Nursing Elites

1. When administering furosemide (Lasix) to a client, which lab value is most important to monitor?

• A. Potassium
• B. Sodium
• C. Calcium
• D. Chloride

Correct answer: A

Rationale: When administering furosemide (Lasix), it is crucial to monitor potassium levels closely. Furosemide is a loop diuretic that can lead to potassium loss, potentially causing hypokalemia. Monitoring potassium levels helps prevent adverse effects associated with low potassium, such as cardiac arrhythmias. While monitoring sodium, calcium, and chloride levels may also be important in certain situations, potassium is the most critical to monitor when administering furosemide.

2. Which fibers distribute the electrical impulse to the ventricles, causing them to contract?

• A. Purkinje fibers
• B. SA node
• C. AV node
• D. Bundle of His

Correct answer: A

Rationale: The correct answer is Purkinje fibers. Purkinje fibers are specialized conducting fibers that distribute the electrical impulse to the ventricles, leading to their contraction. The SA node (sinoatrial node) is responsible for initiating the electrical impulse in the heart, the AV node (atrioventricular node) delays the impulse to allow for proper atrial contraction before ventricular contraction, and the Bundle of His transmits the impulse from the AV node to the ventricles. Therefore, choices B, C, and D are not the correct options for fibers directly distributing the impulse to the ventricles.

3. What is a device that delivers a fine spray of medication into the airways?

• A. Nebulizer
• B. Inhaler
• C. Oxygen concentrator
• D. Peak flow meter

Correct answer: A

Rationale: A nebulizer is a device that converts liquid medication into a fine mist, allowing it to be inhaled directly into the lungs. This makes it the correct answer to the question. Choice B, an inhaler, delivers medication in a different form - as a pressurized dose that needs to be inhaled. Choice C, an oxygen concentrator, is used to deliver oxygen to patients with breathing difficulties but does not deliver medication. Choice D, a peak flow meter, is used to measure how fast air can be blown out of the lungs and is not involved in delivering medication.

4. The client on digoxin has a potassium level of 3.0 mEq/L. What is the nurse’s priority action?

• A. Administer a potassium supplement
• B. Hold the digoxin and notify the healthcare provider
• C. Continue the current digoxin dose
• D. Administer Digibind

Correct answer: B

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 3.0 mEq/L indicates hypokalemia, which can increase the risk of digoxin toxicity. Digoxin and low potassium levels can lead to serious cardiac arrhythmias. Administering a potassium supplement (choice A) without healthcare provider guidance can worsen the situation. Continuing the current digoxin dose (choice C) can further increase the risk of toxicity. Administering Digibind (choice D) is used in severe cases of digoxin toxicity, not for addressing low potassium levels.

5. What is the term that describes the inability of cardiac cells to respond to a new stimulus while they are still in contraction from a previous stimulus?

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

Correct answer: A

Rationale: Refractoriness is the correct term to describe the inability of cardiac cells to respond to a new stimulus while they are still in contraction from a previous stimulus. This period is essential for the heart to complete its contraction and relaxation phases without interference. Excitability refers to the ability of cells to respond to stimuli, not the inability to respond. Contractility is the force of cardiac muscle contraction, and automaticity is the ability of cardiac cells to generate electrical impulses spontaneously, which are not relevant to the described scenario.

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