Nokea
The client is on digoxin and has severe digoxin toxicity. What is the nursing priority action?
- A. Check the potassium level.
- B. Give Digibind as an antidote.
- C. Change the dosing of digoxin to every other day.
- D. Administer a potassium supplement to decrease digoxin toxicity.
Correct Answer: B
Rationale: The correct answer is B: Give Digibind as an antidote. Digibind is the specific antidote for severe digoxin toxicity. It works by binding to the excess digoxin in the body, preventing it from exerting its toxic effects. This action helps to rapidly reduce the digoxin levels in the body and reverse the toxicity. Checking the potassium level (choice A) is important but not the priority when the client is experiencing severe toxicity. Changing the dosing of digoxin (choice C) or administering a potassium supplement (choice D) would not address the immediate need to counteract the toxicity. The priority is to administer Digibind to quickly neutralize the digoxin and prevent further harm.
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What structures hold up the AV valves and are anchored to the ventricular wall by the papillary muscles?
- A. Chordae tendineae
- B. Papillary muscles
- C. Semilunar valves
- D. Aortic valve
Correct Answer: A
Rationale: The correct answer is A: Chordae tendineae. These fibrous cords hold up the AV valves (mitral and tricuspid valves) and are anchored to the ventricular wall by the papillary muscles. The papillary muscles contract to prevent the AV valves from prolapsing into the atria during ventricular contraction. Choice B (Papillary muscles) is incorrect as they assist in the function but are not the structures that hold up the AV valves. Choices C (Semilunar valves) and D (Aortic valve) are incorrect as they are not directly involved in supporting the AV valves or anchored by the papillary muscles.
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 B: Hold the digoxin and notify the healthcare provider. A potassium level of 3.0 mEq/L can increase the risk of digoxin toxicity as hypokalemia potentiates its effects. Holding the digoxin and informing the healthcare provider allows for further assessment and possible adjustment of the medication regimen. Administering a potassium supplement (A) without adjusting the digoxin dose can still lead to toxicity. Continuing the current digoxin dose (C) without addressing the low potassium level puts the client at risk. Administering Digibind (D) is not necessary at this point as the priority is to address the low potassium level and prevent digoxin toxicity.
You make a home visit to evaluate a hypertensive patient who has been taking enalapril (Vasotec) for 3 weeks. Which information indicates that you need to contact the physician about a change in the drug therapy?
- A. Patient complains of frequent urination.
- B. Patient's blood pressure is 138/86.
- C. Patient coughs often during the visit.
- D. Patient complains of occasional dizziness.
Correct Answer: C
Rationale: A persistent cough is a common side effect of ACE inhibitors like enalapril, and it may warrant a change in medication.
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: Thoracentesis is the correct procedure for removing excess fluid or air from the pleural space. It involves inserting a needle through the chest wall to drain the fluid or air, relieving pressure on the lungs. Bronchoscopy is used to visualize the airways, not remove fluid or air. Chest X-ray is a diagnostic tool for assessing the lungs but does not remove fluid or air. Arterial blood gas (ABG) is a test to assess oxygen and carbon dioxide levels in the blood, not a procedure to remove fluid or air from the pleural space.
Which type of lung cancer begins in the cells lining the bronchi and bronchioles?
- A. Adenocarcinoma
- B. Small cell lung cancer
- C. Squamous cell carcinoma
- D. Mesothelioma
Correct Answer: A
Rationale: The correct answer is A: Adenocarcinoma. This type of lung cancer begins in the cells lining the bronchi and bronchioles. Adenocarcinoma is the most common type of lung cancer and often affects non-smokers. It is characterized by the growth of glandular cells in the lining of the lungs.
B: Small cell lung cancer typically originates in the bronchi, but it is characterized by small, round cells and tends to grow and spread quickly.
C: Squamous cell carcinoma starts in the squamous cells lining the airways and is associated with a history of smoking.
D: Mesothelioma is a cancer of the mesothelial cells that line the lungs, not specifically the bronchi or bronchioles. It is commonly linked to asbestos exposure.