Nursing Elites

1. The client on warfarin has an INR of 3.8. 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. Notify the healthcare provider immediately.

Correct answer: A

Rationale: An INR of 3.8 is elevated, indicating an increased risk of bleeding. Administering vitamin K can help reverse the effects of warfarin. Holding the next dose of warfarin would be appropriate if the INR was too high, but not as the first-line action. Increasing the dose of warfarin would worsen the situation by further increasing the INR. Notifying the healthcare provider is important, but immediate action to address the elevated INR is necessary.

2. Which condition is characterized by chest pain due to reduced blood flow to the heart muscle?

• A. Angina
• B. Myocardial infarction
• C. Pericarditis
• D. Arrhythmia

Correct answer: A

Rationale: The correct answer is A, Angina. Angina is chest pain or discomfort caused by reduced blood flow to the heart muscle, often due to coronary artery disease. Choice B, Myocardial infarction, involves the death of heart muscle tissue due to a lack of blood supply, presenting with symptoms similar to angina but more severe. Pericarditis (Choice C) is inflammation of the pericardium, the sac surrounding the heart, which may cause chest pain but is not primarily due to reduced blood flow. Arrhythmia (Choice D) refers to abnormal heart rhythms but is not directly related to chest pain due to reduced blood flow.

3. What is the term for the ability of cardiac cells to respond to a stimulus by initiating a cardiac impulse?

• A. Excitability
• B. Contractility
• C. Rhythmicity
• D. Conductivity

Correct answer: A

Rationale: The correct answer is A, Excitability. Excitability is the ability of cardiac cells to respond to a stimulus by initiating a cardiac impulse. Choice B, Contractility, refers to the ability of cardiac muscle to shorten forcibly. Choice C, Rhythmicity, refers to the cardiac muscle's ability to contract rhythmically. Choice D, Conductivity, refers to the ability of the heart's cells to conduct electrical impulses.

4. What is a surgical procedure to remove one of the lobes of the lungs, often performed to treat lung cancer?

• A. Lobectomy
• B. Pneumonectomy
• C. Thoracotomy
• D. Tracheostomy

Correct answer: A

Rationale: A lobectomy is the correct answer. This surgical procedure involves removing one of the lobes of the lungs, commonly done to treat lung cancer or other serious lung ailments. Choice B, pneumonectomy, involves the complete removal of a lung, not just a lobe. Choice C, thoracotomy, is a surgical incision into the chest wall and is not specific to removing a lung lobe. Choice D, tracheostomy, is the creation of an opening in the windpipe to assist with breathing and is unrelated to lung lobe removal.

5. What is a condition where the heart's electrical impulses are delayed or blocked, leading to a slower or irregular heartbeat?

• A. Heart block
• B. Tachycardia
• C. Bradycardia
• D. Arrhythmia

Correct answer: A

Rationale: Heart block is the correct answer because it specifically refers to a condition where the heart's electrical impulses are delayed or blocked, resulting in a slower or irregular heartbeat. Tachycardia (choice B) is a condition characterized by a fast heart rate, Bradycardia (choice C) is a slow heart rate, and Arrhythmia (choice D) is a general term used to describe any abnormal heart rhythm, which may or may not involve delays or blocks in electrical impulses.

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