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 type of heart attack that occurs when the blood supply to part of the heart muscle is severely reduced or stopped?

• A. Myocardial infarction
• B. Angina
• C. Stroke
• D. Congestive heart failure

Correct answer: A

Rationale: The correct answer is A: Myocardial infarction. Myocardial infarction, commonly known as a heart attack, occurs when the blood supply to part of the heart muscle is severely reduced or stopped, leading to tissue damage or death. Angina (choice B) is chest pain or discomfort that occurs when the heart muscle doesn't get enough oxygen-rich blood. Stroke (choice C) is a condition where the blood supply to the brain is interrupted or reduced. Congestive heart failure (choice D) is a chronic condition where the heart muscle doesn't pump blood as well as it should.

3. What is the ability of cardiac cells to generate an electrical impulse without being stimulated by an external source?

• A. Automaticity
• B. Contractility
• C. Conductivity
• D. Refractoriness

Correct answer: A

Rationale: Automaticity is the correct answer because it refers to the inherent ability of cardiac cells to generate electrical impulses without the need for external stimulation. Contractility (Choice B) is the ability of the heart muscle to contract and generate force, not related to electrical impulse generation. Conductivity (Choice C) refers to the ability of cardiac cells to transmit electrical impulses from cell to cell, not the spontaneous generation of impulses. Refractoriness (Choice D) is the period during which the cardiac cells are recovering and not able to respond to a new stimulus, not the spontaneous generation of impulses.

4. What term describes a condition where a person experiences difficulty breathing when lying flat and requires multiple pillows to sleep comfortably?

• A. Orthopnea
• B. Dyspnea
• C. Tachypnea
• D. Bradypnea

Correct answer: A

Rationale: The correct answer is A, Orthopnea. Orthopnea is a condition where a person finds it hard to breathe while lying flat and needs to use multiple pillows to sleep comfortably. This position helps relieve the discomfort by allowing better lung expansion. Choice B, Dyspnea, refers to difficulty breathing in general, not specifically related to lying flat. Choice C, Tachypnea, is rapid breathing and is not directly related to difficulty breathing while lying down. Choice D, Bradypnea, is slow breathing and does not describe the condition of having trouble breathing when lying flat.

5. The client is prescribed warfarin. What should the client be taught about this medication?

• A. Avoid foods high in vitamin K.
• B. Take the medication with food to prevent stomach upset.
• C. Take the medication at the same time every day.
• D. Increase the dose if a dose is missed.

Correct answer: A

Rationale: The correct answer is A: Avoid foods high in vitamin K. Warfarin is an anticoagulant medication, and vitamin K can counteract its effects. Therefore, it is important for clients taking warfarin to avoid foods high in vitamin K to maintain the medication's effectiveness. Choice B is incorrect because warfarin should be taken consistently as prescribed, regardless of food intake. Choice C is incorrect because while consistency in timing is important, it is not specific to the effectiveness of warfarin. Choice D is incorrect because clients should never increase the dose of warfarin on their own, especially to make up for a missed dose, as it can lead to serious bleeding risks.

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