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. What type of medication is used to reduce inflammation in the airways and prevent asthma attacks?

• A. Corticosteroid
• B. Bronchodilator
• C. Antihistamine
• D. Mucolytic

Correct answer: A

Rationale: The correct answer is A, Corticosteroid. Corticosteroids are medications that work by reducing inflammation in the airways, helping to prevent asthma attacks and manage chronic respiratory conditions. Bronchodilators (choice B) work by relaxing the muscles around the airways to make breathing easier, but they do not primarily target inflammation. Antihistamines (choice C) are used to treat allergic reactions and do not directly target airway inflammation. Mucolytics (choice D) help to break down and thin mucus in the airways but do not reduce inflammation.

3. The client is on a calcium channel blocker. What is the expected effect on the heart?

• A. Increased heart rate
• B. Decreased heart rate
• C. Increased blood pressure
• D. Decreased blood pressure

Correct answer: D

Rationale: When a client is on a calcium channel blocker, the expected effect on the heart is a decreased heart rate and decreased blood pressure. Calcium channel blockers work by dilating blood vessels and reducing the heart's workload, resulting in decreased blood pressure. Choice A, increased heart rate, is incorrect as calcium channel blockers actually have a negative chronotropic effect, reducing the heart rate. Choice C, increased blood pressure, is also incorrect because these medications are used to lower blood pressure.

4. Which term describes a type of abnormal heart rhythm characterized by rapid and irregular beating of the atria?

• A. Atrial fibrillation
• B. Ventricular fibrillation
• C. Atrial flutter
• D. Sinus tachycardia

Correct answer: A

Rationale: The correct answer is Atrial fibrillation. Atrial fibrillation is indeed a type of abnormal heart rhythm characterized by rapid and irregular beating of the atria. This condition can increase the risk of stroke and heart failure. Choice B, Ventricular fibrillation, is incorrect because it refers to a life-threatening arrhythmia that occurs in the ventricles, not the atria. Choice C, Atrial flutter, is incorrect as it describes a different type of atrial arrhythmia characterized by a regular but fast heartbeat. Choice D, Sinus tachycardia, is incorrect because it is a normal increase in heart rate originating from the sinus node, not an abnormal rhythm.

5. A client on a beta blocker has a heart rate of 52 bpm. What is the nurse’s priority action?

• A. Hold the beta blocker and notify the healthcare provider.
• B. Administer the beta blocker as ordered.
• C. Increase the dose of the beta blocker.
• D. Continue to monitor the client and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the beta blocker and notify the healthcare provider. A heart rate of 52 bpm is low, and beta blockers can further decrease the heart rate, potentially causing harm. Therefore, withholding the medication and promptly informing the healthcare provider is crucial for further assessment and possible adjustment of the treatment plan. Administering the beta blocker as ordered (Choice B) can exacerbate the bradycardia. Increasing the dose of the beta blocker (Choice C) would further suppress the heart rate. Continuing to monitor the client and reassessing in 30 minutes (Choice D) might delay necessary interventions and increase the risk of complications in a client with a heart rate of 52 bpm.

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