Nursing Elites

1. The client is on furosemide (Lasix) and has a potassium level of 2.9 mEq/L. What is the nurse’s priority action?

• A. Administer potassium supplements.
• B. Hold the furosemide and notify the healthcare provider.
• C. Continue the current dose of furosemide.
• D. Decrease the dose of furosemide.

Correct answer: A

Rationale: The correct answer is A: Administer potassium supplements. A potassium level of 2.9 mEq/L indicates hypokalemia (low potassium levels). Furosemide (Lasix) is a loop diuretic that can cause potassium loss. Therefore, the priority action is to administer potassium supplements to correct the imbalance. Option B is incorrect because holding the furosemide without addressing the low potassium level could further worsen the imbalance. Option C is incorrect as continuing the current dose of furosemide without addressing the low potassium level could lead to complications. Option D is incorrect because decreasing the dose of furosemide does not directly address the low potassium level that needs immediate correction.

2. The client is on enoxaparin (Lovenox) for DVT prophylaxis. What is the most important lab value to monitor?

• A. Platelet count
• B. PT/INR
• C. aPTT
• D. Hemoglobin

Correct answer: A

Rationale: The correct answer is A: Platelet count. When a client is on enoxaparin (Lovenox), monitoring the platelet count is crucial as enoxaparin can lead to a rare but serious side effect known as heparin-induced thrombocytopenia (HIT), causing a decrease in platelet count. Monitoring the platelet count helps detect this adverse reaction early. Choices B, C, and D are incorrect because enoxaparin therapy does not directly affect PT/INR, aPTT, or hemoglobin levels.

3. What is a condition where the heart's electrical impulses are blocked or delayed, leading to a slower or irregular heartbeat?

• A. Heart block
• B. Atrial fibrillation
• C. Tachycardia
• D. Bradycardia

Correct answer: A

Rationale: Heart block is the correct answer. It is a condition where the electrical impulses in the heart are blocked or delayed, resulting in a slower or irregular heartbeat. This can lead to symptoms like dizziness, fainting, or other issues. Atrial fibrillation (B) is characterized by rapid, irregular heartbeats. Tachycardia (C) is a condition where the heart rate is too fast. Bradycardia (D) is the opposite of tachycardia, where the heart rate is too slow.

4. What is a condition where the heart muscle becomes thickened without an obvious cause, leading to a reduction in the heart's ability to pump blood?

• A. Hypertrophic cardiomyopathy
• B. Dilated cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Myocarditis

Correct answer: A

Rationale: Hypertrophic cardiomyopathy is the correct answer. It is a condition characterized by the abnormal thickening of the heart muscle without an obvious cause, which impairs the heart's ability to effectively pump blood. Dilated cardiomyopathy (choice B) involves the enlargement and weakening of the heart chambers, not thickening. Restrictive cardiomyopathy (choice C) refers to the stiffening of the heart muscle, limiting its ability to fill properly. Myocarditis (choice D) is inflammation of the heart muscle usually caused by a viral infection, not thickening.

5. Which structure serves as the normal pacemaker of the heart?

• A. SA node
• B. AV node
• C. Purkinje fibers
• D. Atria

Correct answer: A

Rationale: The correct answer is the SA node. The sinoatrial (SA) node is known as the natural pacemaker of the heart as it generates electrical impulses initiating each heartbeat. The SA node is located in the right atrium and sets the rhythm and rate of the heartbeat. The AV node (choice B) is responsible for delaying the electrical impulse to allow the atria to contract before the ventricles. Purkinje fibers (choice C) are specialized cardiac fibers responsible for the rapid conduction of impulses to the myocardial cells, and the atria (choice D) are the upper chambers of the heart involved in receiving blood from the veins.

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