Nursing Elites

1. The client on warfarin has an INR of 5.5. What is the priority nursing action?

• A. Administer vitamin K as an antidote.
• B. Hold the next dose of warfarin.
• C. Increase the dose of warfarin.
• D. Administer fresh frozen plasma.

Correct answer: A

Rationale: An INR of 5.5 is significantly elevated, indicating an increased risk of bleeding. The priority nursing action in this situation is to administer vitamin K as an antidote to reverse the effects of warfarin and lower the INR. Holding the next dose of warfarin (choice B) is important but not as immediate as administering vitamin K. Increasing the dose of warfarin (choice C) would further elevate the INR, worsening the bleeding risk. Administering fresh frozen plasma (choice D) is not the first-line treatment for high INR due to warfarin.

2. What test measures the electrical activity of the heart over a 24- or 48-hour period?

• A. Holter monitor
• B. Electrocardiogram
• C. Stress test
• D. Chest X-ray

Correct answer: A

Rationale: The correct answer is A, Holter monitor. A Holter monitor is a portable device that continuously records the heart's electrical activity over 24 to 48 hours, aiding in the diagnosis of arrhythmias and other heart conditions. Choice B, an Electrocardiogram, provides a snapshot of the heart's electrical activity at a specific point in time, not over an extended period like a Holter monitor. Choice C, a Stress test, measures how the heart responds to physical activity and is not used for continuous monitoring of electrical activity. Choice D, a Chest X-ray, is used to visualize the structures of the chest, not to measure the heart's electrical activity.

3. Which term refers to a condition where the blood supply to part of the heart muscle is blocked, often referred to as a heart attack?

• A. Myocardial infarction
• B. Arrhythmia
• C. Stroke
• D. Aneurysm

Correct answer: A

Rationale: The correct answer is A, myocardial infarction. A myocardial infarction, commonly known as a heart attack, occurs when the blood supply to part of the heart muscle is blocked, often by a blood clot. Choices B, C, and D are incorrect because arrhythmia refers to an irregular heartbeat, stroke involves the interruption of blood flow to the brain, and an aneurysm is a bulge in a blood vessel.

4. What is a condition where the heart beats too fast, reducing its ability to pump blood effectively?

• A. Tachycardia
• B. Bradycardia
• C. Arrhythmia
• D. Ventricular fibrillation

Correct answer: A

Rationale: Tachycardia is the correct answer because it is a condition characterized by a fast heart rate, which can decrease the heart's efficiency in pumping blood. Bradycardia, on the other hand, refers to a slow heart rate, which is the opposite of what is described in the question. Arrhythmia is a general term for any irregularity in the heart's rhythm, not necessarily specifically related to a fast heart rate. Ventricular fibrillation is a life-threatening arrhythmia where the heart's lower chambers quiver instead of pumping blood effectively, but it is not specifically characterized by a fast heart rate.

5. What is the condition where the blood flow through the coronary arteries is reduced or blocked, leading to chest pain or heart attack?

• A. Coronary artery disease
• B. Atherosclerosis
• C. Pulmonary embolism
• D. Pulmonary hypertension

Correct answer: A

Rationale: The correct answer is A, Coronary artery disease (CAD). CAD occurs when the coronary arteries are narrowed or blocked, reducing blood flow to the heart muscle and increasing the risk of chest pain or heart attack. Choice B, Atherosclerosis, is a condition characterized by the hardening and narrowing of arteries due to the buildup of plaque. Choices C and D, Pulmonary embolism and Pulmonary hypertension, involve issues related to the lungs and not the coronary arteries.

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