Nursing Elites

1. The client on warfarin has an INR of 1.2. What is the nurse’s priority action?

• A. Increase the dose of warfarin
• B. Administer vitamin K
• C. Monitor for signs of bleeding
• D. Hold the next dose and notify the healthcare provider

Correct answer: A

Rationale: The correct answer is to increase the dose of warfarin. An INR of 1.2 is below the therapeutic range for a client on warfarin, indicating that the dose is subtherapeutic. The priority action in this situation is to adjust the dose to achieve the target therapeutic INR range (usually 2-3) to prevent thromboembolic events. Administering vitamin K is not necessary as the INR is low, and there are no signs of bleeding. Monitoring for signs of bleeding is important but not the priority in this case since the INR is subtherapeutic. Holding the next dose and notifying the healthcare provider would delay the intervention needed to adjust the dose and achieve the therapeutic range.

2. What is a chronic condition where the bronchial tubes in the lungs become inflamed and narrowed, often caused by smoking?

• A. Chronic bronchitis
• B. Emphysema
• C. Asthma
• D. Tuberculosis

Correct answer: A

Rationale: Chronic bronchitis is the correct answer because it is a long-term condition characterized by inflammation and narrowing of the bronchial tubes in the lungs, commonly triggered by smoking. Emphysema involves damage to the air sacs in the lungs, not specifically the bronchial tubes. Asthma is a condition of reversible airway obstruction usually due to allergies or other triggers, not solely smoking. Tuberculosis is a bacterial infection that primarily affects the lungs but is not directly related to inflammation and narrowing of the bronchial tubes.

3. What term refers to the degree of myocardial fiber stretch before contraction, related to the volume of blood distending the ventricles at the end of diastole, and determined by the amount of venous return?

• A. Preload
• B. Afterload
• C. Contractility
• D. Ejection fraction

Correct answer: A

Rationale: The correct answer is A: Preload. Preload is the degree of myocardial fiber stretch before contraction, influenced by the volume of blood returning to the heart. This parameter is related to the amount of blood in the ventricles at the end of diastole. Choice B, Afterload, refers to the pressure or resistance that the ventricles must overcome to eject blood. Choice C, Contractility, is the intrinsic ability of the heart muscle to contract. Choice D, Ejection fraction, is the percentage of blood pumped out of the ventricles with each contraction.

4. What term describes a condition where a person experiences difficulty breathing when lying flat and requires multiple pillows to sleep comfortably?

• A. Orthopnea
• B. Dyspnea
• C. Tachypnea
• D. Bradypnea

Correct answer: A

Rationale: The correct answer is A, Orthopnea. Orthopnea is a condition where a person finds it hard to breathe while lying flat and needs to use multiple pillows to sleep comfortably. This position helps relieve the discomfort by allowing better lung expansion. Choice B, Dyspnea, refers to difficulty breathing in general, not specifically related to lying flat. Choice C, Tachypnea, is rapid breathing and is not directly related to difficulty breathing while lying down. Choice D, Bradypnea, is slow breathing and does not describe the condition of having trouble breathing when lying flat.

5. What condition is characterized by narrowed or blocked arteries in the legs or arms, leading to pain and mobility issues?

• A. Peripheral artery disease
• B. Atherosclerosis
• C. Raynaud's disease
• D. Varicose veins

Correct answer: A

Rationale: The correct answer is A: Peripheral artery disease (PAD). PAD is a condition where the arteries in the legs or arms become narrowed or blocked, leading to pain and mobility issues. Choice B, Atherosclerosis, refers to the buildup of fats, cholesterol, and other substances in and on the artery walls, not specifically the narrowing or blockage in the extremities. Choice C, Raynaud's disease, is characterized by reduced blood flow to the extremities, leading to coldness, numbness, and color changes in the skin, but it is not primarily about narrowed or blocked arteries. Choice D, Varicose veins, involves enlarged, twisted veins usually in the legs, but it is not related to narrowed or blocked arteries causing pain and mobility issues.

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