Nursing Elites

1. What is a condition where the lung's air sacs (alveoli) are damaged and enlarged, leading to breathlessness?

• A. Emphysema
• B. Chronic bronchitis
• C. Asthma
• D. Pulmonary fibrosis

Correct answer: A

Rationale: Emphysema is the correct answer. It is a condition where the air sacs in the lungs are damaged and enlarged, leading to breathlessness. Chronic bronchitis is characterized by inflammation of the bronchial tubes, not the alveoli. Asthma involves airway inflammation and constriction, not alveolar damage. Pulmonary fibrosis is a condition where lung tissue becomes thickened and scarred, different from the alveolar damage seen in emphysema.

2. The nurse is caring for a client on warfarin with an INR of 1.8. What is the most appropriate action?

• A. Increase the dose of warfarin.
• B. Administer vitamin K.
• C. Hold the warfarin and notify the healthcare provider.
• D. Monitor the client’s INR closely.

Correct answer: D

Rationale: An INR of 1.8 is below the therapeutic range for a client on warfarin, indicating the need for monitoring closely to ensure that the INR levels reach the desired therapeutic range. Increasing the dose of warfarin (Choice A) without proper monitoring may lead to an increased risk of bleeding. Administering vitamin K (Choice B) is not typically recommended unless the client is experiencing major bleeding or requires rapid reversal of warfarin's effects. Holding the warfarin and notifying the healthcare provider (Choice C) may be necessary in certain situations, but the immediate action in this case should be to monitor the client's INR closely to guide further management.

3. 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.

4. Which procedure is used to remove excess fluid or air from the pleural space, helping to relieve pressure on the lungs?

• A. Thoracentesis
• B. Bronchoscopy
• C. Chest X-ray
• D. Arterial blood gas (ABG)

Correct answer: A

Rationale: The correct answer is Thoracentesis. Thoracentesis is a procedure specifically designed to remove excess fluid or air from the pleural space in the chest. This process helps to relieve pressure on the lungs and improve breathing. Bronchoscopy (Choice B) is a procedure used to visualize the airways and diagnose lung conditions, not to remove fluid from the pleural space. Chest X-ray (Choice C) is an imaging test that provides a picture of the structures inside the chest, including the lungs, heart, and bones. Arterial blood gas (ABG) test (Choice D) is a blood test that measures the levels of oxygen and carbon dioxide in the blood, providing information about how well the lungs are working, but it does not involve removing excess fluid or air from the pleural space.

5. What is a chronic condition where the airways in the lungs become damaged and widened, leading to mucus buildup and frequent infections?

• A. Bronchiectasis
• B. Chronic bronchitis
• C. Pneumoconiosis
• D. Asthma

Correct answer: A

Rationale: Bronchiectasis is a chronic condition characterized by the damage and widening of the airways in the lungs, resulting in mucus accumulation and recurrent lung infections. Choice B, chronic bronchitis, involves inflammation of the bronchial tubes and excessive mucus production but does not specifically mention airway damage and widening. Choice C, pneumoconiosis, refers to lung diseases caused by inhalation of mineral dust particles, not airway damage and mucus buildup. Choice D, asthma, is a chronic condition characterized by airway inflammation and narrowing, leading to breathing difficulties, but it does not involve the widening and damage of the airways as seen in bronchiectasis.

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