Nursing Elites

1. What is a condition where the lung's air sacs (alveoli) are damaged and enlarged, leading to breathlessness?

• A. Emphysema
• B. Chronic bronchitis
• C. Asthma
• D. Pulmonary fibrosis

Correct answer: A

Rationale: Emphysema is the correct answer. It is a condition where the air sacs in the lungs are damaged and enlarged, leading to breathlessness. Chronic bronchitis is characterized by inflammation of the bronchial tubes, not the alveoli. Asthma involves airway inflammation and constriction, not alveolar damage. Pulmonary fibrosis is a condition where lung tissue becomes thickened and scarred, different from the alveolar damage seen in emphysema.

2. The nurse is monitoring a client on dobutamine. What adverse effect should the nurse watch for?

• A. Tachycardia
• B. Bradycardia
• C. Hypertension
• D. Respiratory distress

Correct answer: A

Rationale: The correct answer is A: Tachycardia. Dobutamine is a medication that stimulates beta-1 adrenergic receptors in the heart, leading to increased heart rate. Therefore, tachycardia is a common adverse effect that the nurse should monitor for. Choices B, C, and D are incorrect because dobutamine typically does not cause bradycardia, hypertension, or respiratory distress as its primary adverse effects.

3. Which of the following is a chronic lung disease that results in the gradual destruction of the alveoli, causing difficulty breathing and reduced oxygen exchange?

• A. Emphysema
• B. Bronchitis
• C. Pulmonary hypertension
• D. Sarcoidosis

Correct answer: A

Rationale: Emphysema is the correct answer as it is a chronic lung disease characterized by the gradual destruction of the alveoli, which are essential for oxygen exchange. This destruction leads to difficulty breathing and reduced oxygen levels in the blood. Bronchitis is an inflammation of the bronchial tubes, not specifically involving alveoli destruction. Pulmonary hypertension is a condition of high blood pressure in the arteries of the lungs, not directly related to alveoli destruction. Sarcoidosis is a disease characterized by the growth of tiny collections of inflammatory cells in different parts of the body, including the lungs, but it does not primarily involve the destruction of alveoli.

4. 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.

5. The client is on enoxaparin (Lovenox) for DVT prophylaxis. What is the most important lab value to monitor?

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

Correct answer: A

Rationale: The correct answer is A: Platelet count. When a client is on enoxaparin (Lovenox), monitoring the platelet count is crucial as enoxaparin can lead to a rare but serious side effect known as heparin-induced thrombocytopenia (HIT), causing a decrease in platelet count. Monitoring the platelet count helps detect this adverse reaction early. Choices B, C, and D are incorrect because enoxaparin therapy does not directly affect PT/INR, aPTT, or hemoglobin levels.

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