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. The client on furosemide (Lasix) is complaining of muscle cramps. What electrolyte imbalance should the nurse suspect?

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

Correct answer: D

Rationale: The correct answer is D, Hypokalemia. Muscle cramps are a common symptom of hypokalemia, an electrolyte imbalance characterized by low potassium levels. Furosemide, a loop diuretic like Lasix, can lead to potassium loss in the body, contributing to hypokalemia. Choice A, Hyperkalemia, is incorrect as it refers to high potassium levels. Choice B, Hyponatremia, is incorrect as it pertains to low sodium levels. Choice C, Hypocalcemia, is incorrect as it relates to low calcium levels, not typically associated with muscle cramps in the context of furosemide use.

3. What is a condition where the arteries supplying blood to the legs and feet become narrowed or blocked, causing pain and difficulty walking?

• A. Peripheral artery disease
• B. Atherosclerosis
• C. Varicose veins
• D. Raynaud's disease

Correct answer: A

Rationale: The correct answer is A, Peripheral artery disease (PAD). PAD is characterized by the narrowing or blockage of arteries that supply blood to the legs and feet, resulting in pain and difficulty walking. Choice B, Atherosclerosis, is a condition involving the buildup of plaque in the arteries but is not specific to the legs and feet. Varicose veins (Choice C) refer to enlarged, twisted veins usually occurring in the legs. Raynaud's disease (Choice D) involves episodes of reduced blood flow to the extremities, typically triggered by cold temperatures or stress, but it is not directly related to the arteries in the legs and feet.

4. What type of medication is used to reduce high blood pressure by relaxing the blood vessels?

• A. Calcium channel blocker
• B. Beta-blocker
• C. ACE inhibitor
• D. Diuretic

Correct answer: A

Rationale: Calcium channel blockers are medications that reduce high blood pressure by relaxing the blood vessels, facilitating easier blood flow through the vessels. Beta-blockers work by reducing the heart rate and the heart's workload. ACE inhibitors help relax blood vessels by blocking the production of a chemical that narrows blood vessels. Diuretics help the body get rid of excess sodium and water to lower blood pressure, but they do not directly relax blood vessels like calcium channel blockers do.

5. The client asks about side effects of taking digoxin. How does the nurse respond?

• A. Anorexia can be a side effect of digoxin.
• B. Tachycardia can be a side effect of digoxin.
• C. Constipation can be a side effect of digoxin.
• D. Urinary retention can be a side effect of digoxin.

Correct answer: A

Rationale: The correct answer is A: 'Anorexia can be a side effect of digoxin.' Anorexia, nausea, vomiting, and diarrhea are commonly known side effects of digoxin. Choice B, 'Tachycardia can be a side effect of digoxin,' is incorrect as digoxin is used to treat tachycardia, not cause it. Choice C, 'Constipation can be a side effect of digoxin,' is incorrect as constipation is not a typical side effect of digoxin. Choice D, 'Urinary retention can be a side effect of digoxin,' is also incorrect as urinary retention is not a common side effect associated with digoxin use.

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