Nursing Elites

1. How should fluid overload in a patient with heart failure be managed?

• A. Administer diuretics
• B. Increase fluid intake
• C. Provide oral fluids
• D. Provide chest physiotherapy

Correct answer: A

Rationale: Administering diuretics is the appropriate management for fluid overload in a patient with heart failure. Diuretics help to reduce fluid retention by increasing urine output, thereby alleviating the fluid overload. Choices B, C, and D are incorrect. Increasing fluid intake would worsen the condition by adding more fluid to an already overloaded system. Providing oral fluids is not specific enough to address the excess fluid in the body, and chest physiotherapy is not indicated for managing fluid overload in heart failure patients.

2. A healthcare professional is preparing to administer digoxin to a client with heart failure. Which of the following laboratory values should the professional report to the provider?

• A. Potassium 4.0 mEq/L
• B. Calcium 9.5 mg/dL
• C. Sodium 140 mEq/L
• D. Magnesium 2.0 mg/dL

Correct answer: C

Rationale: The correct answer is C: Sodium 140 mEq/L. An elevated sodium level can affect the effectiveness of digoxin therapy and may lead to toxicity. Therefore, it is crucial to report this value to the provider. Potassium, calcium, and magnesium levels are important as well, but elevated sodium can have a more direct impact on digoxin therapy in this scenario.

3. A nurse is reviewing the medical history of a client who has angina. Which of the following findings in the client's medical history should the nurse identify as a risk factor for angina?

• A. Hyperlipidemia.
• B. COPD.
• C. Seizure disorder.
• D. Hyponatremia.

Correct answer: A

Rationale: The correct answer is A: Hyperlipidemia. Hyperlipidemia, which is an elevated level of lipids (fats) in the blood, is a well-established risk factor for angina. High levels of lipids can lead to atherosclerosis, a condition where fatty deposits build up in the arteries, reducing blood flow to the heart muscle and increasing the risk of angina. Choice B, COPD (Chronic Obstructive Pulmonary Disease), is not directly linked to an increased risk of angina. COPD primarily affects the lungs and is not a known risk factor for angina. Choice C, Seizure disorder, and Choice D, Hyponatremia (low sodium levels), are also not typically associated with an increased risk of angina. While medical conditions like hypertension, diabetes, and smoking are other common risk factors for angina, hyperlipidemia is specifically known for its impact on blood vessels, making it a key risk factor to identify in a client's medical history.

4. Which electrolyte imbalance is most concerning for a patient on furosemide?

• A. Hypokalemia
• B. Hyponatremia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is hypokalemia. Furosemide, a loop diuretic, can lead to potassium loss through increased urinary excretion, making hypokalemia the most concerning electrolyte imbalance. Hyponatremia (Choice B) is not typically associated with furosemide use. Hyperkalemia (Choice C) is less likely due to furosemide's potassium-wasting effect. Hypercalcemia (Choice D) is not a common electrolyte imbalance seen with furosemide.

5. A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse report to the provider?

• A. Oxygen saturation of 91%
• B. Use of pursed-lip breathing
• C. Productive cough with green sputum
• D. Decreased breath sounds in the right lower lobe

Correct answer: D

Rationale: The correct finding the nurse should report to the provider is decreased breath sounds in the right lower lobe. This can indicate a respiratory infection or atelectasis in clients with COPD, requiring further evaluation and intervention. Choice A, an oxygen saturation of 91%, although slightly lower than normal, does not necessarily require immediate reporting unless the client's baseline is significantly higher. Choice B, the use of pursed-lip breathing, is actually a beneficial technique for clients with COPD to improve oxygenation and reduce shortness of breath, so it does not need reporting. Choice C, a productive cough with green sputum, can be common in clients with COPD and may indicate an infection, but it is not as concerning as decreased breath sounds in a specific lung lobe which may signify a more acute issue.

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