Nursing Elites

1. What is a condition where the right side of the heart fails due to increased pressure in the pulmonary arteries, often caused by chronic lung disease?

• A. Cor pulmonale
• B. Heart failure
• C. Pulmonary embolism
• D. Myocarditis

Correct answer: A

Rationale: Cor pulmonale is the correct answer. It is a condition where the right side of the heart fails due to increased pressure in the pulmonary arteries, often caused by chronic lung disease such as COPD. Pulmonary embolism (choice C) is a blockage in one of the pulmonary arteries in your lungs. Myocarditis (choice D) is inflammation of the heart muscle. While heart failure (choice B) is a broad term that can involve the failure of either the right or left side of the heart.

2. What type of medication is used to reduce inflammation in the airways and prevent asthma attacks?

• A. Corticosteroid
• B. Bronchodilator
• C. Antihistamine
• D. Mucolytic

Correct answer: A

Rationale: The correct answer is A, Corticosteroid. Corticosteroids are medications that work by reducing inflammation in the airways, helping to prevent asthma attacks and manage chronic respiratory conditions. Bronchodilators (choice B) work by relaxing the muscles around the airways to make breathing easier, but they do not primarily target inflammation. Antihistamines (choice C) are used to treat allergic reactions and do not directly target airway inflammation. Mucolytics (choice D) help to break down and thin mucus in the airways but do not reduce inflammation.

3. The nurse is caring for a client on enalapril (Vasotec). What is the most important side effect to monitor?

• A. Cough
• B. Hyperkalemia
• C. Hypotension
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Cough. Enalapril is an ACE inhibitor, and cough is a common side effect associated with this class of medication. Monitoring for cough is crucial as it can indicate the development of a potentially serious condition known as angioedema. Hyperkalemia (choice B) is a possible side effect of ACE inhibitors but is not the most important side effect to monitor. Hypotension (choice C) and dizziness (choice D) are also potential side effects of enalapril; however, cough takes precedence due to its association with angioedema, a severe adverse reaction.

4. The nurse is caring for a client on warfarin with an INR of 1.8. What is the most appropriate action?

• A. Increase the dose of warfarin.
• B. Administer vitamin K.
• C. Hold the warfarin and notify the healthcare provider.
• D. Monitor the client’s INR closely.

Correct answer: D

Rationale: An INR of 1.8 is below the therapeutic range for a client on warfarin, indicating the need for monitoring closely to ensure that the INR levels reach the desired therapeutic range. Increasing the dose of warfarin (Choice A) without proper monitoring may lead to an increased risk of bleeding. Administering vitamin K (Choice B) is not typically recommended unless the client is experiencing major bleeding or requires rapid reversal of warfarin's effects. Holding the warfarin and notifying the healthcare provider (Choice C) may be necessary in certain situations, but the immediate action in this case should be to monitor the client's INR closely to guide further management.

5. A client on a beta blocker has a blood pressure of 90/60 mm Hg. What is the nurse’s priority action?

• A. Hold the beta blocker and notify the healthcare provider.
• B. Administer the beta blocker as ordered.
• C. Administer a diuretic to reduce blood pressure.
• D. Continue to monitor the client and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the beta blocker and notify the healthcare provider. A blood pressure of 90/60 mm Hg is already low, and beta blockers can further decrease blood pressure. Administering the beta blocker can potentially worsen the situation, leading to complications. Administering a diuretic or continuing to monitor the client without taking immediate action could delay necessary intervention. Therefore, holding the beta blocker and involving the healthcare provider promptly is crucial in this scenario.

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