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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You are the charge nurse for the coronary care step-down unit. Which patient is best to assign to an RN who has floated for the day from the general medical-surgical unit?
- A. Patient requiring discharge teaching about coronary artery stenting prior to going home with spouse today.
- B. Patient receiving IV furosemide (Lasix) to treat acute left ventricular failure.
- C. Patient just transferred from the radiology department after a coronary angioplasty.
- D. Patient just admitted with unstable angina and who has orders for a heparin infusion and aspirin
Correct Answer: A
Rationale: Discharge teaching is less complex and allows the floating RN to focus on educating without needing extensive cardiac experience.
Which term refers to the relaxation phase of the heart, during which the chambers fill with blood?
- A. Diastole
- B. Systole
- C. Refractoriness
- D. Automaticity
Correct Answer: A
Rationale: The correct answer is A: Diastole. Diastole refers to the relaxation phase of the heart, allowing the chambers to fill with blood. During diastole, the ventricles are relaxed, and blood flows into them from the atria. Systole, choice B, is the contraction phase where the heart pumps blood out. Refractoriness, choice C, refers to the period when the heart cannot respond to a new stimulus. Automaticity, choice D, is the ability of the heart to generate its own electrical impulses. So, diastole is the correct term for the relaxation phase of the heart where chambers fill with blood, making it the correct answer.
Explain the different modes of ventilator.
- A. Controlled mechanical ventilation
- B. Assist-control mode
- C. Both A and B
- D. None of the above
Correct Answer: C
Rationale: Modes vary depending on the degree of support required by the patient.
What is a condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle?
- A. Coronary artery disease (CAD)
- B. Atherosclerosis
- C. Stroke
- D. Peripheral artery disease
Correct Answer: A
Rationale: The correct answer is A: Coronary artery disease (CAD). CAD is the condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle. The narrowing or blockage is typically caused by atherosclerosis, which is the buildup of plaque in the arteries. Atherosclerosis is a contributing factor to CAD, but CAD specifically refers to the reduced blood flow in the coronary arteries. Stroke (C) is a condition involving the brain's blood vessels, not the heart. Peripheral artery disease (D) involves narrowing of arteries outside the heart, typically in the legs. Therefore, the most appropriate choice is A as it directly relates to the narrowed or blocked coronary arteries causing reduced blood flow to the heart muscle.
The healthcare provider is preparing to administer heparin to a client. What lab value should be monitored?
- A. PT/INR
- B. aPTT
- C. Platelet count
- D. Hemoglobin
Correct Answer: B
Rationale: The correct lab value to monitor when administering heparin is aPTT (Activated Partial Thromboplastin Time). This is because heparin affects the intrinsic pathway of the clotting cascade, which is reflected in the aPTT value. Monitoring aPTT helps ensure the therapeutic range of heparin to prevent clotting complications. PT/INR and platelet count are not specific to heparin monitoring, and hemoglobin does not directly reflect heparin's anticoagulant effects.