Nursing Elites

1. What is a procedure to remove fluid or air from the pleural space to help a patient breathe easier?

• A. Thoracentesis
• B. Bronchoscopy
• C. Chest X-ray
• D. CT scan

Correct answer: A

Rationale: Correct! Thoracentesis is the correct answer. It is a procedure where fluid or air is removed from the pleural space in the chest to help the patient breathe more easily. Bronchoscopy (choice B) is a procedure to visualize the airways, while Chest X-ray (choice C) and CT scan (choice D) are imaging tests and do not involve the removal of fluid or air from the pleural space.

2. What is the procedure where a small mesh tube is inserted into an artery to keep it open after angioplasty?

• A. Stent placement
• B. Bypass surgery
• C. Angioplasty
• D. Valve replacement

Correct answer: A

Rationale: The correct answer is A, stent placement. Stent placement involves inserting a small mesh tube into an artery to maintain its openness after angioplasty. This choice is correct because it directly describes the procedure mentioned in the question. Choices B, C, and D are incorrect. Bypass surgery involves rerouting blood flow around a blocked artery using a vessel from another part of the body. Angioplasty is the procedure of widening a narrowed or blocked blood vessel, often followed by stent placement. Valve replacement is a surgical procedure to replace a damaged or diseased heart valve with an artificial or biological valve.

3. The nurse is giving the client digoxin for heart failure and recognizes that the drug has what type of effect on the heart?

• A. Negative inotropic, negative chronotropic effect
• B. Positive inotropic, negative chronotropic effect
• C. Negative inotropic, positive chronotropic effect
• D. Positive inotropic, positive chronotropic effect

Correct answer: B

Rationale: The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin strengthens the heart muscle, providing a positive inotropic effect, which increases the force of contraction. It also decreases the heart rate, having a negative chronotropic effect. Choice A is incorrect because digoxin has a positive inotropic effect, not a negative inotropic effect. Choice C is incorrect as digoxin does not have a positive chronotropic effect but a negative one. Choice D is incorrect because while digoxin has a positive inotropic effect, it does not have a positive chronotropic effect.

4. The nurse is giving digoxin to a client. What is the most important parameter to check before administration?

• A. Heart rate
• B. Blood pressure
• C. Respiratory rate
• D. Oxygen saturation

Correct answer: A

Rationale: The correct answer is A: Heart rate. Before administering digoxin, it is crucial to check the client's heart rate because digoxin can cause bradycardia, an abnormally slow heart rate. Monitoring the heart rate is essential to prevent potential complications associated with digoxin therapy. Choices B, C, and D are less critical parameters to assess before administering digoxin. While blood pressure is also important to monitor during digoxin therapy, the most crucial parameter to check due to the medication's potential effect on heart rate is the heart rate itself.

5. 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.

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