Nursing Elites

1. Which surgical procedure involves opening or replacing a narrowed or blocked heart valve?

• A. Valve replacement
• B. Angioplasty
• C. Stent placement
• D. Coronary bypass surgery

Correct answer: A

Rationale: Valve replacement is the correct answer because it specifically involves surgically replacing a damaged or diseased heart valve with a prosthetic valve to address narrowing or blockage, thereby improving blood flow and heart function. Angioplasty (choice B) is a procedure to widen narrowed or obstructed arteries, typically using a balloon catheter. Stent placement (choice C) involves inserting a mesh tube to support a weakened artery. Coronary bypass surgery (choice D) is a procedure to create new routes for blood flow to the heart muscle by bypassing blocked arteries.

2. The client is on warfarin and has an INR of 1.5. What is the nurse’s priority action?

• A. Increase the dose of warfarin.
• B. Hold the next dose of warfarin.
• C. Continue the current dose of warfarin.
• D. Monitor the client’s INR closely.

Correct answer: B

Rationale: An INR of 1.5 is below the therapeutic range for a client on warfarin, indicating that the client may be at risk of clot formation. The nurse's priority action should be to hold the next dose of warfarin to prevent further reduction of the INR. Increasing the dose could potentially lead to an increased risk of bleeding, and continuing the current dose may not be sufficient to bring the INR within the therapeutic range. Monitoring the client's INR closely is important but not the priority action in this scenario.

3. Which of the following is a central vasoconstrictor and peripheral vasodilator?

• A. Parasympathetic nervous system
• B. Sympathetic nervous system
• C. Dopamine
• D. Epinephrine

Correct answer: D

Rationale: The correct answer is D, Epinephrine. Epinephrine acts as a central vasoconstrictor and peripheral vasodilator. It increases heart rate and blood flow to muscles, helping to prepare the body for a 'fight or flight' response. Parasympathetic nervous system (choice A) does not cause vasoconstriction but rather vasodilation. The sympathetic nervous system (choice B) is primarily responsible for the fight or flight response, causing vasoconstriction. Dopamine (choice C) primarily acts as a neurotransmitter and hormone, not directly causing central vasoconstriction and peripheral vasodilation.

4. What is the term used to describe a condition where the blood flow to the brain is temporarily interrupted, often referred to as a 'mini-stroke'?

• A. Transient ischemic attack (TIA)
• B. Stroke
• C. Myocardial infarction
• D. Pulmonary embolism

Correct answer: A

Rationale: The correct answer is A: Transient ischemic attack (TIA). A transient ischemic attack (TIA) is often called a 'mini-stroke' because it is characterized by a temporary interruption of blood flow to the brain, resulting in stroke-like symptoms that typically resolve within a short period. Choice B, 'Stroke,' is incorrect because a stroke involves a more prolonged interruption of blood flow, leading to lasting brain damage. Choices C and D, 'Myocardial infarction' and 'Pulmonary embolism,' are unrelated conditions involving the heart and lungs, respectively, and do not describe a temporary interruption of blood flow to the brain.

5. A client on spironolactone (Aldactone) has a potassium level of 6.0 mEq/L. What is the nurse’s priority action?

• A. Hold the spironolactone and notify the healthcare provider.
• B. Administer a potassium supplement.
• C. Continue the spironolactone as ordered.
• D. Increase the dose of spironolactone.

Correct answer: A

Rationale: The correct action for a client on spironolactone with a potassium level of 6.0 mEq/L is to hold the medication and notify the healthcare provider. Spironolactone is a potassium-sparing diuretic that can further elevate potassium levels, which are already high. Administering a potassium supplement (Choice B) would exacerbate the hyperkalemia. Continuing the spironolactone as ordered (Choice C) could lead to worsening hyperkalemia. Increasing the dose of spironolactone (Choice D) would be contraindicated in the presence of elevated potassium levels.

Similar Questions