Nursing Elites

1. What is a surgical procedure where a blood vessel is grafted to bypass a blocked coronary artery, improving blood flow to the heart muscle?

• A. Coronary artery bypass graft (CABG)
• B. Valve replacement
• C. Angioplasty
• D. Endarterectomy

Correct answer: A

Rationale: The correct answer is A: Coronary artery bypass graft (CABG). CABG involves grafting a blood vessel to bypass a blocked coronary artery, enhancing blood flow to the heart muscle. This procedure helps reduce the risk of heart attack by restoring proper blood circulation to the heart. Choice B, valve replacement, is a different surgical procedure that involves replacing damaged or dysfunctional heart valves. Choice C, angioplasty, is a minimally invasive procedure that uses a balloon to open narrowed or blocked blood vessels. Choice D, endarterectomy, is the surgical removal of plaque from the lining of an artery to improve blood flow.

2. The client on spironolactone (Aldactone) has a potassium level of 5.8 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: With a potassium level of 5.8 mEq/L, which is high, the priority action for the nurse is to hold the spironolactone. Spironolactone is a potassium-sparing diuretic that can further increase potassium levels. Therefore, it is crucial to prevent exacerbating hyperkalemia by discontinuing the medication. Notifying the healthcare provider is necessary for further guidance and potential adjustments to the treatment plan. Administering a potassium supplement (Choice B) would be contraindicated since the client already has elevated potassium levels. Continuing the spironolactone as ordered (Choice C) can worsen hyperkalemia. Increasing the dose of spironolactone (Choice D) would be unsafe and exacerbate the high potassium levels.

3. What is a chronic condition where the blood pressure in the arteries is persistently elevated, increasing the risk of heart disease and stroke?

• A. Hypertension
• B. Hypotension
• C. Hyperlipidemia
• D. Hyperglycemia

Correct answer: A

Rationale: Hypertension, also known as high blood pressure, is a chronic condition characterized by persistently elevated pressure in the arteries. This condition increases the risk of heart disease, stroke, and other health issues. Hypotension (choice B) refers to low blood pressure and is not the correct answer. Hyperlipidemia (choice C) is high levels of fats in the blood, not related to blood pressure. Hyperglycemia (choice D) is high blood sugar levels, not directly related to elevated blood pressure.

4. The nurse is caring for a client on amiodarone who complains of visual disturbances. What is the nurse’s best response?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect.
• C. Advise the client to monitor their symptoms at home.
• D. Suggest the client reduce physical activity.

Correct answer: A

Rationale: The correct answer is to notify the healthcare provider immediately. Visual disturbances in a client taking amiodarone can indicate amiodarone toxicity, a serious side effect. Notifying the healthcare provider promptly is essential for further assessment and management. Reassuring the client that this is a common side effect (choice B) is incorrect as visual disturbances should not be dismissed without evaluation. Advising the client to monitor their symptoms at home (choice C) may delay necessary intervention. Suggesting the client reduce physical activity (choice D) is unrelated to addressing visual disturbances caused by amiodarone.

5. The client on warfarin has an INR of 4.5. 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. Monitor the client’s INR closely.

Correct answer: A

Rationale: An INR of 4.5 is elevated, indicating an increased risk of bleeding due to excessive anticoagulation. The most appropriate action for the nurse in this scenario is to administer vitamin K. Vitamin K helps reverse the anticoagulant effects of warfarin, thus lowering the INR and reducing the risk of bleeding. Holding the next dose of warfarin (choice B) is not sufficient to address the immediate high INR level. Increasing the dose of warfarin (choice C) would further elevate the INR, worsening the risk of bleeding. While monitoring the client's INR closely (choice D) is important, immediate action is required to address the critically high INR level, making the administration of vitamin K the priority intervention.

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