Nursing Elites

1. The nurse is caring for a client on heparin. What is the most important lab value to monitor?

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

Correct answer: A

Rationale: The correct answer is A: aPTT. When a client is on heparin therapy, monitoring the aPTT is crucial. The aPTT helps assess the effectiveness of heparin in preventing blood clots and guides dose adjustments as needed. INR (Choice B) is more commonly used to monitor warfarin therapy. Platelet count (Choice C) is important to assess for potential bleeding disorders or thrombocytopenia but is not the primary lab value to monitor for heparin therapy. Hemoglobin (Choice D) is essential for assessing oxygen-carrying capacity but is not the most important lab value to monitor when a client is on heparin.

2. The nurse is caring for a client on digoxin with a heart rate of 48 bpm. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Administer atropine to increase the heart rate.
• D. Increase the dose of digoxin.

Correct answer: A

Rationale: In this scenario, the nurse's priority action should be to hold the digoxin and notify the healthcare provider. A heart rate of 48 bpm is low, and digoxin, being a medication that can further decrease the heart rate, should be withheld. Administering the digoxin as ordered (Choice B) would not be appropriate in this situation as it can exacerbate bradycardia. Atropine (Choice C) is not the initial treatment for this scenario; holding the digoxin is the first action. Increasing the dose of digoxin (Choice D) would be contraindicated due to the client's bradycardia. Therefore, the correct action is to hold the digoxin and inform the healthcare provider for further guidance.

3. Which heart chamber receives venous blood returning to the heart via the superior and inferior vena cava?

• A. Right atrium
• B. Left atrium
• C. Right ventricle
• D. Left ventricle

Correct answer: A

Rationale: The correct answer is A: Right atrium. The right atrium is the heart chamber that receives deoxygenated blood returning from the body via the superior and inferior vena cava. The blood enters the right atrium from the vena cava and then passes through the tricuspid valve into the right ventricle. Choices B, C, and D are incorrect because the left atrium receives oxygenated blood from the lungs, the right ventricle pumps blood to the lungs for oxygenation, and the left ventricle pumps oxygenated blood to the body.

4. What is the narrowing of the arteries due to the buildup of plaque, which can lead to heart attacks and strokes?

• A. Coronary artery disease
• B. Peripheral artery disease
• C. Aortic stenosis
• D. Mitral valve prolapse

Correct answer: A

Rationale: Coronary artery disease is the correct answer. It is the narrowing or blockage of the coronary arteries due to plaque buildup, which can lead to heart attacks and other cardiovascular issues. Choice B, Peripheral artery disease, involves the narrowing of arteries in the limbs, not specifically the coronary arteries. Choice C, Aortic stenosis, refers to the narrowing of the aortic valve opening, not the arteries. Choice D, Mitral valve prolapse, is a condition where the valve between the left atrium and left ventricle doesn't close properly, unrelated to arterial narrowing.

5. 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.

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