Nursing Elites

1. What is a chronic condition where the bronchial tubes in the lungs become inflamed and narrowed, often caused by smoking?

• A. Chronic bronchitis
• B. Emphysema
• C. Asthma
• D. Tuberculosis

Correct answer: A

Rationale: Chronic bronchitis is the correct answer because it is a long-term condition characterized by inflammation and narrowing of the bronchial tubes in the lungs, commonly triggered by smoking. Emphysema involves damage to the air sacs in the lungs, not specifically the bronchial tubes. Asthma is a condition of reversible airway obstruction usually due to allergies or other triggers, not solely smoking. Tuberculosis is a bacterial infection that primarily affects the lungs but is not directly related to inflammation and narrowing of the bronchial tubes.

2. The nurse is caring for a client on heparin. What is the most important lab value to monitor?

• A. aPTT
• B. INR
• C. Platelet count
• D. Hemoglobin

Correct answer: A

Rationale: The correct answer is A: aPTT. When a client is on heparin therapy, monitoring the aPTT is crucial. The aPTT helps assess the effectiveness of heparin in preventing blood clots and guides dose adjustments as needed. INR (Choice B) is more commonly used to monitor warfarin therapy. Platelet count (Choice C) is important to assess for potential bleeding disorders or thrombocytopenia but is not the primary lab value to monitor for heparin therapy. Hemoglobin (Choice D) is essential for assessing oxygen-carrying capacity but is not the most important lab value to monitor when a client is on heparin.

3. The client on digoxin has a potassium level of 3.0 mEq/L. What is the nurse’s priority action?

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

Correct answer: B

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 3.0 mEq/L indicates hypokalemia, which can increase the risk of digoxin toxicity. Digoxin and low potassium levels can lead to serious cardiac arrhythmias. Administering a potassium supplement (choice A) without healthcare provider guidance can worsen the situation. Continuing the current digoxin dose (choice C) can further increase the risk of toxicity. Administering Digibind (choice D) is used in severe cases of digoxin toxicity, not for addressing low potassium levels.

4. This is a test that measures the oxygen saturation level in the blood, often used to assess respiratory function.

• A. Pulse oximetry
• B. Spirometry
• C. Arterial blood gas (ABG)
• D. Lung function test

Correct answer: A

Rationale: The correct answer is A, Pulse oximetry. Pulse oximetry is a non-invasive test that measures the oxygen saturation level in the blood, helping to assess respiratory and cardiovascular function. Choice B, Spirometry, measures lung function by assessing airflow and volume. Choice C, Arterial blood gas (ABG), evaluates the acidity, oxygen, and carbon dioxide levels in the blood. Choice D, Lung function test, is a broad term that may include various tests to assess lung health, but specifically measuring oxygen saturation is done through pulse oximetry.

5. Which order should the nurse question?

• A. The addition of a loop diuretic with digoxin.
• B. The addition of a beta blocker with digoxin.
• C. A digoxin dose of 0.125 mg per day.
• D. The addition of an ACE inhibitor with digoxin.

Correct answer: B

Rationale: The correct answer is B because adding a beta blocker to digoxin can potentiate the bradycardic effect of digoxin, leading to serious complications such as heart block. This combination requires caution as it can significantly slow down the heart rate. Choices A, C, and D are not the best options to question in this scenario. Loop diuretics are commonly used with digoxin, a digoxin dose of 0.125 mg per day is within the typical range, and ACE inhibitors are often prescribed alongside digoxin for managing heart conditions.

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