Nursing Elites

1. The client is on spironolactone (Aldactone) and has a potassium level of 5.9 mEq/L. What is the nurse’s priority action?

• A. Hold the spironolactone and notify the healthcare provider.
• B. Administer potassium supplements.
• C. Continue the spironolactone as ordered.
• D. Increase the dose of spironolactone.

Correct answer: A

Rationale: The correct answer is A: Hold the spironolactone and notify the healthcare provider. A potassium level of 5.9 mEq/L is high, indicating hyperkalemia. Spironolactone is a potassium-sparing diuretic that can further increase potassium levels. Therefore, the priority action is to hold the medication to prevent exacerbating hyperkalemia and notify the healthcare provider for further guidance. Choice B is incorrect because administering potassium supplements would worsen hyperkalemia. Choice C is incorrect because continuing spironolactone could lead to a further increase in potassium levels. Choice D is incorrect because increasing the dose of spironolactone would exacerbate the hyperkalemia.

2. What is the procedure where a catheter is used to open a blocked or narrowed coronary artery, often involving the placement of a stent?

• A. Angioplasty
• B. Valve replacement
• C. Stent placement
• D. Coronary artery bypass graft (CABG)

Correct answer: A

Rationale: The correct answer is Angioplasty. Angioplasty is a procedure where a catheter is used to open a blocked or narrowed coronary artery, often involving the placement of a stent to keep the artery open and improve blood flow to the heart. Choice B, Valve replacement, is incorrect as it involves replacing a heart valve, not opening a blocked artery. Choice C, Stent placement, is similar to angioplasty but not as specific, as it does not involve the catheter-based procedure. Choice D, Coronary artery bypass graft (CABG), is a different procedure where blocked arteries are bypassed using a blood vessel from another part of the body.

3. What is a condition where the heart muscle becomes abnormally enlarged, thickened, or stiffened, often leading to heart failure?

• A. Cardiomyopathy
• B. Pericarditis
• C. Aortic stenosis
• D. Mitral valve prolapse

Correct answer: A

Rationale: Cardiomyopathy is the correct answer. It is a condition characterized by the abnormal enlargement, thickening, or stiffening of the heart muscle, which can lead to heart failure. Pericarditis (choice B) is inflammation of the pericardium, the sac surrounding the heart, not directly related to heart muscle enlargement. Aortic stenosis (choice C) is the narrowing of the aortic valve opening, affecting blood flow from the heart, but not directly related to heart muscle enlargement. Mitral valve prolapse (choice D) is a condition where the valve between the left atrium and left ventricle doesn't close properly, causing blood to leak backward, and is not directly related to heart muscle enlargement.

4. Which term refers to a condition where the blood supply to part of the heart muscle is blocked, often referred to as a heart attack?

• A. Myocardial infarction
• B. Arrhythmia
• C. Stroke
• D. Aneurysm

Correct answer: A

Rationale: The correct answer is A, myocardial infarction. A myocardial infarction, commonly known as a heart attack, occurs when the blood supply to part of the heart muscle is blocked, often by a blood clot. Choices B, C, and D are incorrect because arrhythmia refers to an irregular heartbeat, stroke involves the interruption of blood flow to the brain, and an aneurysm is a bulge in a blood vessel.

5. Which structure serves as the major chemoreceptor of the heart?

• A. Carotid body
• B. Aortic body
• C. Vagus nerve
• D. SA node

Correct answer: A

Rationale: The correct answer is A, the carotid body. The carotid body is the major chemoreceptor of the heart responsible for detecting changes in blood oxygen, carbon dioxide, and pH levels. This specialized structure helps regulate the cardiovascular system's response to maintain appropriate oxygen levels in the blood. Choices B, C, and D are incorrect as they are not directly involved in chemoreception in the heart. The aortic body is primarily involved in blood pressure regulation, the vagus nerve is a cranial nerve responsible for parasympathetic innervation, and the SA node is known as the heart's natural pacemaker.

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