Nursing Elites

1. The nurse is caring for a heart client on digoxin and notes a potassium level of 2.5. What is the appropriate priority nursing intervention?

• A. Do nothing as this is a normal potassium level.
• B. The potassium level is low so the nurse asks for an order for potassium.
• C. The nurse asks to check the digoxin level as low potassium can increase digoxin toxicity.
• D. The nurse stops the digoxin.

Correct answer: C

Rationale: The correct answer is C. When caring for a client on digoxin with a low potassium level, the priority nursing intervention is to check the digoxin level. Low potassium can increase the risk of digoxin toxicity. Checking the digoxin level will help determine if any adjustments to the medication regimen are needed to prevent potential harm. Choice A is incorrect as a potassium level of 2.5 is low, not normal. Choice B is not the priority as simply giving potassium may not address the underlying issue of potential digoxin toxicity. Choice D is not the initial action to take without assessing the digoxin level first.

2. The healthcare provider is preparing to administer heparin to a client. What lab value should be monitored?

• A. PT/INR
• B. aPTT
• C. Platelet count
• D. Hemoglobin

Correct answer: B

Rationale: The correct lab value that should be monitored when administering heparin is the aPTT (activated partial thromboplastin time). Heparin affects the intrinsic pathway of the coagulation cascade, and aPTT is a sensitive measure to assess the effectiveness of heparin therapy. Monitoring aPTT helps in adjusting the heparin dose to maintain the desired anticoagulant effect. PT/INR is more specific to monitor warfarin therapy, not heparin. Platelet count and hemoglobin levels are important parameters to assess bleeding tendencies and oxygen-carrying capacity but are not directly related to monitoring heparin therapy.

3. What is the procedure to remove a sample of tissue from the lung for examination under a microscope?

• A. Lung biopsy
• B. Bronchoscopy
• C. Thoracentesis
• D. Lobectomy

Correct answer: A

Rationale: The correct answer is A, lung biopsy. A lung biopsy involves removing a small sample of lung tissue for examination under a microscope to diagnose lung conditions. Choice B, bronchoscopy, is a procedure where a thin, flexible tube with a light and camera is inserted into the airways to view the lungs. This procedure is more for diagnostic purposes and not specifically for tissue removal. Choice C, thoracentesis, is a procedure to remove fluid from the pleural space around the lungs for diagnostic or therapeutic purposes, not for tissue biopsy. Choice D, lobectomy, is a surgical procedure to remove a lobe of the lung, usually done to treat conditions like lung cancer or severe infections, but it does not involve removing tissue for microscopic examination.

4. What type of stroke is caused by a blockage in an artery supplying blood to the brain?

• A. Ischemic stroke
• B. Hemorrhagic stroke
• C. Transient ischemic attack
• D. Embolism

Correct answer: A

Rationale: The correct answer is A: Ischemic stroke. Ischemic stroke occurs when a blood clot blocks an artery supplying blood to the brain, leading to brain damage. Choice B, Hemorrhagic stroke, is caused by bleeding in the brain, not a blockage. Choice C, Transient ischemic attack, is a temporary blockage of blood flow to the brain with symptoms similar to a stroke but typically lasting only a few minutes. Choice D, Embolism, refers to a blood clot or other particle that travels through the bloodstream and blocks a blood vessel.

5. Which condition is caused by a bacterium that primarily affects the lungs but can spread to other parts of the body?

• A. Tuberculosis
• B. Pneumonia
• C. Legionnaires' disease
• D. Histoplasmosis

Correct answer: A

Rationale: The correct answer is A, Tuberculosis. Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, primarily affecting the lungs but can spread to other organs. Choice B, Pneumonia, is an infection that inflames the air sacs in one or both lungs. Choice C, Legionnaires' disease, is a severe form of pneumonia caused by the Legionella bacteria. Choice D, Histoplasmosis, is a fungal infection caused by inhaling spores of the Histoplasma capsulatum fungus.

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