Nursing Elites

1. The client is on spironolactone (Aldactone) and has a potassium level of 5.9 mEq/L. What is the nurse’s priority action?

• A. Hold the spironolactone and notify the healthcare provider.
• B. Administer potassium supplements.
• C. Continue the spironolactone as ordered.
• D. Increase the dose of spironolactone.

Correct answer: A

Rationale: The correct answer is A: Hold the spironolactone and notify the healthcare provider. A potassium level of 5.9 mEq/L is high, indicating hyperkalemia. Spironolactone is a potassium-sparing diuretic that can further increase potassium levels. Therefore, the priority action is to hold the medication to prevent exacerbating hyperkalemia and notify the healthcare provider for further guidance. Choice B is incorrect because administering potassium supplements would worsen hyperkalemia. Choice C is incorrect because continuing spironolactone could lead to a further increase in potassium levels. Choice D is incorrect because increasing the dose of spironolactone would exacerbate the hyperkalemia.

2. What is the condition where the walls of the heart's ventricles become thickened, reducing the heart's ability to pump blood effectively?

• A. Ventricular hypertrophy
• B. Atrial fibrillation
• C. Restrictive cardiomyopathy
• D. Cardiomyopathy

Correct answer: A

Rationale: Ventricular hypertrophy is the correct answer. In ventricular hypertrophy, the walls of the heart's ventricles become thickened, which decreases the heart's efficiency in pumping blood. Atrial fibrillation (choice B) is an irregular and often rapid heart rate that can lead to poor blood flow. While restrictive cardiomyopathy (choice C) involves the heart muscle becoming rigid and less compliant, it is not specifically characterized by thickening of the ventricular walls. Cardiomyopathy (choice D) is a general term for diseases of the heart muscle, which can present with various symptoms and causes.

3. Which term refers to the contraction phase of the heart when blood is ejected from the chambers?

• A. Systole
• B. Diastole
• C. Contractility
• D. Afterload

Correct answer: A

Rationale: The correct answer is A, systole. Systole is the phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. During diastole (choice B), the heart relaxes and fills with blood, contrasting with systole. Contractility (choice C) refers to the ability of the heart to contract effectively. Afterload (choice D) is the pressure the heart must work against to eject blood during systole.

4. This is a test that measures the oxygen saturation level in the blood, often used to assess respiratory function.

• A. Pulse oximetry
• B. Spirometry
• C. Arterial blood gas (ABG)
• D. Lung function test

Correct answer: A

Rationale: The correct answer is A, Pulse oximetry. Pulse oximetry is a non-invasive test that measures the oxygen saturation level in the blood, helping to assess respiratory and cardiovascular function. Choice B, Spirometry, measures lung function by assessing airflow and volume. Choice C, Arterial blood gas (ABG), evaluates the acidity, oxygen, and carbon dioxide levels in the blood. Choice D, Lung function test, is a broad term that may include various tests to assess lung health, but specifically measuring oxygen saturation is done through pulse oximetry.

5. The client is on a calcium channel blocker. What is the expected effect on the heart?

• A. Increased heart rate
• B. Decreased heart rate
• C. Increased blood pressure
• D. Decreased blood pressure

Correct answer: D

Rationale: When a client is on a calcium channel blocker, the expected effect on the heart is a decreased heart rate and decreased blood pressure. Calcium channel blockers work by dilating blood vessels and reducing the heart's workload, resulting in decreased blood pressure. Choice A, increased heart rate, is incorrect as calcium channel blockers actually have a negative chronotropic effect, reducing the heart rate. Choice C, increased blood pressure, is also incorrect because these medications are used to lower blood pressure.

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