Nursing Elites

1. The nurse is administering digoxin to a client with a heart rate of 45 bpm. What is the nurse’s priority action?

• A. Hold the digoxin and notify the healthcare provider.
• B. Administer the digoxin as ordered.
• C. Increase the dose of digoxin.
• D. Monitor the client’s heart rate and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A heart rate of 45 bpm is already low, and digoxin can further decrease the heart rate, leading to serious complications like bradycardia or heart block. Administering the medication can exacerbate the bradycardia, hence it should be withheld. Increasing the dose of digoxin is contraindicated due to the client's low heart rate. Monitoring the heart rate alone without taking immediate action to withhold the medication is not the priority when faced with the risk of further lowering the heart rate.

2. The client is on spironolactone (Aldactone). What is the most important dietary instruction?

• A. Avoid foods high in potassium.
• B. Increase intake of foods high in potassium.
• C. Avoid foods high in sodium.
• D. Increase intake of foods high in sodium.

Correct answer: A

Rationale: The correct answer is to avoid foods high in potassium. Spironolactone is a potassium-sparing diuretic, meaning it helps the body retain potassium and can lead to hyperkalemia if too much potassium is consumed. Choices B, C, and D are incorrect because increasing intake of potassium-rich foods can worsen hyperkalemia, while avoiding foods high in sodium is not the primary concern when taking spironolactone.

3. What is a genetic disorder that affects the lungs and digestive system, leading to thick, sticky mucus that can clog the airways?

• A. Cystic fibrosis
• B. COPD
• C. Bronchiectasis
• D. Pulmonary fibrosis

Correct answer: A

Rationale: The correct answer is A, cystic fibrosis. Cystic fibrosis is a genetic disorder that primarily affects the lungs and digestive system. It leads to the production of thick, sticky mucus that can clog the airways, causing respiratory issues. Choice B, COPD (Chronic Obstructive Pulmonary Disease), is a different condition usually caused by smoking or exposure to irritants. Choice C, bronchiectasis, involves the widening and scarring of the airways, not the production of thick mucus. Choice D, pulmonary fibrosis, is a lung disease characterized by scarring of the lung tissue, not excessive mucus production.

4. What is a condition where the walls of the arteries in the lungs become thickened and stiff, leading to increased blood pressure in the pulmonary arteries?

• A. Pulmonary hypertension
• B. Pulmonary fibrosis
• C. Pulmonary embolism
• D. Pulmonary edema

Correct answer: A

Rationale: Pulmonary hypertension is a condition characterized by the thickening and stiffening of the arteries in the lungs, resulting in elevated blood pressure in the pulmonary arteries. This condition is distinct from the other choices provided. Pulmonary fibrosis involves scarring of lung tissue, pulmonary embolism is a blockage in the pulmonary artery, and pulmonary edema is the accumulation of fluid in the lungs.

5. What is the procedure where a device is used to shock the heart back into a normal rhythm during a life-threatening arrhythmia?

• A. Defibrillation
• B. Cardioversion
• C. Echocardiogram
• D. Ablation

Correct answer: A

Rationale: The correct answer is A, Defibrillation. Defibrillation is the procedure of using a device to deliver an electric shock to the heart during life-threatening arrhythmias like ventricular fibrillation or ventricular tachycardia to restore a normal rhythm. Choice B, Cardioversion, is similar but is typically used for less severe arrhythmias. Choice C, Echocardiogram, is a diagnostic test that uses sound waves to create images of the heart. Choice D, Ablation, is a procedure to treat certain types of arrhythmias by scarring or destroying tissue that triggers abnormal electrical signals.

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