Nursing Elites

1. 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.

2. The client is receiving intravenous dopamine. What is the most important nursing assessment?

• A. Monitor heart rate and rhythm
• B. Monitor blood pressure
• C. Monitor respiratory rate
• D. Monitor oxygen saturation

Correct answer: A

Rationale: The correct answer is to monitor heart rate and rhythm when a client is receiving intravenous dopamine. Dopamine is known to potentially cause arrhythmias, making this assessment crucial. While monitoring blood pressure, respiratory rate, and oxygen saturation are important nursing assessments, they are not the most critical when dopamine is being administered.

3. 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.

4. Which term refers to high blood pressure, a condition where the force of the blood against the artery walls is too high?

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

Correct answer: A

Rationale: The correct answer is A, Hypertension. Hypertension is a condition characterized by persistently high blood pressure, which increases the risk of heart disease and stroke. Choice B, Hypotension, refers to low blood pressure. Choice C, Hyperlipidemia, is the term for high levels of fats in the blood. Choice D, Diabetes, is a condition characterized by high blood sugar levels.

5. What is the condition where the heart's mitral valve does not close properly, allowing blood to leak backward into the left atrium?

• A. Mitral regurgitation
• B. Aortic stenosis
• C. Tricuspid regurgitation
• D. Pulmonary hypertension

Correct answer: A

Rationale: Mitral regurgitation is the condition where the heart's mitral valve does not close properly, allowing blood to leak backward into the left atrium. This can result in symptoms like shortness of breath and fatigue. Choices B, C, and D are incorrect because aortic stenosis, tricuspid regurgitation, and pulmonary hypertension involve different heart valves or conditions, not the mitral valve specifically.

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