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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Mr. Olds is admitted with constrictive pericarditis. He complains of chest pain and receives morphine as ordered. Pain relief for this patient is also facilitated by
- A. Sitting forward
- B. Lying supine
- C. Taking deep breaths
- D. Coughing
Correct Answer: A
Rationale: Sitting forward reduces pressure on the heart.
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.
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 A: Angioplasty. During angioplasty, a catheter with a balloon at its tip is inserted into the blocked or narrowed coronary artery to widen the artery and improve blood flow. This procedure often involves the placement of a stent to help keep the artery open. Angioplasty is a minimally invasive procedure compared to a coronary artery bypass graft (CABG), which requires open-heart surgery. Echocardiogram and CT angiography are diagnostic imaging tests and do not involve the insertion of a catheter to treat a blocked or narrowed coronary artery.
What is the patient with primary hypertension likely to report?
- A. No symptoms
- B. Cardiac palpitations
- C. Dyspnea on exertion
- D. Dizziness and vertigo
Correct Answer: A
Rationale: Primary hypertension often lacks overt symptoms.
The client is on hydrochlorothiazide and digoxin. What effect can the nurse expect?
- A. Hydrochlorothiazide increases digoxin levels.
- B. Hydrochlorothiazide decreases digoxin levels.
- C. Hydrochlorothiazide decreases potassium, increasing the risk of digoxin toxicity.
- D. Digoxin can increase the effectiveness of hydrochlorothiazide.
Correct Answer: C
Rationale: The correct answer is C because hydrochlorothiazide is a diuretic that can lead to hypokalemia (decreased potassium levels), which increases the risk of digoxin toxicity as digoxin requires adequate potassium levels for proper function.
Choice A is incorrect because hydrochlorothiazide does not increase digoxin levels. Choice B is incorrect because hydrochlorothiazide can actually increase digoxin levels due to potential electrolyte disturbances. Choice D is incorrect as digoxin does not affect the effectiveness of hydrochlorothiazide.