Nursing Elites

1. What is a condition where the walls of the arteries in the lungs become thickened and stiff, leading to increased blood pressure in the pulmonary arteries?

• A. Pulmonary hypertension
• B. Pulmonary fibrosis
• C. Pulmonary embolism
• D. Pulmonary edema

Correct answer: A

Rationale: Pulmonary hypertension is a condition characterized by the thickening and stiffening of the arteries in the lungs, resulting in elevated blood pressure in the pulmonary arteries. This condition is distinct from the other choices provided. Pulmonary fibrosis involves scarring of lung tissue, pulmonary embolism is a blockage in the pulmonary artery, and pulmonary edema is the accumulation of fluid in the lungs.

2. 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.

3. 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.

4. What procedure involves inserting a flexible tube with a light and camera into the airways to examine the lungs and collect samples?

• A. Bronchoscopy
• B. Thoracentesis
• C. Lung biopsy
• D. Chest X-ray

Correct answer: A

Rationale: The correct answer is A: Bronchoscopy. Bronchoscopy is a procedure that entails inserting a flexible tube with a light and camera into the airways to examine the lungs and collect tissue or fluid samples. This procedure is commonly performed to diagnose lung conditions such as infections, tumors, or obstructions. Choice B, thoracentesis, involves inserting a needle into the pleural space to remove fluid for diagnostic or therapeutic purposes related to the lungs or pleura, not the airways. Choice C, lung biopsy, typically involves obtaining tissue samples from the lungs for further examination, not directly visualizing the airways. Choice D, chest X-ray, is a diagnostic imaging technique that uses radiation to create images of the chest area, providing a different type of information compared to bronchoscopy.

5. 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.

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