Nursing Elites

1. A client on spironolactone (Aldactone) has a potassium level of 6.0 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: The correct action for a client on spironolactone with a potassium level of 6.0 mEq/L is to hold the medication and notify the healthcare provider. Spironolactone is a potassium-sparing diuretic that can further elevate potassium levels, which are already high. Administering a potassium supplement (Choice B) would exacerbate the hyperkalemia. Continuing the spironolactone as ordered (Choice C) could lead to worsening hyperkalemia. Increasing the dose of spironolactone (Choice D) would be contraindicated in the presence of elevated potassium levels.

2. The client is receiving digoxin and complains of nausea. What is the nurse’s priority action?

• A. Check the client’s digoxin level.
• B. Continue the current dose of digoxin.
• C. Administer an antiemetic for nausea.
• D. Discontinue the digoxin immediately.

Correct answer: A

Rationale: The correct answer is to check the client’s digoxin level (Choice A). Nausea can be a sign of digoxin toxicity, so assessing the digoxin level is crucial to determine if the medication dosage needs adjustment. Continuing the current dose of digoxin (Choice B) may worsen the symptoms if toxicity is present. Administering an antiemetic (Choice C) may provide temporary relief but does not address the underlying issue of digoxin toxicity. Discontinuing digoxin immediately (Choice D) without assessing the digoxin level can be harmful if the medication is within the therapeutic range.

3. Which of the following is a chronic respiratory disease characterized by the irreversible obstruction of airflow?

• A. Chronic obstructive pulmonary disease (COPD)
• B. Asthma
• C. Pulmonary edema
• D. Bronchiectasis

Correct answer: A

Rationale: The correct answer is A, Chronic obstructive pulmonary disease (COPD). COPD is a chronic respiratory disease where the airflow in the lungs becomes obstructed, making it difficult to breathe. Choice B, Asthma, is a different chronic respiratory condition characterized by reversible airflow obstruction and airway hyperresponsiveness. Choice C, Pulmonary edema, is a condition where fluid accumulates in the lungs, leading to difficulty in breathing but not irreversible airflow obstruction. Choice D, Bronchiectasis, is a condition characterized by abnormal widening of the bronchial tubes, leading to recurrent respiratory infections, but it is not specifically defined by irreversible airflow obstruction.

4. What is the abnormal accumulation of fluid in the pleural space, often associated with infections or malignancies?

• A. Pleural effusion
• B. Pneumothorax
• C. Pulmonary edema
• D. Atelectasis

Correct answer: A

Rationale: The correct answer is A, pleural effusion. Pleural effusion is the accumulation of excess fluid between the layers of the pleura outside the lungs, often caused by infections, cancer, or other diseases. Pneumothorax (choice B) is the presence of air in the pleural space, not fluid. Pulmonary edema (choice C) is the accumulation of fluid in the lungs' air sacs and tissue, not in the pleural space. Atelectasis (choice D) is the collapse or closure of a lung resulting in reduced or absent gas exchange.

5. Which condition is characterized by a chronic cough that produces mucus, often caused by long-term exposure to irritants?

• A. Chronic bronchitis
• B. Tuberculosis
• C. Asthma
• D. Sinusitis

Correct answer: A

Rationale: Chronic bronchitis is the correct answer. It is characterized by a long-term cough with mucus production, often caused by smoking or prolonged exposure to irritants. Tuberculosis (choice B) is a bacterial infection that primarily affects the lungs but does not usually present with a chronic cough as the main symptom. Asthma (choice C) is a chronic respiratory condition characterized by inflammation and narrowing of the airways, leading to wheezing and shortness of breath, but it does not typically cause chronic mucus production. Sinusitis (choice D) is inflammation of the sinuses and presents with symptoms like facial pain, nasal congestion, and post-nasal drip, but not specifically a chronic cough with mucus production.

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