Nursing Elites

1. Which condition is characterized by fluid collection in the lungs, making it difficult to breathe?

• A. Pulmonary edema
• B. Pleurisy
• C. Pleural effusion
• D. Pneumothorax

Correct answer: A

Rationale: The correct answer is A, Pulmonary edema. Pulmonary edema is a condition where fluid accumulates in the air sacs of the lungs, causing breathing difficulty. Pleurisy (choice B) is inflammation of the pleura causing chest pain. Pleural effusion (choice C) is the buildup of excess fluid in the pleural space, the area between the layers of tissue that line the lungs and chest cavity. Pneumothorax (choice D) is the presence of air in the pleural space, which can cause a lung to collapse.

2. The nurse is caring for a client with atrial fibrillation on dabigatran (Pradaxa). What is the most important instruction to give to the client?

• A. Take the medication with food to prevent stomach upset.
• B. Do not miss a dose and take it at the same time each day.
• C. Avoid consuming alcohol while on this medication.
• D. Monitor for signs of bleeding.

Correct answer: B

Rationale: The most important instruction to give to a client on dabigatran (Pradaxa) is not to miss a dose and take it at the same time each day. This is crucial for maintaining the anticoagulant effect of the medication. Choice A is not necessary as dabigatran does not need to be taken with food. Choice C is important but not as crucial as ensuring proper dosing. Choice D is also important but falls behind in priority compared to maintaining consistent dosing.

3. What term describes the phenomenon wherein decreased BP causes a reflex SNS response with increased pulse, increased contractility, and vasoconstriction; and increased BP causes reflex vagal responses resulting in decreased heart rate and passive vasodilation in the systemic arterioles?

• A. Baroreflex
• B. Cheyne-Stokes breathing
• C. Frank-Starling Law
• D. Starling reflex

Correct answer: A

Rationale: The correct answer is A: Baroreflex. The Baroreflex is a mechanism by which the body maintains blood pressure homeostasis through reflexive adjustments in heart rate and vascular tone. Choice B, Cheyne-Stokes breathing, is a pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing. Choices C and D, Frank-Starling Law and Starling reflex, are related to the intrinsic ability of the heart to adjust its output based on venous return, not specifically regulating blood pressure through reflex adjustments in heart rate and vascular tone as seen in the described phenomenon.

4. Which condition is characterized by an inability to effectively pump blood, leading to fluid buildup and swelling in the body?

• A. Heart failure
• B. Cardiomyopathy
• C. Angina
• D. Myocarditis

Correct answer: A

Rationale: Heart failure is the correct answer. It is a condition where the heart is unable to pump blood effectively, resulting in fluid accumulation and swelling in the body. Cardiomyopathy is a disease of the heart muscle that affects its ability to pump blood but is not the specific condition described in the question. Angina is chest pain or discomfort caused by reduced blood flow to the heart, not directly related to fluid buildup and swelling. Myocarditis is inflammation of the heart muscle and does not necessarily involve the inability to pump blood effectively.

5. When administering enoxaparin (Lovenox) to a client, what is the most important lab value to monitor?

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

Correct answer: A

Rationale: The correct answer is A: Platelet count. When administering enoxaparin (Lovenox), it is crucial to monitor the platelet count because enoxaparin can cause a rare but serious side effect known as heparin-induced thrombocytopenia, which is a decrease in platelet count that can lead to increased risk of bleeding. Monitoring the platelet count allows for early detection of this potential complication. Choices B, C, and D are incorrect because aPTT, Hemoglobin, and INR are not the most important lab values to monitor specifically when administering enoxaparin.

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