Nursing Elites

1. What procedure uses a catheter to open up a blocked or narrowed coronary artery, often involving the placement of a stent?

• A. Angioplasty
• B. Echocardiogram
• C. CT angiography
• D. Coronary artery bypass graft (CABG)

Correct answer: A

Rationale: The correct answer is Angioplasty. Angioplasty is a procedure that uses a catheter to open up a blocked or narrowed coronary artery, often involving the placement of a stent. Echocardiogram is a diagnostic test that uses sound waves to create images of the heart. CT angiography is a type of imaging test that looks at blood vessels, but it does not involve the placement of a stent. Coronary artery bypass graft (CABG) is a surgical procedure to improve blood flow to the heart muscle by bypassing blocked coronary arteries.

2. The client on amiodarone develops pulmonary fibrosis. What action should the nurse take?

• A. Notify the healthcare provider immediately.
• B. Continue the medication and monitor lung function.
• C. Discontinue the medication and start oxygen therapy.
• D. Reduce the dose and monitor respiratory status.

Correct answer: A

Rationale: When a client on amiodarone develops pulmonary fibrosis, a serious side effect, the immediate action the nurse should take is to notify the healthcare provider. This is crucial because pulmonary fibrosis can lead to severe respiratory compromise and requires prompt evaluation and management by the healthcare provider. Continuing the medication (choice B) can worsen the condition, and delaying action by reducing the dose and monitoring respiratory status (choice D) may not be appropriate given the seriousness of pulmonary fibrosis. Discontinuing the medication and starting oxygen therapy (choice C) may be necessary, but the priority is to notify the healthcare provider first for further assessment and guidance.

3. What procedure uses a catheter to open blocked coronary arteries and improve blood flow to the heart muscle?

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

Correct answer: A

Rationale: The correct answer is A, Angioplasty. Angioplasty is a procedure where a catheter is used to open blocked coronary arteries and may involve the insertion of a stent to improve blood flow to the heart muscle. Stent placement (B) is a related procedure but specifically refers to the insertion of a stent. Coronary artery bypass graft (CABG) (C) is a surgical procedure that uses blood vessels to bypass blocked coronary arteries. Valve replacement (D) is a different procedure that involves replacing a heart valve, not opening blocked coronary arteries.

4. The client on warfarin has an INR of 3.8. What is the most appropriate action by the nurse?

• A. Administer vitamin K.
• B. Hold the next dose of warfarin.
• C. Increase the dose of warfarin.
• D. Notify the healthcare provider immediately.

Correct answer: A

Rationale: An INR of 3.8 is elevated, indicating an increased risk of bleeding. Administering vitamin K can help reverse the effects of warfarin. Holding the next dose of warfarin would be appropriate if the INR was too high, but not as the first-line action. Increasing the dose of warfarin would worsen the situation by further increasing the INR. Notifying the healthcare provider is important, but immediate action to address the elevated INR is necessary.

5. Which order should the nurse question?

• A. The addition of a loop diuretic with digoxin.
• B. The addition of a beta blocker with digoxin.
• C. A digoxin dose of 0.125 mg per day.
• D. The addition of an ACE inhibitor with digoxin.

Correct answer: B

Rationale: The correct answer is B because adding a beta blocker to digoxin can potentiate the bradycardic effect of digoxin, leading to serious complications such as heart block. This combination requires caution as it can significantly slow down the heart rate. Choices A, C, and D are not the best options to question in this scenario. Loop diuretics are commonly used with digoxin, a digoxin dose of 0.125 mg per day is within the typical range, and ACE inhibitors are often prescribed alongside digoxin for managing heart conditions.

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