Nursing Elites

1. 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.

2. Which condition is characterized by the narrowing or blockage of arteries that supply blood to the heart by plaque?

• A. Coronary artery disease (CAD)
• B. Atherosclerosis
• C. Peripheral artery disease
• D. Congestive heart failure

Correct answer: A

Rationale: The correct answer is A, Coronary artery disease (CAD). CAD specifically refers to the condition where the arteries supplying blood to the heart become narrowed or blocked by plaque buildup. Choice B, Atherosclerosis, is a general term for the hardening and narrowing of arteries due to plaque buildup but does not specifically mention the heart. Choice C, Peripheral artery disease, involves narrowing of arteries that supply blood to areas other than the heart. Choice D, Congestive heart failure, is a condition where the heart is unable to pump blood effectively but is not primarily caused by narrowed or blocked arteries.

3. The healthcare provider is preparing to administer heparin to a client. What lab value should be monitored?

• A. PT/INR
• B. aPTT
• C. Platelet count
• D. Hemoglobin

Correct answer: B

Rationale: The correct lab value that should be monitored when administering heparin is the aPTT (activated partial thromboplastin time). Heparin affects the intrinsic pathway of the coagulation cascade, and aPTT is a sensitive measure to assess the effectiveness of heparin therapy. Monitoring aPTT helps in adjusting the heparin dose to maintain the desired anticoagulant effect. PT/INR is more specific to monitor warfarin therapy, not heparin. Platelet count and hemoglobin levels are important parameters to assess bleeding tendencies and oxygen-carrying capacity but are not directly related to monitoring heparin therapy.

4. 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.

5. Which valve prevents backflow of blood into the right ventricle from the pulmonary artery?

• A. Pulmonary valve
• B. Aortic valve
• C. Tricuspid valve
• D. Mitral valve

Correct answer: A

Rationale: The correct answer is the Pulmonary valve. The Pulmonary valve prevents backflow of blood into the right ventricle from the pulmonary artery after it has been ejected. The Aortic valve (choice B) prevents backflow from the aorta into the left ventricle. The Tricuspid valve (choice C) prevents backflow of blood into the right atrium from the right ventricle. The Mitral valve (choice D) prevents backflow from the left ventricle into the left atrium.

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