Nursing Elites

1. A healthcare professional is administering a Dopamine infusion at a low dose to a client with severe heart failure. Which of the following findings is an expected effect of this medication?

• A. Lowered heart rate
• B. Increased myocardial contractility
• C. Decreased conduction through the AV node
• D. Vasoconstriction of renal blood vessels

Correct answer: B

Rationale: Dopamine, when administered at a low dose, is expected to increase myocardial contractility by stimulating beta1 receptors. This positive inotropic effect leads to an increase in cardiac output. Therefore, the correct answer is increased myocardial contractility, as it is a desired effect of administering dopamine to a client with severe heart failure.

2. A client has a prescription for furosemide. Which of the following instructions should the nurse include?

• A. Take furosemide in the morning.
• B. Eat a diet high in potassium.
• C. Avoid foods high in magnesium.
• D. Limit fluid intake to 1 liter per day.

Correct answer: B

Rationale: The correct instruction for a client taking furosemide is to eat a diet high in potassium. Furosemide is a loop diuretic that can lead to potassium loss, potentially causing hypokalemia. Consuming foods rich in potassium can help maintain normal potassium levels in the body and counteract the potential side effect of furosemide. Choices A, C, and D are incorrect because taking furosemide in the morning does not specifically relate to its effectiveness or side effects, avoiding foods high in magnesium is not a primary concern when taking furosemide, and limiting fluid intake to 1 liter per day is not a general recommendation for individuals taking furosemide.

3. A healthcare professional is preparing to administer Spironolactone to a client. Which of the following laboratory results should the professional review before administering this medication?

• A. Serum potassium.
• B. Serum sodium.
• C. Serum chloride.
• D. Serum calcium.

Correct answer: A

Rationale: When administering Spironolactone, it is essential to monitor the client's serum potassium levels because Spironolactone is a potassium-sparing diuretic. Monitoring potassium levels helps to detect hyperkalemia, a potential adverse effect of the medication.

4. A client is prescribed Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?

• A. Sodium level of 138 mEq/L
• B. Potassium level of 5.2 mEq/L
• C. Chloride level of 100 mEq/L
• D. Calcium level of 9.5 mg/dL

Correct answer: B

Rationale: Spironolactone is a potassium-sparing diuretic, causing potassium retention, potentially leading to elevated potassium levels. A potassium level of 5.2 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia, a serious condition. Elevated potassium levels can lead to life-threatening cardiac arrhythmias. Monitoring and reporting high potassium levels promptly to the healthcare provider are crucial to prevent potential complications. Sodium, chloride, and calcium levels are not directly influenced by Spironolactone, making choices A, C, and D incorrect.

5. When providing discharge instructions to a client with a new prescription for Lisinopril, which of the following instructions should the nurse include?

• A. Avoid salt substitutes.
• B. Take this medication at bedtime.
• C. Increase your intake of potassium-rich foods.
• D. Take this medication with food.

Correct answer: A

Rationale: The correct answer is to instruct the client to avoid salt substitutes. Lisinopril, an ACE inhibitor, can lead to hyperkalemia, so it is essential to avoid salt substitutes containing potassium, which can further increase potassium levels in the body. This instruction aims to prevent potential adverse effects and ensure the client's safety while taking Lisinopril. Choices B, C, and D are incorrect because Lisinopril is typically taken once a day in the morning, it can lead to hyperkalemia (so increasing potassium-rich foods is not advised), and it can be taken with or without food.

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