Nursing Elites

1. A client on an ACE inhibitor reports a persistent cough. What is the nurse’s best response?

• A. Reassure the client that the cough is a common side effect and is usually not serious.
• B. Instruct the client to report the cough to the healthcare provider as it may require discontinuation of the medication.
• C. Advise the client to use a humidifier at night to relieve the cough.
• D. Suggest the client take an over-the-counter cough suppressant.

Correct answer: B

Rationale: The correct answer is B. A persistent cough in a client on an ACE inhibitor may indicate a serious side effect that requires discontinuation of the medication. Instructing the client to report the cough to the healthcare provider is essential for proper evaluation and management. Choice A is incorrect because simply reassuring the client may delay necessary action. Choice C is incorrect as using a humidifier may not address the underlying cause of the cough. Choice D is incorrect because taking a cough suppressant without healthcare provider guidance may mask symptoms without addressing the cause.

2. What is a blood clot that forms in a vein, often in the legs, and can cause serious complications if it travels to the lungs?

• A. Deep vein thrombosis (DVT)
• B. Pulmonary embolism
• C. Varicose veins
• D. Atherosclerosis

Correct answer: A

Rationale: The correct answer is Deep vein thrombosis (DVT). DVT is a blood clot that forms in a deep vein, typically in the legs, and can lead to serious complications if it breaks loose and travels to the lungs, causing a pulmonary embolism. Varicose veins (choice C) are enlarged, twisted veins usually found in the legs but are not related to blood clots. Atherosclerosis (choice D) is a condition where arteries become narrowed and hardened due to a buildup of plaque, not directly related to blood clots.

3. What is a chronic condition where the airways in the lungs become damaged and widened, leading to mucus buildup and frequent infections?

• A. Bronchiectasis
• B. Chronic bronchitis
• C. Pneumoconiosis
• D. Asthma

Correct answer: A

Rationale: Bronchiectasis is a chronic condition characterized by the damage and widening of the airways in the lungs, resulting in mucus accumulation and recurrent lung infections. Choice B, chronic bronchitis, involves inflammation of the bronchial tubes and excessive mucus production but does not specifically mention airway damage and widening. Choice C, pneumoconiosis, refers to lung diseases caused by inhalation of mineral dust particles, not airway damage and mucus buildup. Choice D, asthma, is a chronic condition characterized by airway inflammation and narrowing, leading to breathing difficulties, but it does not involve the widening and damage of the airways as seen in bronchiectasis.

4. Which valve opens during ventricular systole and closes during ventricular diastole?

• A. Aortic valve
• B. Pulmonary valve
• C. Mitral valve
• D. Tricuspid valve

Correct answer: B

Rationale: The correct answer is B: Pulmonary valve. The pulmonary valve opens during ventricular systole to allow blood to flow from the right ventricle into the pulmonary artery. The aortic valve opens during ventricular systole to allow blood to flow from the left ventricle into the aorta. The mitral valve and tricuspid valve are atrioventricular valves that open during ventricular diastole to allow blood to flow from the atria into the ventricles.

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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