Nokea
The client is on spironolactone (Aldactone). What is the most important dietary instruction?
- A. Avoid foods high in potassium.
- B. Increase intake of foods high in potassium.
- C. Avoid foods high in sodium.
- D. Increase intake of foods high in sodium.
Correct Answer: A
Rationale: The correct answer is A: Avoid foods high in potassium. Spironolactone is a potassium-sparing diuretic that can increase potassium levels in the body. Consuming foods high in potassium while on spironolactone can lead to hyperkalemia, which can be dangerous. By avoiding foods high in potassium, the client can help maintain a safe potassium level.
Summary:
- Choice B (Increase intake of foods high in potassium) is incorrect because it can lead to hyperkalemia when combined with spironolactone.
- Choice C (Avoid foods high in sodium) is unrelated to spironolactone's mechanism of action.
- Choice D (Increase intake of foods high in sodium) is incorrect as it is not relevant to the dietary instruction needed for a client on spironolactone.
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The patient is experiencing chest pain and pain radiating to his arms, jaw, and back. The provider diagnosed his condition as a myocardial infarction. The patient asks what happened to him. The best response is:
- A. You cannot tell him what has happened; he needs to wait for the provider to return and explain what is going on currently.
- B. His aortic valve was malformed at birth causing a disruption in blood flow.
- C. All patients who are overweight like him will have a heart attack.
- D. One or more arteries that supply blood to his heart are blocked, thereby preventing an adequate amount of blood from getting to his cardiac muscles.
Correct Answer: D
Rationale: A myocardial infarction occurs when there is a blockage in one or more arteries supplying blood to the heart.
The client is on spironolactone (Aldactone) and has a potassium level of 5.9 mEq/L. What is the nurse's priority action?
- A. Hold the spironolactone and notify the healthcare provider.
- B. Administer potassium supplements.
- C. Continue the spironolactone as ordered.
- D. Increase the dose of spironolactone.
Correct Answer: A
Rationale: The correct answer is A: Hold the spironolactone and notify the healthcare provider. Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia. With a potassium level of 5.9 mEq/L, the client is at risk for serious complications like cardiac arrhythmias. The priority action is to stop the medication to prevent further elevation of potassium levels and inform the healthcare provider for further management. Administering potassium supplements (B) would worsen the hyperkalemia. Continuing spironolactone (C) or increasing the dose (D) would be inappropriate and potentially harmful in this situation.
What is the condition where the lungs become filled with fluid, often due to heart failure, making it difficult to breathe?
- A. Pulmonary edema
- B. Pleural effusion
- C. Pulmonary hypertension
- D. Pneumothorax
Correct Answer: A
Rationale: Step-by-step rationale:
1. Pulmonary edema is the condition where lungs fill with fluid due to heart failure, causing breathing difficulty.
2. Pleural effusion is fluid accumulation in the pleural space, not in the lung tissue.
3. Pulmonary hypertension is high blood pressure in the pulmonary arteries, not related to fluid accumulation.
4. Pneumothorax is the presence of air in the pleural space, not fluid.
Summary:
Pulmonary edema is the correct answer as it specifically describes the condition of fluid accumulation in the lungs due to heart failure, leading to breathing difficulties. Pleural effusion, pulmonary hypertension, and pneumothorax are incorrect as they involve different pathologies not related to lung fluid accumulation.
What procedure involves using a balloon to open a narrowed or blocked blood vessel, often followed by the placement of a stent?
- A. Angioplasty
- B. Valve replacement
- C. Coronary artery bypass graft (CABG)
- D. Endarterectomy
Correct Answer: A
Rationale: The correct answer is A: Angioplasty. Angioplasty involves using a balloon to open a narrowed or blocked blood vessel, followed by the placement of a stent to keep the vessel open. This procedure is commonly used to treat conditions like coronary artery disease. Valve replacement (B) involves replacing damaged heart valves, CABG (C) involves bypassing blocked coronary arteries using grafts, and endarterectomy (D) involves removing plaque from arteries, but none of these procedures specifically involve using a balloon and stent to open a narrowed or blocked blood vessel.
Which of the following nursing interventions should a nurse perform to relieve tachycardia that may develop in a client with myocarditis from hypoxemia?
- A. Maintain the client on bed rest.
- B. Administer a prescribed antipyretic.
- C. Elevate the client's head.
- D. Administer supplemental oxygen.
Correct Answer: D
Rationale: Supplemental oxygen addresses hypoxemia, which can reduce tachycardia in clients with myocarditis.