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 of the following is a chronic condition where the heart muscle is weakened and unable to pump blood effectively, often leading to heart failure?

• A. Dilated cardiomyopathy
• B. Hypertrophic cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Myocarditis

Correct answer: A

Rationale: Dilated cardiomyopathy is characterized by the heart muscle being weakened and unable to pump blood effectively, ultimately resulting in heart failure. Choice B, Hypertrophic cardiomyopathy, involves the heart muscle becoming abnormally thick, reducing the heart's efficiency. Choice C, Restrictive cardiomyopathy, refers to the heart becoming rigid and less able to fill with blood properly. Myocarditis, as in Choice D, is inflammation of the heart muscle usually caused by a viral infection and is different from the chronic weakening seen in dilated cardiomyopathy.

3. The client on furosemide (Lasix) is at risk for which electrolyte imbalance?

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

Correct answer: B

Rationale: The correct answer is B: Hypokalemia. Furosemide is a loop diuretic that can lead to potassium loss, resulting in hypokalemia. This electrolyte imbalance is a significant risk associated with diuretic use. Choices A, C, and D are incorrect. Hyperkalemia (choice A) is not typically associated with furosemide use. Hyponatremia (choice C) and hypernatremia (choice D) are related to sodium levels, not potassium levels affected by furosemide.

4. What is the procedure where a device is used to shock the heart back into a normal rhythm during a life-threatening arrhythmia?

• A. Defibrillation
• B. Cardioversion
• C. Echocardiogram
• D. Ablation

Correct answer: A

Rationale: The correct answer is A, Defibrillation. Defibrillation is the procedure of using a device to deliver an electric shock to the heart during life-threatening arrhythmias like ventricular fibrillation or ventricular tachycardia to restore a normal rhythm. Choice B, Cardioversion, is similar but is typically used for less severe arrhythmias. Choice C, Echocardiogram, is a diagnostic test that uses sound waves to create images of the heart. Choice D, Ablation, is a procedure to treat certain types of arrhythmias by scarring or destroying tissue that triggers abnormal electrical signals.

5. Which artery supplies the anterior wall of the left ventricle, the anterior interventricular septum, the anterior papillary muscles, and apex of the heart?

• A. Left anterior descending artery
• B. Left circumflex artery
• C. Posterior descending artery
• D. Aortic artery

Correct answer: A

Rationale: The correct answer is the Left anterior descending artery. This artery supplies the anterior wall of the left ventricle, the anterior interventricular septum, the anterior papillary muscles, and apex of the heart. The Left circumflex artery (choice B) supplies the lateral and posterior walls of the left ventricle, the posterior descending artery (choice C) supplies the inferior part of the heart, and the aortic artery (choice D) is not a specific coronary artery.

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