Nursing Elites

1. What is a condition characterized by episodes of severe, acute shortness of breath, often occurring at night?

• A. Paroxysmal nocturnal dyspnea
• B. Sleep apnea
• C. Orthopnea
• D. Dyspnea

Correct answer: A

Rationale: Paroxysmal nocturnal dyspnea is the correct answer. It is characterized by sudden episodes of severe shortness of breath during sleep, often waking the individual. Choice B, Sleep apnea, involves pauses in breathing during sleep but does not usually present with acute shortness of breath. Choice C, Orthopnea, refers to shortness of breath that occurs when lying flat and is relieved by sitting up. Choice D, Dyspnea, is a general term for difficult or labored breathing and does not specifically describe acute episodes at night.

2. The nurse is caring for a client on heparin. What is the most important lab value to monitor?

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

Correct answer: A

Rationale: The correct answer is A: aPTT. When a client is on heparin therapy, monitoring the aPTT is crucial. The aPTT helps assess the effectiveness of heparin in preventing blood clots and guides dose adjustments as needed. INR (Choice B) is more commonly used to monitor warfarin therapy. Platelet count (Choice C) is important to assess for potential bleeding disorders or thrombocytopenia but is not the primary lab value to monitor for heparin therapy. Hemoglobin (Choice D) is essential for assessing oxygen-carrying capacity but is not the most important lab value to monitor when a client is on heparin.

3. What procedure is used to visualize the airways and diagnose lung disease?

• A. Bronchoscopy
• B. Thoracentesis
• C. Pulmonary function test
• D. Chest X-ray

Correct answer: A

Rationale: Bronchoscopy is the correct answer because it is a procedure specifically designed to visualize the airways and diagnose lung diseases by allowing doctors to examine the inside of the airways. Thoracentesis involves the removal of fluid from the pleural space around the lungs, not the airways. Pulmonary function tests assess how well the lungs work but do not visualize the airways directly. A chest X-ray provides an image of the lungs and surrounding structures but does not involve direct visualization of the airways.

4. A client on spironolactone (Aldactone) has a potassium level of 6.0 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: The correct action for a client on spironolactone with a potassium level of 6.0 mEq/L is to hold the medication and notify the healthcare provider. Spironolactone is a potassium-sparing diuretic that can further elevate potassium levels, which are already high. Administering a potassium supplement (Choice B) would exacerbate the hyperkalemia. Continuing the spironolactone as ordered (Choice C) could lead to worsening hyperkalemia. Increasing the dose of spironolactone (Choice D) would be contraindicated in the presence of elevated potassium levels.

5. The client is on a beta blocker for hypertension. What should the nurse monitor for?

• A. Bradycardia
• B. Tachycardia
• C. Hypertension
• D. Respiratory distress

Correct answer: A

Rationale: Corrected Rationale: When a client is on a beta blocker for hypertension, the nurse should monitor for bradycardia. Beta blockers are known to decrease heart rate, which can lead to bradycardia. Tachycardia (choice B) is unlikely as beta blockers have the opposite effect. Hypertension (choice C) is the condition being treated, not a side effect of beta blockers. Respiratory distress (choice D) is not a common effect of beta blockers and is not typically monitored in clients taking beta blockers.

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