Nursing Elites

1. The client on digoxin has a potassium level of 2.7 mEq/L. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Increase the 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 2.7 mEq/L is considered low and can increase the risk of digoxin toxicity. Holding the medication and informing the healthcare provider is crucial to prevent adverse effects. Administering the digoxin as ordered (Choice B) would put the client at a higher risk for toxicity. Increasing the dose of digoxin (Choice C) is not appropriate when the client's potassium level is low. Administering potassium supplements (Choice D) may be necessary but is not the priority action in this situation.

2. When administering furosemide (Lasix) to a client, which lab value is most important to monitor?

• A. Potassium
• B. Sodium
• C. Calcium
• D. Chloride

Correct answer: A

Rationale: When administering furosemide (Lasix), it is crucial to monitor potassium levels closely. Furosemide is a loop diuretic that can lead to potassium loss, potentially causing hypokalemia. Monitoring potassium levels helps prevent adverse effects associated with low potassium, such as cardiac arrhythmias. While monitoring sodium, calcium, and chloride levels may also be important in certain situations, potassium is the most critical to monitor when administering furosemide.

3. The nurse is giving the client digoxin for heart failure and recognizes that the drug has what type of effect on the heart?

• A. Negative inotropic, negative chronotropic effect
• B. Positive inotropic, negative chronotropic effect
• C. Negative inotropic, positive chronotropic effect
• D. Positive inotropic, positive chronotropic effect

Correct answer: B

Rationale: The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin strengthens the heart muscle, providing a positive inotropic effect, which increases the force of contraction. It also decreases the heart rate, having a negative chronotropic effect. Choice A is incorrect because digoxin has a positive inotropic effect, not a negative inotropic effect. Choice C is incorrect as digoxin does not have a positive chronotropic effect but a negative one. Choice D is incorrect because while digoxin has a positive inotropic effect, it does not have a positive chronotropic effect.

4. The client on spironolactone (Aldactone) has a potassium level of 5.6 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 5.6 mEq/L is high, indicating hyperkalemia. Spironolactone is a potassium-sparing diuretic that can further elevate potassium levels. Therefore, the priority action is to withhold the medication to prevent exacerbating hyperkalemia and notify the healthcare provider for further management. Option B is incorrect because administering potassium supplements would worsen the hyperkalemia. Option C is incorrect as continuing spironolactone can lead to a further increase in potassium levels. Option D is incorrect as increasing the dose of spironolactone would be inappropriate in the presence of elevated potassium levels.

5. What is a condition where the pulmonary arteries become blocked by a blood clot, leading to chest pain, shortness of breath, and other symptoms?

• A. Pulmonary embolism
• B. Pneumothorax
• C. Pulmonary edema
• D. Pulmonary hypertension

Correct answer: A

Rationale: The correct answer is A, pulmonary embolism. Pulmonary embolism is a condition where a blood clot blocks one of the pulmonary arteries in the lungs, resulting in symptoms like chest pain, shortness of breath, and other related signs. Choices B, C, and D are incorrect because pneumothorax refers to a collapsed lung, pulmonary edema is the build-up of fluid in the lungs, and pulmonary hypertension is high blood pressure in the arteries of the lungs - none of which directly involve a blood clot blocking the pulmonary arteries.

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