the client on spironolactone aldactone has a potassium level of 56 meql what is the nurses priority action
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Nursing Elites

ATI RN

Physical Exam Cardiovascular System

1. The client on spironolactone (Aldactone) has a potassium level of 5.6 mEq/L. What is the nurse’s priority action?

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. What test uses high-frequency sound waves to create images of the heart, allowing doctors to assess its structure and function?

Correct answer: A

Rationale: The correct answer is an echocardiogram. An echocardiogram utilizes high-frequency sound waves (ultrasound) to create images of the heart, enabling doctors to evaluate its structure, function, and detect any abnormalities. MRI (Choice B) uses magnetic fields and radio waves to produce detailed images of the body's structures. CT scan (Choice C) combines X-rays and computer technology to create cross-sectional images of the body. X-ray (Choice D) uses electromagnetic radiation to produce images of the internal structures of the body, but it is not the most suitable for assessing the heart's structure and function.

3. What procedure uses a catheter to open blocked coronary arteries and improve blood flow to the heart muscle?

Correct answer: A

Rationale: The correct answer is A, Angioplasty. Angioplasty is a procedure where a catheter is used to open blocked coronary arteries and may involve the insertion of a stent to improve blood flow to the heart muscle. Stent placement (B) is a related procedure but specifically refers to the insertion of a stent. Coronary artery bypass graft (CABG) (C) is a surgical procedure that uses blood vessels to bypass blocked coronary arteries. Valve replacement (D) is a different procedure that involves replacing a heart valve, not opening blocked coronary arteries.

4. What is a condition where the lung's air sacs become inflamed and fill with fluid or pus, causing cough, fever, chills, and difficulty breathing?

Correct answer: A

Rationale: Pneumonia is the correct answer. It is an infection that inflames the air sacs in one or both lungs, leading to the accumulation of fluid or pus, which results in symptoms such as cough, fever, chills, and difficulty breathing. Tuberculosis (choice B) is a bacterial infection affecting the lungs but does not typically cause the same acute symptoms as described. Asthma (choice C) is a chronic respiratory condition characterized by inflammation and narrowing of the airways, not specifically involving the air sacs. Bronchitis (choice D) is an inflammation of the bronchial tubes, not the air sacs in the lungs, and does not typically cause the same symptoms as pneumonia.

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

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.

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