Nokea
The client on warfarin has an INR of 1.2. What is the nurse's priority action?
- A. Increase the dose of warfarin
- B. Administer vitamin K
- C. Monitor for signs of bleeding
- D. Hold the next dose and notify the healthcare provider
Correct Answer: A
Rationale: The correct answer is A: Increase the dose of warfarin. INR of 1.2 indicates subtherapeutic levels. The nurse's priority is to adjust the dose to achieve a therapeutic range (usually 2-3). Increasing the dose is essential to prevent clot formation. Administering vitamin K (B) is not indicated for a low INR. Monitoring for bleeding (C) is important, but not the priority when the INR is subtherapeutic. Holding the next dose and notifying the healthcare provider (D) may be necessary if the INR is too high, not low.
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Which condition involves the body's immune system attacking the lungs and kidneys, causing severe respiratory and renal damage?
- A. Goodpasture syndrome
- B. Sarcoidosis
- C. Wegener's granulomatosis
- D. Interstitial lung disease
Correct Answer: A
Rationale: Step-by-step rationale for A being correct:
1. Goodpasture syndrome is an autoimmune disease where the body produces antibodies against collagen in the lungs and kidneys.
2. Antibodies attack the basement membrane of the lungs and kidneys, leading to severe respiratory and renal damage.
3. Symptoms include coughing up blood, difficulty breathing, and kidney failure.
4. Treatment involves immunosuppressive therapy and plasma exchange to remove harmful antibodies.
Summary:
- B: Sarcoidosis involves granulomas in multiple organs but typically not lung-kidney damage.
- C: Wegener's granulomatosis affects the respiratory tract and kidneys but involves inflammation, not antibodies against collagen.
- D: Interstitial lung disease is a broad term for various lung conditions but doesn't specifically involve the immune system attacking lungs and kidneys.
This is a branch of the left coronary arteries which supplies the LEFT ATRIUM, posterior lateral surface of the left ventricle.
- A. Right coronary artery
- B. Left circumflex artery
- C. Left anterior descending artery
- D. Posterior descending artery
Correct Answer: B
Rationale: The correct answer is B, the Left circumflex artery. This artery branches off the left coronary artery and supplies the left atrium and the posterior lateral surface of the left ventricle. The Left anterior descending artery (C) supplies the anterior surface of the left ventricle. The Right coronary artery (A) supplies the right atrium and right ventricle. The Posterior descending artery (D) is a branch of the right coronary artery and supplies the posterior wall of the left ventricle. Therefore, B is the correct answer based on the specific areas supplied by each artery.
Which procedure is used to restore a normal heart rhythm in patients with arrhythmias, typically using electrical shocks?
- A. Cardioversion
- B. Defibrillation
- C. Ablation
- D. Angioplasty
Correct Answer: A
Rationale: Sure! Cardioversion is the correct answer because it is the procedure used to restore normal heart rhythm in patients with arrhythmias by delivering synchronized electrical shocks. This method is specifically used for irregular heart rhythms that are not immediately life-threatening. Defibrillation, while also using electrical shocks, is used for life-threatening arrhythmias such as ventricular fibrillation. Ablation involves the destruction of abnormal heart tissue causing arrhythmias, and angioplasty is a procedure to open blocked arteries, not related to restoring heart rhythm.
Which test measures how much and how quickly you can move air out of your lungs?
- A. Spirometry
- B. Peak flow meter
- C. Lung volume test
- D. Arterial blood gas
Correct Answer: A
Rationale: Spirometry is the correct answer because it measures the volume of air exhaled in a specific time frame, assessing lung function and capacity. It is commonly used to diagnose conditions like asthma and COPD. Peak flow meter measures only the maximum speed of exhalation, not volume. Lung volume test measures the total lung capacity, not the speed of air movement. Arterial blood gas measures oxygen and carbon dioxide levels in the blood, not lung function.
Mr. Ross experiences nausea and vomiting as the result of receiving large-volume irradiation to his thoracic region. Which is the best approach in planning to meet his nutritional needs?
- A. Plan for frequent small meals of palatable foods
- B. Offer Mr. Ross three balanced meals a day
- C. Determine Mr. Ross' caloric needs
- D. Ask the physician to prescribe an oral antiemetic for p.r.n. use
Correct Answer: A
Rationale: Frequent small meals can help manage nausea and improve intake compared to large meals.