Nursing Elites

1. What is a surgical procedure to create an opening in the windpipe to assist with breathing?

• A. Tracheostomy
• B. Lobectomy
• C. Thoracotomy
• D. Pleurodesis

Correct answer: A

Rationale: Tracheostomy is the correct answer. It is a surgical procedure to create an opening in the windpipe (trachea) to assist with breathing. This procedure is commonly used for patients who require long-term ventilation support. Choice B, Lobectomy, involves the removal of a lobe of the lung and is not related to creating an opening in the windpipe. Choice C, Thoracotomy, is a surgical incision into the chest wall and is not specifically related to creating an opening in the windpipe. Choice D, Pleurodesis, is a procedure to treat recurrent pleural effusions by causing the pleural layers to stick together, and it is not related to creating an opening in the windpipe.

2. What test measures the pressure in the arteries during the contraction and relaxation of the heart?

• A. Blood pressure test
• B. Electrocardiogram (ECG or EKG)
• C. Spirometry
• D. Pulse oximetry

Correct answer: A

Rationale: The correct answer is 'Blood pressure test.' This test measures the pressure in the arteries during the contraction (systolic) and relaxation (diastolic) phases of the heart, providing important information about heart health. Choice B, 'Electrocardiogram (ECG or EKG),' records the heart's electrical activity and is not specifically related to measuring arterial pressure. Choice C, 'Spirometry,' assesses lung function by measuring airflow. Choice D, 'Pulse oximetry,' measures oxygen saturation in the blood, not arterial pressure.

3. Which procedure is used to restore a normal heart rhythm in patients with arrhythmias, typically using electrical shocks?

• A. Cardioversion
• B. Defibrillation
• C. Ablation
• D. Angioplasty

Correct answer: A

Rationale: The correct answer is A: Cardioversion. Cardioversion is the procedure used to restore a normal heart rhythm in patients with arrhythmias by delivering controlled electrical shocks to the heart. Choice B, Defibrillation, is incorrect because defibrillation is used to treat life-threatening arrhythmias by delivering an unsynchronized high-energy shock to the heart. Choice C, Ablation, is incorrect as it involves destroying abnormal tissue that causes arrhythmias, not necessarily restoring normal heart rhythm. Choice D, Angioplasty, is unrelated to heart rhythm restoration and is a procedure to open blocked or narrowed blood vessels.

4. 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.

5. When administering enoxaparin (Lovenox) to a client, what is the most important lab value to monitor?

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

Correct answer: A

Rationale: The correct answer is A: Platelet count. When administering enoxaparin (Lovenox), it is crucial to monitor the platelet count because enoxaparin can cause a rare but serious side effect known as heparin-induced thrombocytopenia, which is a decrease in platelet count that can lead to increased risk of bleeding. Monitoring the platelet count allows for early detection of this potential complication. Choices B, C, and D are incorrect because aPTT, Hemoglobin, and INR are not the most important lab values to monitor specifically when administering enoxaparin.

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