Nursing Elites

1. What is a condition where the heart is unable to pump blood effectively, leading to a buildup of fluid in the lungs and other parts of the body?

• A. Heart failure
• B. Cardiomyopathy
• C. Myocardial infarction
• D. Pulmonary edema

Correct answer: A

Rationale: The correct answer is A: Heart failure. Heart failure occurs when the heart is unable to pump blood effectively, resulting in a buildup of fluid in the lungs and other parts of the body. Choice B, Cardiomyopathy, refers to diseases of the heart muscle, not specifically the inability to pump blood effectively. Choice C, Myocardial infarction, is a heart attack caused by a blocked blood supply to the heart muscle, not directly related to the heart's pumping efficiency. Choice D, Pulmonary edema, is a condition characterized by fluid accumulation in the lungs, often a consequence of heart failure but not the primary condition described in the question.

2. What is a surgical procedure to remove one of the lobes of the lungs, often performed to treat lung cancer?

• A. Lobectomy
• B. Pneumonectomy
• C. Thoracotomy
• D. Tracheostomy

Correct answer: A

Rationale: A lobectomy is the correct answer. This surgical procedure involves removing one of the lobes of the lungs, commonly done to treat lung cancer or other serious lung ailments. Choice B, pneumonectomy, involves the complete removal of a lung, not just a lobe. Choice C, thoracotomy, is a surgical incision into the chest wall and is not specific to removing a lung lobe. Choice D, tracheostomy, is the creation of an opening in the windpipe to assist with breathing and is unrelated to lung lobe removal.

3. The client is on digoxin and has severe digoxin toxicity. What is the nursing priority action?

• A. Check the potassium level.
• B. Give Digibind as an antidote.
• C. Change the dosing of digoxin to every other day.
• D. Administer a potassium supplement to decrease digoxin toxicity.

Correct answer: B

Rationale: The correct answer is to give Digibind as an antidote in cases of severe digoxin toxicity. Digibind works by binding to digoxin and preventing it from causing further harm. Checking the potassium level (choice A) is important but not the priority when the client has severe toxicity. Changing the dosing to every other day (choice C) is not appropriate in the setting of severe toxicity where immediate action is required. Giving a potassium supplement (choice D) may be needed eventually, but the priority is to administer Digibind to counteract the toxic effects of digoxin.

4. The nurse is administering nitroglycerin IV to a client with chest pain. What is the most important parameter to monitor?

• A. Blood pressure
• B. Heart rate
• C. Oxygen saturation
• D. Respiratory rate

Correct answer: A

Rationale: The correct answer is A: Blood pressure. When administering nitroglycerin IV to a client with chest pain, monitoring blood pressure is crucial as nitroglycerin can cause significant hypotension. While heart rate, oxygen saturation, and respiratory rate are important parameters to assess, blood pressure takes precedence in this scenario due to the potential hypotensive effects of nitroglycerin.

5. The client on warfarin has an INR of 1.2. What is the nurse’s priority action?

• A. Increase the dose of warfarin
• B. Administer vitamin K
• C. Monitor for signs of bleeding
• D. Hold the next dose and notify the healthcare provider

Correct answer: A

Rationale: The correct answer is to increase the dose of warfarin. An INR of 1.2 is below the therapeutic range for a client on warfarin, indicating that the dose is subtherapeutic. The priority action in this situation is to adjust the dose to achieve the target therapeutic INR range (usually 2-3) to prevent thromboembolic events. Administering vitamin K is not necessary as the INR is low, and there are no signs of bleeding. Monitoring for signs of bleeding is important but not the priority in this case since the INR is subtherapeutic. Holding the next dose and notifying the healthcare provider would delay the intervention needed to adjust the dose and achieve the therapeutic range.

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