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. Which of the following is a chronic lung disease that includes conditions such as chronic bronchitis and emphysema, characterized by obstructed airflow from the lungs?

• A. Chronic obstructive pulmonary disease (COPD)
• B. Pulmonary fibrosis
• C. Asthma
• D. Pneumonia

Correct answer: A

Rationale: The correct answer is A, Chronic obstructive pulmonary disease (COPD). COPD is a chronic lung disease that encompasses conditions like chronic bronchitis and emphysema. These conditions lead to obstructed airflow from the lungs, causing symptoms such as cough, shortness of breath, and wheezing. Choice B, Pulmonary fibrosis, involves scarring of the lung tissue, leading to breathing difficulties but is not specifically characterized by obstructed airflow like COPD. Asthma (Choice C) is a chronic condition characterized by airway inflammation and bronchoconstriction, not always resulting in obstructed airflow. Pneumonia (Choice D) is an acute infection of the lung tissue, causing symptoms like fever, cough, and difficulty breathing, but is not a chronic condition like COPD.

3. The client is on a nitrate for angina. What is the most common side effect the nurse should monitor for?

• A. Headache
• B. Flushing
• C. Dizziness
• D. Nausea

Correct answer: A

Rationale: The correct answer is A, Headache. Nitrates commonly cause headaches as a side effect due to vasodilation. Flushing, dizziness, and nausea are less common side effects associated with nitrates. Flushing is more related to the dilation of blood vessels closer to the skin's surface, dizziness could occur but is not as common as headaches, and nausea is a less typical side effect of nitrates.

4. What is a condition where the walls of the arteries become thickened and stiff, often due to the buildup of plaque, leading to reduced blood flow?

• A. Atherosclerosis
• B. Angina
• C. Hypertension
• D. Arrhythmia

Correct answer: A

Rationale: Atherosclerosis is the correct answer. It is a condition characterized by the thickening and stiffening of artery walls due to plaque buildup, which restricts blood flow. Angina (choice B) is chest pain or discomfort caused by reduced blood flow to the heart. Hypertension (choice C) is high blood pressure, not directly related to arterial wall thickening. Arrhythmia (choice D) refers to irregular heart rhythms and is not specifically linked to artery wall changes like atherosclerosis.

5. The client is on spironolactone (Aldactone) and has a potassium level of 5.9 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 5.9 mEq/L is high, indicating hyperkalemia. Spironolactone is a potassium-sparing diuretic that can further increase potassium levels. Therefore, the priority action is to hold the medication to prevent exacerbating hyperkalemia and notify the healthcare provider for further guidance. Choice B is incorrect because administering potassium supplements would worsen hyperkalemia. Choice C is incorrect because continuing spironolactone could lead to a further increase in potassium levels. Choice D is incorrect because increasing the dose of spironolactone would exacerbate the hyperkalemia.

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