Nursing Elites

1. 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.

2. Which type of lung cancer is strongly associated with exposure to asbestos?

• A. Mesothelioma
• B. Adenocarcinoma
• C. Squamous cell carcinoma
• D. Small cell lung cancer

Correct answer: A

Rationale: The correct answer is Mesothelioma. This type of lung cancer is indeed strongly associated with exposure to asbestos, affecting the lining of the lungs or abdomen. Adenocarcinoma, Squamous cell carcinoma, and Small cell lung cancer are not primarily linked to asbestos exposure, making them incorrect choices for this question.

3. What test measures the electrical activity of the heart and can detect heart rhythm problems?

• A. Electrocardiogram (ECG or EKG)
• B. Chest X-ray
• C. MRI
• D. CT scan

Correct answer: A

Rationale: The correct answer is Electrocardiogram (ECG or EKG). An electrocardiogram is a test that measures the electrical activity of the heart and can detect irregularities in heart rhythm. Choices B, C, and D are incorrect because a chest X-ray, MRI, and CT scan do not specifically measure the electrical activity of the heart or detect heart rhythm problems.

4. The client on amiodarone develops symptoms of hypothyroidism. What is the nurse’s best response?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect of amiodarone.
• C. Monitor the client’s thyroid function tests regularly.
• D. Discontinue the amiodarone immediately.

Correct answer: C

Rationale: When a client on amiodarone develops symptoms of hypothyroidism, the nurse's best response is to monitor the client's thyroid function tests regularly. Amiodarone can affect thyroid function, so monitoring is essential to assess the impact and adjust treatment if necessary. Notifying the healthcare provider immediately (Choice A) may be necessary in some cases but the priority is to monitor first. Reassuring the client (Choice B) is not sufficient as monitoring is crucial. Discontinuing amiodarone (Choice D) abruptly without healthcare provider guidance can lead to serious consequences.

5. Which type of medication helps to reduce blood pressure by relaxing the blood vessels?

• A. Calcium channel blocker
• B. ACE inhibitor
• C. Beta-blocker
• D. Diuretic

Correct answer: A

Rationale: The correct answer is A, Calcium channel blocker. Calcium channel blockers work by relaxing the blood vessels, making it easier for the heart to pump blood and reducing blood pressure. Choice B, ACE inhibitor, reduces blood pressure by blocking the production of angiotensin II, a substance that narrows blood vessels. Choice C, Beta-blocker, reduces heart rate and the heart's workload, not directly relaxing blood vessels. Choice D, Diuretic, reduces blood pressure by increasing urine output, reducing the volume of fluid in the blood vessels, rather than directly relaxing them.

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