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. Which type of medication is used to reduce the workload on the heart by slowing down the heart rate and lowering blood pressure?

• A. Beta-blocker
• B. ACE inhibitor
• C. Calcium channel blocker
• D. Diuretic

Correct answer: A

Rationale: The correct answer is A: Beta-blocker. Beta-blockers are medications that reduce the workload on the heart by slowing down the heart rate and lowering blood pressure. They are commonly used in the treatment of heart conditions such as hypertension and heart failure. ACE inhibitors (B) work by dilating blood vessels to reduce blood pressure, calcium channel blockers (C) prevent calcium from entering the heart muscle and blood vessel walls, and diuretics (D) help the body get rid of excess salt and water by increasing urine production.

3. What is the term that describes the inability of cardiac cells to respond to a new stimulus while they are still in contraction from a previous stimulus?

• A. Refractoriness
• B. Excitability
• C. Contractility
• D. Automaticity

Correct answer: A

Rationale: Refractoriness is the correct term to describe the inability of cardiac cells to respond to a new stimulus while they are still in contraction from a previous stimulus. This period is essential for the heart to complete its contraction and relaxation phases without interference. Excitability refers to the ability of cells to respond to stimuli, not the inability to respond. Contractility is the force of cardiac muscle contraction, and automaticity is the ability of cardiac cells to generate electrical impulses spontaneously, which are not relevant to the described scenario.

4. What is the condition where the heart's mitral valve becomes narrowed, restricting blood flow from the left atrium to the left ventricle?

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

Correct answer: A

Rationale: Mitral stenosis is the correct answer. It is a condition characterized by the narrowing of the heart's mitral valve, which hinders the flow of blood from the left atrium to the left ventricle. This obstruction can lead to symptoms such as shortness of breath and fatigue. Aortic stenosis (choice B) is the narrowing of the aortic valve, not the mitral valve. Tricuspid regurgitation (choice C) is the backflow of blood through the tricuspid valve, not narrowing. Pulmonary hypertension (choice D) is increased blood pressure in the pulmonary arteries, not narrowing of the mitral valve.

5. Which test measures how much and how quickly you can move air out of your lungs?

• A. Spirometry
• B. Peak flow meter
• C. Lung volume test
• D. Arterial blood gas

Correct answer: A

Rationale: The correct answer is A, Spirometry. Spirometry is a common pulmonary function test that measures lung function by assessing the amount (volume) and speed (flow) of air that can be inhaled and exhaled. This test helps in diagnosing conditions like asthma, chronic obstructive pulmonary disease (COPD), and other lung diseases. Peak flow meter (choice B) measures the maximum speed at which a person can exhale air, mainly used in asthma management. Lung volume test (choice C) evaluates the total amount of air the lungs can hold. Arterial blood gas (choice D) measures the levels of oxygen and carbon dioxide in the blood, providing information on how well the lungs are functioning in gas exchange, but it does not specifically measure the amount and speed of air movement in and out of the lungs like spirometry does.

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