Nursing Elites

1. The nurse is giving nitroglycerin sublingually for chest pain. What is the most important instruction to give to the client?

• A. Place the tablet under the tongue and let it dissolve completely.
• B. Swallow the tablet whole with a glass of water.
• C. Chew the tablet and then swallow it.
• D. Take one tablet every 5 minutes until pain is relieved.

Correct answer: A

Rationale: The correct answer is A. The tablet should be placed under the tongue and allowed to dissolve completely to ensure rapid absorption. This route of administration allows the medication to be quickly absorbed into the bloodstream. Choice B is incorrect because nitroglycerin is meant to be absorbed sublingually, not swallowed. Choice C is incorrect as chewing the tablet can cause the medication to be rapidly absorbed, leading to adverse effects like a drop in blood pressure. Choice D is incorrect because the client should take only one tablet every 5 minutes up to a maximum of three tablets for chest pain relief.

2. What is a condition where a blood clot forms in a vein, often in the legs, which can cause pain and swelling and may lead to serious complications if it travels to the lungs?

• A. Deep vein thrombosis (DVT)
• B. Pulmonary embolism
• C. Varicose veins
• D. Aneurysm

Correct answer: A

Rationale: Deep vein thrombosis (DVT) is the correct answer. It is a condition where a blood clot forms in a deep vein, usually in the legs. If the clot breaks loose and travels to the lungs, it can cause a pulmonary embolism. Varicose veins are enlarged, twisted veins that are not typically associated with blood clots. Aneurysm is the abnormal swelling or bulging of a blood vessel.

3. What test uses high-frequency sound waves to create images of the heart, allowing doctors to assess its structure and function?

• A. Echocardiogram
• B. MRI
• C. CT scan
• D. X-ray

Correct answer: A

Rationale: The correct answer is an echocardiogram. An echocardiogram utilizes high-frequency sound waves (ultrasound) to create images of the heart, enabling doctors to evaluate its structure, function, and detect any abnormalities. MRI (Choice B) uses magnetic fields and radio waves to produce detailed images of the body's structures. CT scan (Choice C) combines X-rays and computer technology to create cross-sectional images of the body. X-ray (Choice D) uses electromagnetic radiation to produce images of the internal structures of the body, but it is not the most suitable for assessing the heart's structure and function.

4. The client on warfarin has an INR of 1.2. What is the nurse’s priority action?

• A. Increase the dose of warfarin
• B. Administer vitamin K
• C. Monitor for signs of bleeding
• D. Hold the next dose and notify the healthcare provider

Correct answer: A

Rationale: The correct answer is to increase the dose of warfarin. An INR of 1.2 is below the therapeutic range for a client on warfarin, indicating that the dose is subtherapeutic. The priority action in this situation is to adjust the dose to achieve the target therapeutic INR range (usually 2-3) to prevent thromboembolic events. Administering vitamin K is not necessary as the INR is low, and there are no signs of bleeding. Monitoring for signs of bleeding is important but not the priority in this case since the INR is subtherapeutic. Holding the next dose and notifying the healthcare provider would delay the intervention needed to adjust the dose and achieve the therapeutic range.

5. What is a chronic condition where the bronchial tubes in the lungs become inflamed and narrowed, often caused by smoking?

• A. Chronic bronchitis
• B. Emphysema
• C. Asthma
• D. Tuberculosis

Correct answer: A

Rationale: Chronic bronchitis is the correct answer because it is a long-term condition characterized by inflammation and narrowing of the bronchial tubes in the lungs, commonly triggered by smoking. Emphysema involves damage to the air sacs in the lungs, not specifically the bronchial tubes. Asthma is a condition of reversible airway obstruction usually due to allergies or other triggers, not solely smoking. Tuberculosis is a bacterial infection that primarily affects the lungs but is not directly related to inflammation and narrowing of the bronchial tubes.

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