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. What is a condition where the heart is unable to relax properly between beats, reducing its ability to fill with blood?

• A. Diastolic heart failure
• B. Systolic heart failure
• C. Hypertrophic cardiomyopathy
• D. Restrictive cardiomyopathy

Correct answer: A

Rationale: The correct answer is A: Diastolic heart failure. In diastolic heart failure, the heart is unable to relax properly between beats, leading to a reduced ability to fill with blood. This condition primarily affects the heart's filling function rather than its pumping function, which is characteristic of systolic heart failure (choice B). Hypertrophic cardiomyopathy (choice C) involves the abnormal thickening of the heart muscle, while restrictive cardiomyopathy (choice D) is characterized by the heart muscle becoming stiff and less compliant. Therefore, choices B, C, and D are incorrect in the context of a heart condition where relaxation between beats is impaired.

3. What procedure uses a balloon to open narrowed or blocked blood vessels in the heart?

• A. Angioplasty
• B. Coronary artery bypass graft
• C. Stent placement
• D. Valve replacement

Correct answer: A

Rationale: The correct answer is Angioplasty. Angioplasty is a procedure that involves using a balloon to open narrowed or blocked blood vessels in the heart, thereby improving blood flow. This choice is correct because it directly matches the description provided in the question. Choices B, C, and D are incorrect because they involve different procedures: Bypass graft is a surgical procedure to redirect blood flow, stent placement involves inserting a mesh tube to keep an artery open, and valve replacement is the surgical replacement of a heart valve.

4. The client on furosemide (Lasix) has a potassium level of 3.1 mEq/L. What is the nurse’s priority action?

• A. Administer a potassium supplement.
• B. Hold the furosemide and notify the healthcare provider.
• C. Continue the current dose of furosemide.
• D. Administer Digibind.

Correct answer: A

Rationale: The correct answer is to administer a potassium supplement. A potassium level of 3.1 mEq/L indicates hypokalemia, which can lead to serious complications like cardiac dysrhythmias. Therefore, the priority action is to address the low potassium level by administering a potassium supplement. Holding the furosemide (Choice B) may be necessary in the long term to prevent further potassium loss, but the immediate need is to correct the low potassium level. Continuing the current dose of furosemide (Choice C) without addressing the low potassium level can worsen hypokalemia. Administering Digibind (Choice D) is not indicated for low potassium levels; Digibind is used to treat digoxin toxicity.

5. When monitoring a client on dobutamine, what is the most important parameter to assess?

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

Correct answer: A

Rationale: The correct answer is A: Blood pressure. When a client is on dobutamine, it is crucial to closely monitor their blood pressure as dobutamine can cause significant changes in blood pressure. While heart rate is also important to monitor during this time, blood pressure is the most critical parameter to assess. Oxygen saturation and respiratory rate are also important parameters to monitor in a patient receiving dobutamine, but they are not as crucial as blood pressure in this scenario.

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