Nursing Elites

1. Which heart chamber ejects blood into the lungs via the pulmonary artery?

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

Correct answer: C

Rationale: The correct answer is C, the right ventricle. The right ventricle is responsible for pumping deoxygenated blood into the lungs through the pulmonary artery for oxygenation. Choices A, B, and D are incorrect because the right atrium receives deoxygenated blood from the body, the left atrium receives oxygenated blood from the lungs, and the left ventricle pumps oxygenated blood to the body, respectively.

2. What is this surgical procedure that restores blood flow to the heart by diverting blood around a blocked artery?

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

Correct answer: A

Rationale: The correct answer is A, Coronary artery bypass graft (CABG), which is a surgical procedure to improve blood flow to the heart by redirecting blood around blocked or narrowed arteries. This procedure is specifically designed to bypass blocked coronary arteries, allowing blood to flow more freely to the heart muscle. Choices B, C, and D are incorrect because angioplasty involves opening up narrowed or blocked blood vessels, stent placement involves inserting a mesh tube to keep arteries open, and valve replacement involves replacing a damaged heart valve - none of which directly address diverting blood flow around a blocked artery.

3. The client on spironolactone (Aldactone) has a potassium level of 5.6 mEq/L. What is the nurse’s priority action?

• A. Hold the spironolactone and notify the healthcare provider.
• B. Administer potassium supplements.
• C. Continue the spironolactone as ordered.
• D. Increase the dose of spironolactone.

Correct answer: A

Rationale: The correct answer is A: Hold the spironolactone and notify the healthcare provider. A potassium level of 5.6 mEq/L is high, indicating hyperkalemia. Spironolactone is a potassium-sparing diuretic that can further elevate potassium levels. Therefore, the priority action is to withhold the medication to prevent exacerbating hyperkalemia and notify the healthcare provider for further management. Option B is incorrect because administering potassium supplements would worsen the hyperkalemia. Option C is incorrect as continuing spironolactone can lead to a further increase in potassium levels. Option D is incorrect as increasing the dose of spironolactone would be inappropriate in the presence of elevated potassium levels.

4. The client is on warfarin and has an INR of 1.5. What is the nurse’s priority action?

• A. Increase the dose of warfarin.
• B. Hold the next dose of warfarin.
• C. Continue the current dose of warfarin.
• D. Monitor the client’s INR closely.

Correct answer: B

Rationale: An INR of 1.5 is below the therapeutic range for a client on warfarin, indicating that the client may be at risk of clot formation. The nurse's priority action should be to hold the next dose of warfarin to prevent further reduction of the INR. Increasing the dose could potentially lead to an increased risk of bleeding, and continuing the current dose may not be sufficient to bring the INR within the therapeutic range. Monitoring the client's INR closely is important but not the priority action in this scenario.

5. 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.

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