.5. What is the priority nursing action?

• A. Administer vitamin K as an antidote.
• B. Hold the next dose of warfarin.
• C. Increase the dose of warfarin.
• D. Administer fresh frozen plasma.

Correct answer: A

Rationale: An INR of 5.5 is significantly elevated, indicating an increased risk of bleeding. The priority nursing action in this situation is to administer vitamin K as an antidote to reverse the effects of warfarin and lower the INR. Holding the next dose of warfarin (choice B) is important but not as immediate as administering vitamin K. Increasing the dose of warfarin (choice C) would further elevate the INR, worsening the bleeding risk. Administering fresh frozen plasma (choice D) is not the first-line treatment for high INR due to warfarin.

3. The nurse is caring for a client on digoxin with a heart rate of 48 bpm. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Administer atropine to increase the heart rate.
• D. Increase the dose of digoxin.

Correct answer: A

Rationale: In this scenario, the nurse's priority action should be to hold the digoxin and notify the healthcare provider. A heart rate of 48 bpm is low, and digoxin, being a medication that can further decrease the heart rate, should be withheld. Administering the digoxin as ordered (Choice B) would not be appropriate in this situation as it can exacerbate bradycardia. Atropine (Choice C) is not the initial treatment for this scenario; holding the digoxin is the first action. Increasing the dose of digoxin (Choice D) would be contraindicated due to the client's bradycardia. Therefore, the correct action is to hold the digoxin and inform the healthcare provider for further guidance.

4. Which term refers to the contraction phase of the heart when blood is ejected from the chambers?

• A. Systole
• B. Diastole
• C. Contractility
• D. Afterload

Correct answer: A

Rationale: The correct answer is A, systole. Systole is the phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. During diastole (choice B), the heart relaxes and fills with blood, contrasting with systole. Contractility (choice C) refers to the ability of the heart to contract effectively. Afterload (choice D) is the pressure the heart must work against to eject blood during systole.

5. Which condition involves the heart muscle becoming abnormally thickened, reducing its ability to pump blood?

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

Correct answer: A

Rationale: The correct answer is A: Hypertrophic cardiomyopathy. In this condition, the heart muscle thickens, leading to a decreased ability to pump blood effectively. Choice B, Dilated cardiomyopathy, is characterized by the heart chambers enlarging and weakening. Choice C, Restrictive cardiomyopathy, involves the heart muscle becoming rigid and less compliant. Choice D, Ischemic cardiomyopathy, is when the heart muscle is weakened due to reduced blood flow.

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