Nursing Elites

1. The nurse is caring for a client on amiodarone. What adverse effect is the nurse most concerned about?

• A. Pulmonary toxicity
• B. Liver toxicity
• C. Thyroid dysfunction
• D. Renal dysfunction

Correct answer: A

Rationale: The correct answer is A, Pulmonary toxicity. Amiodarone is known to cause pulmonary toxicity, which can be serious and even fatal in some cases. This adverse effect includes interstitial pneumonitis, pulmonary fibrosis, and acute respiratory distress syndrome. Monitoring for symptoms such as cough, dyspnea, and fever is crucial. Choices B, Liver toxicity, C, Thyroid dysfunction, and D, Renal dysfunction, are incorrect because while amiodarone can also affect the liver, thyroid, and kidneys, the most concerning adverse effect that requires immediate attention and monitoring is pulmonary toxicity.

2. 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.

3. Which of the following is a chronic condition characterized by difficulty breathing due to airflow obstruction, commonly associated with long-term smoking?

• A. Chronic obstructive pulmonary disease (COPD)
• B. Asthma
• C. Pulmonary hypertension
• D. Bronchitis

Correct answer: A

Rationale: The correct answer is A, Chronic obstructive pulmonary disease (COPD). COPD is a chronic lung condition characterized by persistent airflow obstruction, commonly linked to long-term smoking. Choice B, Asthma, is a chronic condition characterized by reversible airflow obstruction and airway inflammation triggered by various factors like allergens and irritants. Choice C, Pulmonary hypertension, is a condition characterized by high blood pressure in the arteries of the lungs. Choice D, Bronchitis, is an inflammation of the bronchial tubes that may be acute or chronic, but it is not typically associated with long-term smoking like COPD.

4. When administering enoxaparin (Lovenox) to a client, what is the most important lab value to monitor?

• A. Platelet count
• B. aPTT
• C. Hemoglobin
• D. INR

Correct answer: A

Rationale: The correct answer is A: Platelet count. When administering enoxaparin (Lovenox), it is crucial to monitor the platelet count because enoxaparin can cause a rare but serious side effect known as heparin-induced thrombocytopenia, which is a decrease in platelet count that can lead to increased risk of bleeding. Monitoring the platelet count allows for early detection of this potential complication. Choices B, C, and D are incorrect because aPTT, Hemoglobin, and INR are not the most important lab values to monitor specifically when administering enoxaparin.

5. The healthcare provider is administering IV nitroglycerin to a patient for chest pain. What is the most critical parameter to monitor?

• A. Heart rate
• B. Blood pressure
• C. Oxygen saturation
• D. Respiratory rate

Correct answer: B

Rationale: The correct answer is 'Blood pressure.' Nitroglycerin is a vasodilator that can cause a rapid drop in blood pressure, leading to hypotension. Monitoring the blood pressure is crucial to prevent potential complications such as hypotension-induced dizziness, syncope, or organ hypoperfusion. While heart rate, oxygen saturation, and respiratory rate are important parameters to monitor in a clinical setting, the immediate concern with IV nitroglycerin administration is the risk of hypotension, making blood pressure the most critical parameter to assess.

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