Nokea
The client on furosemide is at risk for which electrolyte imbalance?
- A. Hypokalemia
- B. Hypernatremia
- C. Hyperkalemia
- D. Hyponatremia
Correct Answer: A
Rationale: The correct answer is A: Hypokalemia. Furosemide is a loop diuretic that increases potassium excretion in the urine, leading to low potassium levels (hypokalemia). This can cause muscle weakness, cramps, and cardiac arrhythmias. Hypernatremia (B) is high sodium levels, unrelated to furosemide. Hyperkalemia (C) is the opposite of what furosemide causes. Hyponatremia (D) is low sodium levels, not typically associated with furosemide use.
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Receiving a report that Mr. K.'s prothrombin time (PT) is 4-4.5 times normal, your nursing action would be to
- A. call Mr. K.'s physician to report the PT
- B. stop the heparin infusion
- C. increase the heparin infusion by 10 mg/hr
- D. nothing, as the value is therapeutic
Correct Answer: A
Rationale: An elevated PT indicates potential bleeding risk, necessitating immediate medical review.
The nurse is giving the client digoxin for heart failure and recognizes that the drug has what type of effect on the heart?
- A. Negative inotropic, negative chronotropic effect
- B. Positive inotropic, negative chronotropic effect
- C. Negative inotropic, positive chronotropic effect
- D. Positive inotropic, positive chronotropic effect
Correct Answer: B
Rationale: The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin is a positive inotrope, meaning it increases the force of myocardial contraction, which helps improve cardiac output in heart failure. It has a negative chronotropic effect, meaning it decreases the heart rate by slowing down the electrical conduction in the heart, which can be beneficial in certain heart conditions.
Choice A (Negative inotropic, negative chronotropic effect) is incorrect because digoxin is a positive inotrope, not a negative inotrope. Choice C (Negative inotropic, positive chronotropic effect) is incorrect because digoxin does not have a positive chronotropic effect. Choice D (Positive inotropic, positive chronotropic effect) is incorrect because digoxin has a negative chronotropic effect, not a positive one.
Therefore, the correct choice is B due to the combination of positive inotropic effect and negative chronotropic effect of digoxin on the heart
What is the condition where the heart's mitral valve becomes narrowed, restricting blood flow from the left atrium to the left ventricle?
- A. Mitral stenosis
- B. Aortic stenosis
- C. Tricuspid regurgitation
- D. Pulmonary hypertension
Correct Answer: A
Rationale: The correct answer is A: Mitral stenosis. Mitral stenosis refers to the narrowing of the mitral valve, which obstructs blood flow from the left atrium to the left ventricle. This condition leads to increased pressure in the left atrium and lungs, causing symptoms like shortness of breath and fatigue.
Explanation:
1. Mitral stenosis specifically involves the mitral valve, not the aortic valve (B) or the tricuspid valve (C).
2. Tricuspid regurgitation (C) involves leakage of blood backward through the tricuspid valve, not narrowing.
3. Pulmonary hypertension (D) is a condition characterized by high blood pressure in the arteries of the lungs due to various causes, not specifically related to mitral valve narrowing.
What structure separates the left and right sides of the heart?
- A. Interventricular septum
- B. Endocardium
- C. Epicardium
- D. Pericardium
Correct Answer: A
Rationale: The correct answer is A: Interventricular septum. This structure separates the left and right sides of the heart, forming a barrier between the two ventricles. It ensures that oxygenated and deoxygenated blood do not mix within the heart chambers. The endocardium (B) is the inner layer of the heart's chambers, the epicardium (C) is the outer layer of the heart, and the pericardium (D) is the sac surrounding the heart. These structures do not specifically separate the left and right sides of the heart.
The nurse is caring for a client on warfarin with an INR of 1.8. What is the most appropriate action?
- A. Increase the dose of warfarin.
- B. Administer vitamin K.
- C. Hold the warfarin and notify the healthcare provider.
- D. Monitor the client's INR closely.
Correct Answer: D
Rationale: The correct answer is D: Monitor the client's INR closely. An INR of 1.8 indicates the client is below the therapeutic range for warfarin. By closely monitoring the client's INR, the nurse can assess the effectiveness of the current dosage and make informed decisions about potential adjustments. Increasing the dose of warfarin (Choice A) without monitoring could lead to over-anticoagulation. Administering vitamin K (Choice B) is not indicated unless the client is experiencing severe bleeding. Holding the warfarin and notifying the healthcare provider (Choice C) may be necessary in some cases, but monitoring is the initial appropriate action to evaluate the situation before making changes.