Nursing Elites

1. The client on spironolactone (Aldactone) has a potassium level of 5.8 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: With a potassium level of 5.8 mEq/L, which is high, the priority action for the nurse is to hold the spironolactone. Spironolactone is a potassium-sparing diuretic that can further increase potassium levels. Therefore, it is crucial to prevent exacerbating hyperkalemia by discontinuing the medication. Notifying the healthcare provider is necessary for further guidance and potential adjustments to the treatment plan. Administering a potassium supplement (Choice B) would be contraindicated since the client already has elevated potassium levels. Continuing the spironolactone as ordered (Choice C) can worsen hyperkalemia. Increasing the dose of spironolactone (Choice D) would be unsafe and exacerbate the high potassium levels.

2. What is the condition where the blood flow through the coronary arteries is reduced or blocked, leading to chest pain or heart attack?

• A. Coronary artery disease
• B. Atherosclerosis
• C. Pulmonary embolism
• D. Pulmonary hypertension

Correct answer: A

Rationale: The correct answer is A, Coronary artery disease (CAD). CAD occurs when the coronary arteries are narrowed or blocked, reducing blood flow to the heart muscle and increasing the risk of chest pain or heart attack. Choice B, Atherosclerosis, is a condition characterized by the hardening and narrowing of arteries due to the buildup of plaque. Choices C and D, Pulmonary embolism and Pulmonary hypertension, involve issues related to the lungs and not the coronary arteries.

3. What is a device that delivers a fine spray of medication into the airways?

• A. Nebulizer
• B. Inhaler
• C. Oxygen concentrator
• D. Peak flow meter

Correct answer: A

Rationale: A nebulizer is a device that converts liquid medication into a fine mist, allowing it to be inhaled directly into the lungs. This makes it the correct answer to the question. Choice B, an inhaler, delivers medication in a different form - as a pressurized dose that needs to be inhaled. Choice C, an oxygen concentrator, is used to deliver oxygen to patients with breathing difficulties but does not deliver medication. Choice D, a peak flow meter, is used to measure how fast air can be blown out of the lungs and is not involved in delivering medication.

4. What is a condition where the heart is unable to pump blood effectively, leading to a buildup of fluid in the lungs and other parts of the body?

• A. Heart failure
• B. Cardiomyopathy
• C. Myocardial infarction
• D. Pulmonary edema

Correct answer: A

Rationale: The correct answer is A: Heart failure. Heart failure occurs when the heart is unable to pump blood effectively, resulting in a buildup of fluid in the lungs and other parts of the body. Choice B, Cardiomyopathy, refers to diseases of the heart muscle, not specifically the inability to pump blood effectively. Choice C, Myocardial infarction, is a heart attack caused by a blocked blood supply to the heart muscle, not directly related to the heart's pumping efficiency. Choice D, Pulmonary edema, is a condition characterized by fluid accumulation in the lungs, often a consequence of heart failure but not the primary condition described in the question.

5. The client is on digoxin and has severe digoxin toxicity. What is the nursing priority action?

• A. Check the potassium level.
• B. Give Digibind as an antidote.
• C. Change the dosing of digoxin to every other day.
• D. Administer a potassium supplement to decrease digoxin toxicity.

Correct answer: B

Rationale: The correct answer is to give Digibind as an antidote in cases of severe digoxin toxicity. Digibind works by binding to digoxin and preventing it from causing further harm. Checking the potassium level (choice A) is important but not the priority when the client has severe toxicity. Changing the dosing to every other day (choice C) is not appropriate in the setting of severe toxicity where immediate action is required. Giving a potassium supplement (choice D) may be needed eventually, but the priority is to administer Digibind to counteract the toxic effects of digoxin.

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