Nursing Elites

1. The client is receiving digoxin and has a potassium level of 2.8 mEq/L. What is the nurse’s priority action?

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

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 2.8 mEq/L indicates hypokalemia, which can increase the risk of digoxin toxicity. Holding the medication and informing the healthcare provider is crucial to prevent adverse effects. Choice B is incorrect because increasing the dose of digoxin would further raise the risk of toxicity. Choice C is incorrect as continuing the current dose could exacerbate the toxicity risk. Choice D is incorrect because administering potassium supplements alone is not sufficient to address the potential digoxin toxicity; the first step should be to hold the digoxin and seek further guidance.

2. What is a condition where the alveoli are gradually destroyed, leading to shortness of breath and reduced oxygen exchange?

• A. Emphysema
• B. Pulmonary fibrosis
• C. Pulmonary edema
• D. Lung cancer

Correct answer: A

Rationale: The correct answer is A: Emphysema. Emphysema is a chronic lung condition where the alveoli (air sacs) in the lungs are damaged, reducing the surface area available for gas exchange. This destruction leads to symptoms like shortness of breath and reduced oxygen exchange. Choice B, pulmonary fibrosis, involves scarring and thickening of the lung tissue, not destruction of alveoli. Choice C, pulmonary edema, is the accumulation of fluid in the lungs, not destruction of alveoli. Choice D, lung cancer, is the uncontrolled growth of abnormal cells in the lungs, not destruction of alveoli.

3. What is a chronic inflammatory disease that affects the small airways in the lungs, leading to episodes of wheezing, breathlessness, and coughing?

• A. Asthma
• B. COPD
• C. Bronchitis
• D. Lung cancer

Correct answer: A

Rationale: Asthma is the correct answer. It is a chronic inflammatory disease that affects the small airways in the lungs, leading to symptoms like wheezing, breathlessness, and coughing. Asthma is commonly triggered by allergens, exercise, respiratory infections, and other factors. Choice B, COPD (Chronic Obstructive Pulmonary Disease), is characterized by airflow limitation and is often caused by smoking. Choice C, Bronchitis, is an inflammation of the bronchial tubes and can be acute or chronic. Choice D, Lung cancer, is a disease characterized by uncontrolled cell growth in lung tissues and is commonly associated with smoking or environmental factors.

4. What structure separates the left and right sides of the heart?

• A. Interventricular septum
• B. Endocardium
• C. Epicardium
• D. Pericardium

Correct answer: A

Rationale: The interventricular septum is the correct answer as it is the wall that separates the left and right sides of the heart, ensuring the oxygenated and deoxygenated blood do not mix. The endocardium is the inner lining of the heart chambers, the epicardium is the outermost layer of the heart wall, and the pericardium is the sac that surrounds the heart, providing protection and anchoring the heart in place. Therefore, choices B, C, and D are incorrect in the context of separating the left and right sides of the heart.

5. Which order should the nurse question?

• A. The addition of a loop diuretic with digoxin.
• B. The addition of a beta blocker with digoxin.
• C. A digoxin dose of 0.125 mg per day.
• D. The addition of an ACE inhibitor with digoxin.

Correct answer: B

Rationale: The correct answer is B because adding a beta blocker to digoxin can potentiate the bradycardic effect of digoxin, leading to serious complications such as heart block. This combination requires caution as it can significantly slow down the heart rate. Choices A, C, and D are not the best options to question in this scenario. Loop diuretics are commonly used with digoxin, a digoxin dose of 0.125 mg per day is within the typical range, and ACE inhibitors are often prescribed alongside digoxin for managing heart conditions.

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