Nursing Elites

1. The healthcare provider is preparing to administer heparin to a client. What lab value should be monitored?

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

Correct answer: B

Rationale: The correct lab value that should be monitored when administering heparin is the aPTT (activated partial thromboplastin time). Heparin affects the intrinsic pathway of the coagulation cascade, and aPTT is a sensitive measure to assess the effectiveness of heparin therapy. Monitoring aPTT helps in adjusting the heparin dose to maintain the desired anticoagulant effect. PT/INR is more specific to monitor warfarin therapy, not heparin. Platelet count and hemoglobin levels are important parameters to assess bleeding tendencies and oxygen-carrying capacity but are not directly related to monitoring heparin therapy.

2. Which chronic condition is characterized by abnormally thickened heart muscle, making it harder for the heart to pump blood efficiently?

• A. Hypertrophic cardiomyopathy
• B. Dilated cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Ventricular hypertrophy

Correct answer: A

Rationale: Hypertrophic cardiomyopathy is the correct answer. In this condition, the heart muscle becomes abnormally thickened, leading to difficulties in pumping blood efficiently. Dilated cardiomyopathy (choice B) involves the enlargement of the heart chambers, not thickening of the heart muscle. Restrictive cardiomyopathy (choice C) is characterized by stiffening of the heart muscle, impairing its ability to fill properly. Ventricular hypertrophy (choice D) refers to the thickening of the heart's ventricle walls, which can result from various conditions, not solely hypertrophic cardiomyopathy.

3. Which of the following is a chronic condition where the heart muscle is weakened and unable to pump blood effectively, often leading to heart failure?

• A. Dilated cardiomyopathy
• B. Hypertrophic cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Myocarditis

Correct answer: A

Rationale: Dilated cardiomyopathy is characterized by the heart muscle being weakened and unable to pump blood effectively, ultimately resulting in heart failure. Choice B, Hypertrophic cardiomyopathy, involves the heart muscle becoming abnormally thick, reducing the heart's efficiency. Choice C, Restrictive cardiomyopathy, refers to the heart becoming rigid and less able to fill with blood properly. Myocarditis, as in Choice D, is inflammation of the heart muscle usually caused by a viral infection and is different from the chronic weakening seen in dilated cardiomyopathy.

4. This term refers to a change in the inotropic state of the muscle without a change in myocardial fiber length.

• A. Contractility
• B. Excitability
• C. Refractoriness
• D. Automaticity

Correct answer: A

Rationale: The correct answer is A: Contractility. Contractility specifically refers to the change in the force of contraction of the heart muscle without changing its length. In this scenario, the focus is on the change in the inotropic state of the muscle, which directly relates to contractility. Choice B, Excitability, refers to the ability of a cell to respond to a stimulus, not specifically related to changes in contractile force. Choice C, Refractoriness, pertains to the period during which a cell is unresponsive to a new stimulus. Choice D, Automaticity, refers to the ability of cardiac cells to spontaneously generate electrical impulses.

5. 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.

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