Nursing Elites

1. Which of the following is a chronic lung disease that results in the gradual destruction of the alveoli, causing difficulty breathing and reduced oxygen exchange?

• A. Emphysema
• B. Bronchitis
• C. Pulmonary hypertension
• D. Sarcoidosis

Correct answer: A

Rationale: Emphysema is the correct answer as it is a chronic lung disease characterized by the gradual destruction of the alveoli, which are essential for oxygen exchange. This destruction leads to difficulty breathing and reduced oxygen levels in the blood. Bronchitis is an inflammation of the bronchial tubes, not specifically involving alveoli destruction. Pulmonary hypertension is a condition of high blood pressure in the arteries of the lungs, not directly related to alveoli destruction. Sarcoidosis is a disease characterized by the growth of tiny collections of inflammatory cells in different parts of the body, including the lungs, but it does not primarily involve the destruction of alveoli.

2. The client on spironolactone (Aldactone) has a potassium level of 5.8 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: With a potassium level of 5.8 mEq/L, which is high, the priority action for the nurse is to hold the spironolactone. Spironolactone is a potassium-sparing diuretic that can further increase potassium levels. Therefore, it is crucial to prevent exacerbating hyperkalemia by discontinuing the medication. Notifying the healthcare provider is necessary for further guidance and potential adjustments to the treatment plan. Administering a potassium supplement (Choice B) would be contraindicated since the client already has elevated potassium levels. Continuing the spironolactone as ordered (Choice C) can worsen hyperkalemia. Increasing the dose of spironolactone (Choice D) would be unsafe and exacerbate the high potassium levels.

3. The nurse is preparing to administer a beta blocker to a client with hypertension. What is the priority assessment?

• A. Check the client's heart rate.
• B. Check the client's blood pressure.
• C. Check the client's respiratory rate.
• D. Check the client's temperature.

Correct answer: B

Rationale: The correct answer is to check the client's blood pressure. Before administering a beta blocker to a client with hypertension, assessing the blood pressure is crucial because beta blockers can cause hypotension, potentially leading to adverse effects. Checking the heart rate may also be important but is secondary to monitoring the blood pressure in this scenario. Respiratory rate and temperature assessments are not directly related to assessing the client's response to a beta blocker in hypertension management, making choices C and D less relevant.

4. This is a type of therapy that involves removing fluid from the lungs, typically through the use of diuretics.

• A. Diuretic therapy
• B. Oxygen therapy
• C. Inhaler therapy
• D. Antihistamine therapy

Correct answer: A

Rationale: The correct answer is A: Diuretic therapy. Diuretic therapy involves the use of medications that help remove excess fluid from the body, often used to treat conditions like pulmonary edema. Choice B, Oxygen therapy, is used to provide oxygen to patients with breathing difficulties but does not involve removing fluid from the lungs. Choice C, Inhaler therapy, is used to deliver medication directly to the lungs to help with respiratory conditions but does not focus on removing fluid. Choice D, Antihistamine therapy, is used to treat allergies by blocking histamine but is not related to removing fluid from the lungs.

5. A client on a beta blocker has a blood pressure of 90/60 mm Hg. What is the nurse’s priority action?

• A. Hold the beta blocker and notify the healthcare provider.
• B. Administer the beta blocker as ordered.
• C. Administer a diuretic to reduce blood pressure.
• D. Continue to monitor the client and reassess in 30 minutes.

Correct answer: A

Rationale: The correct answer is to hold the beta blocker and notify the healthcare provider. A blood pressure of 90/60 mm Hg is already low, and beta blockers can further decrease blood pressure. Administering the beta blocker can potentially worsen the situation, leading to complications. Administering a diuretic or continuing to monitor the client without taking immediate action could delay necessary intervention. Therefore, holding the beta blocker and involving the healthcare provider promptly is crucial in this scenario.

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