Nursing Elites

1. The client on amiodarone reports shortness of breath. What is the nurse’s best response?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect.
• C. Instruct the client to monitor their symptoms at home.
• D. Suggest the client reduce physical activity.

Correct answer: A

Rationale: When a client on amiodarone reports shortness of breath, it can be indicative of pulmonary toxicity, a severe side effect associated with this medication. The nurse's priority is to notify the healthcare provider immediately to assess the situation and determine the appropriate course of action. Choice B is incorrect because shortness of breath with amiodarone should not be dismissed as a common side effect. Instructing the client to monitor symptoms at home (Choice C) may delay necessary intervention. Suggesting the client reduce physical activity (Choice D) does not address the potential serious nature of the symptom and the need for prompt evaluation.

2. A client on spironolactone (Aldactone) has a potassium level of 6.0 mEq/L. What is the nurse’s priority action?

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

Correct answer: A

Rationale: The correct action for a client on spironolactone with a potassium level of 6.0 mEq/L is to hold the medication and notify the healthcare provider. Spironolactone is a potassium-sparing diuretic that can further elevate potassium levels, which are already high. Administering a potassium supplement (Choice B) would exacerbate the hyperkalemia. Continuing the spironolactone as ordered (Choice C) could lead to worsening hyperkalemia. Increasing the dose of spironolactone (Choice D) would be contraindicated in the presence of elevated potassium levels.

3. A client on a beta blocker has a heart rate of 52 bpm. What is the nurse’s priority action?

• A. Hold the beta blocker and notify the healthcare provider.
• B. Administer the beta blocker as ordered.
• C. Increase the dose of the beta blocker.
• D. Continue to monitor the client and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the beta blocker and notify the healthcare provider. A heart rate of 52 bpm is low, and beta blockers can further decrease the heart rate, potentially causing harm. Therefore, withholding the medication and promptly informing the healthcare provider is crucial for further assessment and possible adjustment of the treatment plan. Administering the beta blocker as ordered (Choice B) can exacerbate the bradycardia. Increasing the dose of the beta blocker (Choice C) would further suppress the heart rate. Continuing to monitor the client and reassessing in 30 minutes (Choice D) might delay necessary interventions and increase the risk of complications in a client with a heart rate of 52 bpm.

4. What is the procedure where a small mesh tube is inserted into an artery to keep it open after angioplasty?

• A. Stent placement
• B. Bypass surgery
• C. Angioplasty
• D. Valve replacement

Correct answer: A

Rationale: The correct answer is A, stent placement. Stent placement involves inserting a small mesh tube into an artery to maintain its openness after angioplasty. This choice is correct because it directly describes the procedure mentioned in the question. Choices B, C, and D are incorrect. Bypass surgery involves rerouting blood flow around a blocked artery using a vessel from another part of the body. Angioplasty is the procedure of widening a narrowed or blocked blood vessel, often followed by stent placement. Valve replacement is a surgical procedure to replace a damaged or diseased heart valve with an artificial or biological valve.

5. 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.

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