Nursing Elites

1. The nurse is administering an ACE inhibitor to a client. What is the most common side effect?

• A. Cough
• B. Dizziness
• C. Hypotension
• D. Hyperkalemia

Correct answer: A

Rationale: The correct answer is A: Cough. Cough is a well-known side effect of ACE inhibitors due to an increase in bradykinin levels. This irritating cough can be bothersome to clients and should be monitored. Choice B, Dizziness, is not the most common side effect of ACE inhibitors. While ACE inhibitors can cause hypotension (Choice C), cough is more prevalent. Hyperkalemia (Choice D) is a possible side effect of ACE inhibitors but is less common compared to cough.

2. 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.

3. What term refers to the degree of myocardial fiber stretch before contraction, related to the volume of blood distending the ventricles at the end of diastole, and determined by the amount of venous return?

• A. Preload
• B. Afterload
• C. Contractility
• D. Ejection fraction

Correct answer: A

Rationale: The correct answer is A: Preload. Preload is the degree of myocardial fiber stretch before contraction, influenced by the volume of blood returning to the heart. This parameter is related to the amount of blood in the ventricles at the end of diastole. Choice B, Afterload, refers to the pressure or resistance that the ventricles must overcome to eject blood. Choice C, Contractility, is the intrinsic ability of the heart muscle to contract. Choice D, Ejection fraction, is the percentage of blood pumped out of the ventricles with each contraction.

4. 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.

5. What test uses sound waves to create pictures of the heart, allowing doctors to see how well the heart is functioning?

• A. Echocardiogram
• B. MRI
• C. CT scan
• D. X-ray

Correct answer: A

Rationale: The correct answer is an echocardiogram. This test utilizes sound waves to generate images of the heart, enabling doctors to evaluate both the function and structure of the heart. Choice B, MRI, uses magnetic fields and radio waves to produce detailed images of the body's organs and structures, not specifically focused on the heart. Choice C, CT scan, employs X-rays to create detailed cross-sectional images of the body, not primarily for the heart. Choice D, X-ray, uses electromagnetic radiation to produce images of internal structures, but it does not provide the detailed pictures of the heart's function that an echocardiogram does.

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