Nursing Elites

1. The client on digoxin has a potassium level of 2.7 mEq/L. What is the nurse’s priority action?

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

Correct answer: A

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 2.7 mEq/L is considered low and can increase the risk of digoxin toxicity. Holding the medication and informing the healthcare provider is crucial to prevent adverse effects. Administering the digoxin as ordered (Choice B) would put the client at a higher risk for toxicity. Increasing the dose of digoxin (Choice C) is not appropriate when the client's potassium level is low. Administering potassium supplements (Choice D) may be necessary but is not the priority action in this situation.

2. Which of the following is a rare genetic disorder that affects the lungs, liver, and skin, causing the buildup of a specific protein that damages organs?

• A. Alpha-1 antitrypsin deficiency
• B. Cystic fibrosis
• C. Wegener's granulomatosis
• D. Marfan syndrome

Correct answer: A

Rationale: The correct answer is Alpha-1 antitrypsin deficiency. This disorder leads to the accumulation of a specific protein that can harm the lungs, liver, and skin. Choice B, Cystic fibrosis, is incorrect because it primarily affects the lungs and digestive system due to a defective gene. Choice C, Wegener's granulomatosis, is an autoimmune disease that involves inflammation of blood vessels, not protein buildup. Choice D, Marfan syndrome, is a connective tissue disorder impacting the heart, blood vessels, bones, and eyes, but not involving protein accumulation that damages organs.

3. What is the abnormal accumulation of fluid in the pleural space, often associated with infections or malignancies?

• A. Pleural effusion
• B. Pneumothorax
• C. Pulmonary edema
• D. Atelectasis

Correct answer: A

Rationale: The correct answer is A, pleural effusion. Pleural effusion is the accumulation of excess fluid between the layers of the pleura outside the lungs, often caused by infections, cancer, or other diseases. Pneumothorax (choice B) is the presence of air in the pleural space, not fluid. Pulmonary edema (choice C) is the accumulation of fluid in the lungs' air sacs and tissue, not in the pleural space. Atelectasis (choice D) is the collapse or closure of a lung resulting in reduced or absent gas exchange.

4. The client on furosemide (Lasix) has a potassium level of 3.1 mEq/L. What is the nurse’s priority action?

• A. Administer a potassium supplement.
• B. Hold the furosemide and notify the healthcare provider.
• C. Continue the current dose of furosemide.
• D. Administer Digibind.

Correct answer: A

Rationale: The correct answer is to administer a potassium supplement. A potassium level of 3.1 mEq/L indicates hypokalemia, which can lead to serious complications like cardiac dysrhythmias. Therefore, the priority action is to address the low potassium level by administering a potassium supplement. Holding the furosemide (Choice B) may be necessary in the long term to prevent further potassium loss, but the immediate need is to correct the low potassium level. Continuing the current dose of furosemide (Choice C) without addressing the low potassium level can worsen hypokalemia. Administering Digibind (Choice D) is not indicated for low potassium levels; Digibind is used to treat digoxin toxicity.

5. Which of the following is a chronic condition where the heart muscle is weakened and unable to pump blood effectively, often leading to heart failure?

• A. Dilated cardiomyopathy
• B. Hypertrophic cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Myocarditis

Correct answer: A

Rationale: Dilated cardiomyopathy is characterized by the heart muscle being weakened and unable to pump blood effectively, ultimately resulting in heart failure. Choice B, Hypertrophic cardiomyopathy, involves the heart muscle becoming abnormally thick, reducing the heart's efficiency. Choice C, Restrictive cardiomyopathy, refers to the heart becoming rigid and less able to fill with blood properly. Myocarditis, as in Choice D, is inflammation of the heart muscle usually caused by a viral infection and is different from the chronic weakening seen in dilated cardiomyopathy.

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