the client on spironolactone aldactone has a potassium level of 58 meql what is the nurses priority action
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Nursing Elites

ATI RN

Cardiovascular System Exam

1. The client on spironolactone (Aldactone) has a potassium level of 5.8 mEq/L. What is the nurse’s priority action?

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.

2. What is a condition where the arteries supplying blood to the legs and feet become narrowed or blocked, causing pain and difficulty walking?

Correct answer: A

Rationale: The correct answer is A, Peripheral artery disease (PAD). PAD is characterized by the narrowing or blockage of arteries that supply blood to the legs and feet, resulting in pain and difficulty walking. Choice B, Atherosclerosis, is a condition involving the buildup of plaque in the arteries but is not specific to the legs and feet. Varicose veins (Choice C) refer to enlarged, twisted veins usually occurring in the legs. Raynaud's disease (Choice D) involves episodes of reduced blood flow to the extremities, typically triggered by cold temperatures or stress, but it is not directly related to the arteries in the legs and feet.

3. What is a genetic disorder that affects the lungs and digestive system, leading to thick, sticky mucus that can clog the airways?

Correct answer: A

Rationale: The correct answer is A, cystic fibrosis. Cystic fibrosis is a genetic disorder that primarily affects the lungs and digestive system. It leads to the production of thick, sticky mucus that can clog the airways, causing respiratory issues. Choice B, COPD (Chronic Obstructive Pulmonary Disease), is a different condition usually caused by smoking or exposure to irritants. Choice C, bronchiectasis, involves the widening and scarring of the airways, not the production of thick mucus. Choice D, pulmonary fibrosis, is a lung disease characterized by scarring of the lung tissue, not excessive mucus production.

4. What term describes a condition where a person experiences difficulty breathing when lying flat and requires multiple pillows to sleep comfortably?

Correct answer: A

Rationale: The correct answer is A, Orthopnea. Orthopnea is a condition where a person finds it hard to breathe while lying flat and needs to use multiple pillows to sleep comfortably. This position helps relieve the discomfort by allowing better lung expansion. Choice B, Dyspnea, refers to difficulty breathing in general, not specifically related to lying flat. Choice C, Tachypnea, is rapid breathing and is not directly related to difficulty breathing while lying down. Choice D, Bradypnea, is slow breathing and does not describe the condition of having trouble breathing when lying flat.

5. Which condition involves the heart muscle becoming abnormally thickened, reducing its ability to pump blood?

Correct answer: A

Rationale: The correct answer is A: Hypertrophic cardiomyopathy. In this condition, the heart muscle thickens, leading to a decreased ability to pump blood effectively. Choice B, Dilated cardiomyopathy, is characterized by the heart chambers enlarging and weakening. Choice C, Restrictive cardiomyopathy, involves the heart muscle becoming rigid and less compliant. Choice D, Ischemic cardiomyopathy, is when the heart muscle is weakened due to reduced blood flow.

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