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. The nurse is caring for a client on digoxin. What is the most important assessment before administering this medication?

• 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 oxygen saturation.

Correct answer: A

Rationale: The correct answer is to check the client’s heart rate before administering digoxin because one of the side effects of digoxin is bradycardia. Monitoring the heart rate is crucial to assess whether the client's heart rate is within the acceptable range before giving the medication. Checking the blood pressure (Choice B), respiratory rate (Choice C), or oxygen saturation (Choice D) are important assessments in general patient care, but they are not specifically related to the administration of digoxin.

3. Which medication relaxes the muscles around the airways, making it easier to breathe?

• A. Bronchodilator
• B. Corticosteroid
• C. Antihistamine
• D. Mucolytic

Correct answer: A

Rationale: The correct answer is A, Bronchodilator. Bronchodilators are medications that relax the muscles surrounding the airways, which helps to open them and makes breathing easier. Corticosteroids (choice B) work by reducing inflammation, antihistamines (choice C) are used to manage allergies, and mucolytics (choice D) help to break down and thin mucus in the airways.

4. Which of the following is a chronic respiratory disease characterized by the irreversible obstruction of airflow?

• A. Chronic obstructive pulmonary disease (COPD)
• B. Asthma
• C. Pulmonary edema
• D. Bronchiectasis

Correct answer: A

Rationale: The correct answer is A, Chronic obstructive pulmonary disease (COPD). COPD is a chronic respiratory disease where the airflow in the lungs becomes obstructed, making it difficult to breathe. Choice B, Asthma, is a different chronic respiratory condition characterized by reversible airflow obstruction and airway hyperresponsiveness. Choice C, Pulmonary edema, is a condition where fluid accumulates in the lungs, leading to difficulty in breathing but not irreversible airflow obstruction. Choice D, Bronchiectasis, is a condition characterized by abnormal widening of the bronchial tubes, leading to recurrent respiratory infections, but it is not specifically defined by irreversible airflow obstruction.

5. 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.

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