Nursing Elites

1. What is a surgical procedure to create an opening in the windpipe to assist with breathing?

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

Correct answer: A

Rationale: Tracheostomy is the correct answer. It is a surgical procedure to create an opening in the windpipe (trachea) to assist with breathing. This procedure is commonly used for patients who require long-term ventilation support. Choice B, Lobectomy, involves the removal of a lobe of the lung and is not related to creating an opening in the windpipe. Choice C, Thoracotomy, is a surgical incision into the chest wall and is not specifically related to creating an opening in the windpipe. Choice D, Pleurodesis, is a procedure to treat recurrent pleural effusions by causing the pleural layers to stick together, and it is not related to creating an opening in the windpipe.

2. The client on warfarin has an INR of 3.8. What is the most appropriate action by the nurse?

• A. Administer vitamin K.
• B. Hold the next dose of warfarin.
• C. Increase the dose of warfarin.
• D. Notify the healthcare provider immediately.

Correct answer: A

Rationale: An INR of 3.8 is elevated, indicating an increased risk of bleeding. Administering vitamin K can help reverse the effects of warfarin. Holding the next dose of warfarin would be appropriate if the INR was too high, but not as the first-line action. Increasing the dose of warfarin would worsen the situation by further increasing the INR. Notifying the healthcare provider is important, but immediate action to address the elevated INR is necessary.

3. What is an infection that causes inflammation in the air sacs of one or both lungs, which may fill with fluid or pus?

• A. Pneumonia
• B. Tuberculosis
• C. Pleurisy
• D. Pulmonary edema

Correct answer: A

Rationale: The correct answer is A, Pneumonia. Pneumonia is an infection that inflames the air sacs in one or both lungs, which may fill with fluid or pus, causing symptoms like cough, fever, chills, and difficulty breathing. Tuberculosis (B) is a bacterial infection that primarily affects the lungs but is caused by a different bacterium. Pleurisy (C) is inflammation of the tissues that line the lungs and chest cavity, not the air sacs. Pulmonary edema (D) is a condition where fluid accumulates in the lungs' air sacs but is often due to heart problems rather than an infection.

4. The client is prescribed warfarin. What should the client be taught about this medication?

• A. Avoid foods high in vitamin K.
• B. Take the medication with food to prevent stomach upset.
• C. Take the medication at the same time every day.
• D. Increase the dose if a dose is missed.

Correct answer: A

Rationale: The correct answer is A: Avoid foods high in vitamin K. Warfarin is an anticoagulant medication, and vitamin K can counteract its effects. Therefore, it is important for clients taking warfarin to avoid foods high in vitamin K to maintain the medication's effectiveness. Choice B is incorrect because warfarin should be taken consistently as prescribed, regardless of food intake. Choice C is incorrect because while consistency in timing is important, it is not specific to the effectiveness of warfarin. Choice D is incorrect because clients should never increase the dose of warfarin on their own, especially to make up for a missed dose, as it can lead to serious bleeding risks.

5. The client is on amiodarone and reports blurred vision. What is the nurse’s best response?

• A. Reassure the client that this is a common side effect.
• B. Instruct the client to report this symptom to the healthcare provider immediately.
• C. Advise the client to stop taking the medication.
• D. Discontinue the amiodarone immediately.

Correct answer: B

Rationale: Blurred vision is a potential side effect of amiodarone. Instructing the client to report this symptom to the healthcare provider immediately is the most appropriate response. Choice A is incorrect because although blurred vision can be a common side effect of amiodarone, it should not be dismissed without further evaluation. Choice C is incorrect as advising the client to stop taking the medication without consulting the healthcare provider can be dangerous and is not the first course of action. Choice D is too drastic as discontinuing the medication should be done under the guidance of a healthcare provider after proper evaluation.

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