Nursing Elites

1. Which procedure is used to remove excess fluid or air from the pleural space, helping to relieve pressure on the lungs?

• A. Thoracentesis
• B. Bronchoscopy
• C. Chest X-ray
• D. Arterial blood gas (ABG)

Correct answer: A

Rationale: The correct answer is Thoracentesis. Thoracentesis is a procedure specifically designed to remove excess fluid or air from the pleural space in the chest. This process helps to relieve pressure on the lungs and improve breathing. Bronchoscopy (Choice B) is a procedure used to visualize the airways and diagnose lung conditions, not to remove fluid from the pleural space. Chest X-ray (Choice C) is an imaging test that provides a picture of the structures inside the chest, including the lungs, heart, and bones. Arterial blood gas (ABG) test (Choice D) is a blood test that measures the levels of oxygen and carbon dioxide in the blood, providing information about how well the lungs are working, but it does not involve removing excess fluid or air from the pleural space.

2. Which of the following is a type of heart valve disease where the aortic valve becomes narrowed, restricting blood flow from the heart to the rest of the body?

• A. Aortic stenosis
• B. Mitral stenosis
• C. Tricuspid regurgitation
• D. Pulmonary hypertension

Correct answer: A

Rationale: The correct answer is Aortic stenosis. In aortic stenosis, the aortic valve becomes narrowed, which obstructs the blood flow from the heart to the rest of the body. This condition can lead to symptoms like chest pain, shortness of breath, and fainting. Mitral stenosis (choice B) involves narrowing of the mitral valve, not the aortic valve. Tricuspid regurgitation (choice C) is a condition where the tricuspid valve leaks, causing blood to flow backward in the heart. Pulmonary hypertension (choice D) is high blood pressure in the arteries of the lungs.

3. When administering furosemide (Lasix) to a client, which lab value is most important to monitor?

• A. Potassium
• B. Sodium
• C. Calcium
• D. Chloride

Correct answer: A

Rationale: When administering furosemide (Lasix), it is crucial to monitor potassium levels closely. Furosemide is a loop diuretic that can lead to potassium loss, potentially causing hypokalemia. Monitoring potassium levels helps prevent adverse effects associated with low potassium, such as cardiac arrhythmias. While monitoring sodium, calcium, and chloride levels may also be important in certain situations, potassium is the most critical to monitor when administering furosemide.

4. The client on warfarin has an INR of 4.5. 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. Monitor the client’s INR closely.

Correct answer: A

Rationale: An INR of 4.5 is elevated, indicating an increased risk of bleeding due to excessive anticoagulation. The most appropriate action for the nurse in this scenario is to administer vitamin K. Vitamin K helps reverse the anticoagulant effects of warfarin, thus lowering the INR and reducing the risk of bleeding. Holding the next dose of warfarin (choice B) is not sufficient to address the immediate high INR level. Increasing the dose of warfarin (choice C) would further elevate the INR, worsening the risk of bleeding. While monitoring the client's INR closely (choice D) is important, immediate action is required to address the critically high INR level, making the administration of vitamin K the priority intervention.

5. What test measures the electrical activity of the heart over a 24- or 48-hour period?

• A. Holter monitor
• B. Electrocardiogram
• C. Stress test
• D. Chest X-ray

Correct answer: A

Rationale: The correct answer is A, Holter monitor. A Holter monitor is a portable device that continuously records the heart's electrical activity over 24 to 48 hours, aiding in the diagnosis of arrhythmias and other heart conditions. Choice B, an Electrocardiogram, provides a snapshot of the heart's electrical activity at a specific point in time, not over an extended period like a Holter monitor. Choice C, a Stress test, measures how the heart responds to physical activity and is not used for continuous monitoring of electrical activity. Choice D, a Chest X-ray, is used to visualize the structures of the chest, not to measure the heart's electrical activity.

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