Nursing Elites

1. The client is being taught about the use of warfarin. What is the most important dietary instruction?

• A. Avoid foods high in vitamin K.
• B. Increase the intake of vitamin K-rich foods.
• C. Avoid foods high in protein.
• D. Increase the intake of foods high in calcium.

Correct answer: A

Rationale: The correct answer is A: Avoid foods high in vitamin K. Warfarin is a medication that works by decreasing the activity of vitamin K in the body to prevent blood clotting. Therefore, consuming foods high in vitamin K like green leafy vegetables can interfere with the medication's effectiveness. Choices B, C, and D are incorrect. Increasing the intake of vitamin K-rich foods would counteract the effects of warfarin. Avoiding foods high in protein or increasing the intake of foods high in calcium are not specifically related to the use of warfarin.

2. What is the procedure to remove a sample of tissue from the lung for examination under a microscope?

• A. Lung biopsy
• B. Bronchoscopy
• C. Thoracentesis
• D. Lobectomy

Correct answer: A

Rationale: The correct answer is A, lung biopsy. A lung biopsy involves removing a small sample of lung tissue for examination under a microscope to diagnose lung conditions. Choice B, bronchoscopy, is a procedure where a thin, flexible tube with a light and camera is inserted into the airways to view the lungs. This procedure is more for diagnostic purposes and not specifically for tissue removal. Choice C, thoracentesis, is a procedure to remove fluid from the pleural space around the lungs for diagnostic or therapeutic purposes, not for tissue biopsy. Choice D, lobectomy, is a surgical procedure to remove a lobe of the lung, usually done to treat conditions like lung cancer or severe infections, but it does not involve removing tissue for microscopic examination.

3. Which neurotransmitter is released by the sympathetic nervous system (SNS) to increase heart rate and the force of contraction of the heart?

• A. Norepinephrine
• B. Epinephrine
• C. Dopamine
• D. Acetylcholine

Correct answer: A

Rationale: The correct answer is Norepinephrine. Norepinephrine is the neurotransmitter released by the sympathetic nervous system that increases heart rate and the force of contraction. Epinephrine, though similar, is more involved in the fight-or-flight response and has a broader range of effects on various organs. Dopamine is not primarily responsible for increasing heart rate and contractility. Acetylcholine is a neurotransmitter that predominantly acts on the parasympathetic nervous system to decrease heart rate and contractility.

4. 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.

5. Which surgical procedure involves opening or replacing a narrowed or blocked heart valve?

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

Correct answer: A

Rationale: Valve replacement is the correct answer because it specifically involves surgically replacing a damaged or diseased heart valve with a prosthetic valve to address narrowing or blockage, thereby improving blood flow and heart function. Angioplasty (choice B) is a procedure to widen narrowed or obstructed arteries, typically using a balloon catheter. Stent placement (choice C) involves inserting a mesh tube to support a weakened artery. Coronary bypass surgery (choice D) is a procedure to create new routes for blood flow to the heart muscle by bypassing blocked arteries.

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