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 type of heart valve disease occurs when the mitral valve does not close properly, allowing blood to flow backward into the left atrium?

• A. Mitral regurgitation
• B. Aortic stenosis
• C. Tricuspid regurgitation
• D. Pulmonary hypertension

Correct answer: A

Rationale: Mitral regurgitation is the correct answer. It occurs when the mitral valve does not close properly, allowing blood to flow backward into the left atrium. This condition can lead to symptoms such as fatigue, shortness of breath, and if left untreated, it can progress to heart failure. Aortic stenosis (choice B) is a different heart valve condition characterized by narrowing of the aortic valve, restricting blood flow from the heart. Tricuspid regurgitation (choice C) involves the tricuspid valve not closing properly, leading to blood flowing back into the right atrium. Pulmonary hypertension (choice D) is a condition characterized by high blood pressure in the arteries of the lungs.

3. Which type of medication helps to lower cholesterol levels in the blood?

• A. Statins
• B. Beta-blockers
• C. ACE inhibitors
• D. Diuretics

Correct answer: A

Rationale: Statins are a type of medication specifically designed to lower cholesterol levels in the blood by inhibiting an enzyme involved in cholesterol production. Beta-blockers are mainly used to treat conditions like high blood pressure and heart problems by reducing the heart rate and workload. ACE inhibitors are used to manage conditions like high blood pressure and heart failure by relaxing blood vessels. Diuretics are medications that help the body get rid of excess salt and water by increasing urine production. Therefore, in the context of lowering cholesterol levels, statins are the most appropriate choice.

4. Which surgical procedure involves grafting a blood vessel to bypass a blocked artery in the heart?

• A. Coronary artery bypass graft (CABG)
• B. Valve replacement
• C. Stent placement
• D. Angioplasty

Correct answer: A

Rationale: The correct answer is A, Coronary artery bypass graft (CABG). This surgical procedure involves grafting a blood vessel to bypass a blocked coronary artery, improving blood flow to the heart muscle. Choice B, Valve replacement, is a procedure to replace a damaged heart valve and is not directly related to bypassing blocked arteries. Choice C, Stent placement, involves inserting a mesh tube to keep blocked arteries open and is different from grafting a blood vessel. Choice D, Angioplasty, is a procedure to widen narrowed or blocked arteries, typically using a balloon catheter, and does not involve grafting a blood vessel.

5. The client is being taught about the use of warfarin. What is the most important dietary instruction?

• A. Avoid foods high in vitamin K.
• B. Increase the intake of vitamin K-rich foods.
• C. Avoid foods high in protein.
• D. Increase the intake of foods high in calcium.

Correct answer: A

Rationale: The correct answer is A: Avoid foods high in vitamin K. Warfarin is a medication that works by decreasing the activity of vitamin K in the body to prevent blood clotting. Therefore, consuming foods high in vitamin K like green leafy vegetables can interfere with the medication's effectiveness. Choices B, C, and D are incorrect. Increasing the intake of vitamin K-rich foods would counteract the effects of warfarin. Avoiding foods high in protein or increasing the intake of foods high in calcium are not specifically related to the use of warfarin.

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