Nursing Elites

1. The client is on spironolactone (Aldactone). What is the most important dietary instruction?

• A. Avoid foods high in potassium.
• B. Increase intake of foods high in potassium.
• C. Avoid foods high in sodium.
• D. Increase intake of foods high in sodium.

Correct answer: A

Rationale: The correct answer is to avoid foods high in potassium. Spironolactone is a potassium-sparing diuretic, meaning it helps the body retain potassium and can lead to hyperkalemia if too much potassium is consumed. Choices B, C, and D are incorrect because increasing intake of potassium-rich foods can worsen hyperkalemia, while avoiding foods high in sodium is not the primary concern when taking spironolactone.

2. What is the ability of cardiac cells to generate an electrical impulse without being stimulated by an external source?

• A. Automaticity
• B. Contractility
• C. Conductivity
• D. Refractoriness

Correct answer: A

Rationale: Automaticity is the correct answer because it refers to the inherent ability of cardiac cells to generate electrical impulses without the need for external stimulation. Contractility (Choice B) is the ability of the heart muscle to contract and generate force, not related to electrical impulse generation. Conductivity (Choice C) refers to the ability of cardiac cells to transmit electrical impulses from cell to cell, not the spontaneous generation of impulses. Refractoriness (Choice D) is the period during which the cardiac cells are recovering and not able to respond to a new stimulus, not the spontaneous generation of impulses.

3. The client is on hydrochlorothiazide and digoxin. What effect can the nurse expect?

• A. Hydrochlorothiazide increases digoxin levels.
• B. Hydrochlorothiazide decreases digoxin levels.
• C. Hydrochlorothiazide decreases potassium, increasing the risk of digoxin toxicity.
• D. Digoxin can increase the effectiveness of hydrochlorothiazide.

Correct answer: C

Rationale: The correct answer is C. Hydrochlorothiazide is a diuretic that can decrease potassium levels, which in turn can increase the risk of digoxin toxicity. Digoxin typically doesn't impact hydrochlorothiazide levels or effectiveness, making choices A, B, and D incorrect. Choice A stating that hydrochlorothiazide increases digoxin levels is inaccurate. Choice B suggesting that hydrochlorothiazide decreases digoxin levels is also incorrect. Choice D, stating that digoxin can increase the effectiveness of hydrochlorothiazide, is not a typical interaction seen between these medications.

4. What is the condition where the pericardium, the sac surrounding the heart, becomes inflamed, leading to chest pain and other symptoms?

• A. Pericarditis
• B. Myocarditis
• C. Endocarditis
• D. Pulmonary hypertension

Correct answer: A

Rationale: Pericarditis is the correct answer. It is the inflammation of the pericardium, the sac surrounding the heart, which can lead to chest pain and other symptoms. Myocarditis (choice B) is inflammation of the heart muscle, not the pericardium. Endocarditis (choice C) is inflammation of the inner lining of the heart chambers and valves, not the pericardium. Pulmonary hypertension (choice D) is high blood pressure in the arteries of the lungs, not related to pericardial inflammation.

5. What type of medication is used to relax the muscles around the airways and improve breathing in conditions like asthma and COPD?

• A. Bronchodilator
• B. Corticosteroid
• C. Mucolytic
• D. Antihistamine

Correct answer: A

Rationale: Bronchodilators are medications that relax the muscles around the airways, improving airflow and making breathing easier for patients with asthma or COPD. Corticosteroids are anti-inflammatory drugs used to reduce airway inflammation, while mucolytics help in thinning and clearing mucus. Antihistamines are used to treat allergies and not specifically to improve breathing in conditions like asthma or COPD.

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