Nursing Elites

1. The client on spironolactone (Aldactone) has a potassium level of 5.6 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 5.6 mEq/L is high, indicating hyperkalemia. Spironolactone is a potassium-sparing diuretic that can further elevate potassium levels. Therefore, the priority action is to withhold the medication to prevent exacerbating hyperkalemia and notify the healthcare provider for further management. Option B is incorrect because administering potassium supplements would worsen the hyperkalemia. Option C is incorrect as continuing spironolactone can lead to a further increase in potassium levels. Option D is incorrect as increasing the dose of spironolactone would be inappropriate in the presence of elevated potassium levels.

2. Which valve prevents backflow of blood into the right ventricle from the pulmonary artery?

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

Correct answer: A

Rationale: The correct answer is the Pulmonary valve. The Pulmonary valve prevents backflow of blood into the right ventricle from the pulmonary artery after it has been ejected. The Aortic valve (choice B) prevents backflow from the aorta into the left ventricle. The Tricuspid valve (choice C) prevents backflow of blood into the right atrium from the right ventricle. The Mitral valve (choice D) prevents backflow from the left ventricle into the left atrium.

3. What procedure involves using a catheter to create a small scar in the heart tissue to block abnormal electrical signals and restore normal heart rhythm?

• A. Catheter ablation
• B. Angioplasty
• C. Stent placement
• D. Valve replacement

Correct answer: A

Rationale: Catheter ablation is the correct answer. During catheter ablation, a catheter is used to create a small scar in the heart tissue to block abnormal electrical signals, thereby restoring a normal heart rhythm. Choices B, C, and D are incorrect because angioplasty is a procedure to widen narrowed or obstructed arteries, stent placement involves inserting a mesh tube to support a weak artery, and valve replacement is the surgical procedure of replacing a heart valve, none of which match the description provided in the question.

4. During which process does coronary artery blood flow to the myocardium occur during diastole, when coronary vascular resistance is reduced?

• A. Coronary perfusion pressure
• B. Coronary vascular resistance
• C. Diastolic filling
• D. Ventricular ejection

Correct answer: A

Rationale: The correct answer is A: Coronary perfusion pressure. Coronary perfusion pressure refers to the process of coronary artery blood flow to the myocardium during diastole when coronary vascular resistance is reduced. This process ensures that the myocardium receives sufficient oxygen and nutrients for proper functioning. Choice B, Coronary vascular resistance, is the opposite of what is described in the question. During coronary perfusion, resistance is reduced to enhance blood flow. Choices C and D, Diastolic filling and Ventricular ejection, do not directly relate to the process of coronary artery blood flow during diastole.

5. This heart condition is characterized by decreased cardiac output and tissue perfusion, which can lead to organ failure.

• A. Cardiogenic shock
• B. Myocardial infarction
• C. Endocarditis
• D. Pericarditis

Correct answer: A

Rationale: The correct answer is A: Cardiogenic shock. Cardiogenic shock is a severe condition characterized by the heart's inability to pump enough blood, leading to decreased cardiac output and tissue perfusion, which can result in organ failure. Choice B, Myocardial infarction, specifically refers to a blockage of blood flow to the heart muscle. Choices C and D, Endocarditis and Pericarditis, do not directly involve decreased cardiac output leading to organ failure, making them incorrect in the context of the symptoms described in the question.

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