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. The nurse is administering a beta blocker to a client with a heart rate of 50 bpm. What is the priority action?

• A. Hold the beta blocker and notify the healthcare provider.
• B. Administer the beta blocker as ordered.
• C. Decrease the dose of the beta blocker.
• D. Monitor the client’s heart rate and reassess in 30 minutes.

Correct answer: A

Rationale: The correct action is to hold the beta blocker and notify the healthcare provider. A heart rate of 50 bpm is already low, and beta blockers can further decrease the heart rate, potentially causing adverse effects like bradycardia or heart block. Administering the beta blocker as ordered (Choice B) can exacerbate the low heart rate. Decreasing the dose of the beta blocker (Choice C) may not be sufficient to address the potential harm. Monitoring the client’s heart rate and reassessing in 30 minutes (Choice D) may delay necessary interventions if the heart rate drops further. Therefore, the priority is to hold the medication and seek guidance from the healthcare provider.

3. The client on amiodarone develops symptoms of hypothyroidism. What is the nurse’s best response?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect of amiodarone.
• C. Monitor the client’s thyroid function tests regularly.
• D. Discontinue the amiodarone immediately.

Correct answer: C

Rationale: When a client on amiodarone develops symptoms of hypothyroidism, the nurse's best response is to monitor the client's thyroid function tests regularly. Amiodarone can affect thyroid function, so monitoring is essential to assess the impact and adjust treatment if necessary. Notifying the healthcare provider immediately (Choice A) may be necessary in some cases but the priority is to monitor first. Reassuring the client (Choice B) is not sufficient as monitoring is crucial. Discontinuing amiodarone (Choice D) abruptly without healthcare provider guidance can lead to serious consequences.

4. What is the amount of blood the heart pumps through the circulatory system in a minute?

• A. Cardiac output
• B. Stroke volume
• C. End-diastolic volume
• D. Ejection fraction

Correct answer: A

Rationale: The correct answer is A: Cardiac output. Cardiac output is the volume of blood pumped by the heart per minute. It is calculated by multiplying the stroke volume (the amount of blood pumped out of the heart in each beat) by the heart rate (number of heartbeats per minute). This question specifically asks for the total amount of blood pumped through the circulatory system in a minute, which is represented by cardiac output. Choices B, C, and D are incorrect because stroke volume refers to the amount of blood pumped out of the heart in each beat, end-diastolic volume is the volume of blood in the heart at the end of diastole, and ejection fraction is the percentage of blood pumped out of the heart with each contraction, not the total amount pumped per minute.

5. What test measures the pressure inside the arteries as the heart pumps blood?

• A. Blood pressure test
• B. Pulse oximetry
• C. Echocardiogram
• D. Spirometry

Correct answer: A

Rationale: The correct answer is A) Blood pressure test. A blood pressure test is specifically designed to measure the pressure inside the arteries as the heart pumps blood. This test is crucial in providing information about cardiovascular health by determining the force of blood against the artery walls. Choice B, Pulse oximetry, measures oxygen saturation in the blood, not blood pressure. Choice C, Echocardiogram, is an ultrasound test that evaluates the structure and function of the heart, not specifically blood pressure. Choice D, Spirometry, is a test used to assess lung function, not blood pressure.

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