Nokea
The nurse is caring for a client on warfarin with an INR of 5.2. What is the most appropriate action?
- A. Administer vitamin K as an antidote.
- B. Hold the next dose of warfarin.
- C. Increase the dose of warfarin.
- D. Monitor the client's INR closely.
Correct Answer: A
Rationale: The correct answer is A: Administer vitamin K as an antidote. A high INR level of 5.2 indicates the client is at risk of bleeding due to excess anticoagulation from warfarin. Vitamin K helps reverse the effects of warfarin by promoting clotting factor production. Administering vitamin K is crucial to prevent bleeding complications. Holding the next dose of warfarin (B) is not enough to rapidly lower the INR. Increasing the dose of warfarin (C) would worsen the situation. Monitoring the client's INR closely (D) is important, but immediate action with vitamin K is necessary in this case.
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A client on an ACE inhibitor reports a persistent cough. What is the nurse's best response?
- A. Reassure the client that the cough is a common side effect and is usually not serious.
- B. Instruct the client to report the cough to the healthcare provider as it may require discontinuation of the medication.
- C. Advise the client to use a humidifier at night to relieve the cough.
- D. Suggest the client take an over-the-counter cough suppressant.
Correct Answer: B
Rationale: The correct answer is B because a persistent cough could indicate a serious side effect of ACE inhibitors, such as angioedema or bronchospasm. Instructing the client to report the cough to the healthcare provider is crucial to evaluate the need to discontinue the medication.
Choice A is incorrect as it downplays the potential seriousness of the cough. Choice C is incorrect because a humidifier may not address the underlying cause of the cough. Choice D is incorrect because using a cough suppressant without proper evaluation can mask symptoms of a serious side effect.
Which condition is characterized by chronic inflammation of the airways resulting in excess mucus production, leading to frequent coughing and breathing difficulties?
- A. Chronic bronchitis
- B. Asthma
- C. Pneumonia
- D. COPD
Correct Answer: A
Rationale: Chronic bronchitis is characterized by chronic inflammation of the airways leading to excess mucus production, coughing, and breathing difficulties. This condition is specifically defined by a productive cough lasting at least three months for two consecutive years. Asthma involves airway inflammation and hyperreactivity, but it is not primarily characterized by excess mucus production. Pneumonia is an acute infection of the lungs, not a chronic inflammatory condition. COPD is a broad term that includes chronic bronchitis, but it also encompasses emphysema, so it is not as specific as chronic bronchitis in this context.
What is a chronic condition where the heart is unable to pump blood effectively, leading to fluid buildup in the lungs and other parts of the body?
- A. Heart failure
- B. Myocardial infarction
- C. Pericarditis
- D. Pulmonary edema
Correct Answer: A
Rationale: Step 1: Heart failure is the correct answer because it is a chronic condition where the heart is unable to pump blood effectively.
Step 2: This ineffective pumping leads to fluid buildup in the lungs (pulmonary congestion) and other parts of the body (edema).
Step 3: Myocardial infarction (B) is incorrect as it is an acute condition resulting from a blockage in coronary arteries causing heart muscle damage.
Step 4: Pericarditis (C) is incorrect as it is inflammation of the pericardium, the outer lining of the heart, not directly related to heart pumping efficiency.
Step 5: Pulmonary edema (D) is incorrect as it specifically refers to fluid accumulation in the lungs, not necessarily linked to heart failure.
Which medication is used to prevent blood clots by thinning the blood, reducing the risk of stroke and heart attack?
- A. Anticoagulant
- B. ACE inhibitor
- C. Beta-blocker
- D. Calcium channel blocker
Correct Answer: A
Rationale: The correct answer is A: Anticoagulant. Anticoagulants prevent blood clots by thinning the blood, reducing the risk of stroke and heart attack. They work by inhibiting clot formation. ACE inhibitors (B), Beta-blockers (C), and Calcium channel blockers (D) are not used to prevent blood clots. ACE inhibitors are used to treat high blood pressure and heart failure, Beta-blockers are used to treat high blood pressure and heart conditions, and Calcium channel blockers are used to treat high blood pressure and certain heart conditions.
Which artery supplies the right atrium, right ventricle, a portion of the septum, SA node, AV node, and inferior portion of the left ventricle?
- A. Right coronary artery
- B. Left circumflex artery
- C. Posterior descending artery
- D. Aortic artery
Correct Answer: A
Rationale: The correct answer is A: Right coronary artery. This artery supplies the mentioned structures as it branches off from the aorta and follows the coronary sulcus to reach the right side of the heart. It provides blood to the right atrium, right ventricle, part of the septum, SA node, AV node, and inferior left ventricle. The Left circumflex artery (B) mainly supplies the left atrium and lateral part of the left ventricle. The Posterior descending artery (C) typically arises from the right coronary artery and supplies the inferior part of the heart. The Aortic artery (D) is not a specific artery that directly supplies the structures mentioned.