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The nurse is caring for a heart client on digoxin and notes a potassium level of 2.5. What is the appropriate priority nursing intervention?
- A. Do nothing as this is a normal potassium level.
- B. The potassium level is low so the nurse asks for an order for potassium.
- C. The nurse asks to check the digoxin level as low potassium can increase digoxin toxicity.
- D. The nurse stops the digoxin.
Correct Answer: C
Rationale: The correct answer is C because low potassium levels can increase the risk of digoxin toxicity. Digoxin and potassium have a reciprocal relationship, so low potassium levels can lead to digoxin toxicity. Checking the digoxin level is important to monitor for toxicity.
A is incorrect because a potassium level of 2.5 is low and requires intervention. B is not the appropriate action as giving potassium without checking the digoxin levels first can worsen toxicity. D is incorrect because abruptly stopping digoxin can be harmful and should only be done under the guidance of a healthcare provider.
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The echocardiogram indicates a large thrombus in the left atrium of a patient admitted with heart failure. During the night, the patient complains of severe, sudden onset left foot pain. You note that no pulse is palpable in the left foot and that it is cold and pale. Which action should you take next?
- A. Lower the patient's left foot below heart level.
- B. Administer oxygen at 4 L/minute to the patient.
- C. Notify the patient's physician about the assessment data.
- D. Check the patient's vital signs and oximetry.
Correct Answer: C
Rationale: This likely indicates embolic occlusion, requiring immediate physician intervention.
If Mr. Lane, with essential hypertension, complains of dizziness when changing position, your evaluation would be that Mr. Lane
- A. is probably not taking his medications properly
- B. should be instructed in preventing hypotensive reactions
- C. is responding as expected to the prescribed medications
- D. should be totally reevaluated
Correct Answer: B
Rationale: Dizziness may indicate postural hypotension, requiring preventive education.
A client is admitted to the hospital with a dysrhythmia. Which of the following is the most common cause of dysrhythmias?
- A. Hypothermia
- B. Metabolic acidosis
- C. Drug therapy
- D. Ischemic heart disease
Correct Answer: D
Rationale: Ischemic heart disease is the leading cause of dysrhythmias due to compromised blood flow to the heart muscle.
What is a condition where the walls of the arteries in the lungs become thickened and stiff, leading to increased blood pressure in the pulmonary arteries?
- A. Pulmonary hypertension
- B. Pulmonary fibrosis
- C. Pulmonary embolism
- D. Pulmonary edema
Correct Answer: A
Rationale: The correct answer is A: Pulmonary hypertension. Pulmonary hypertension refers to the condition where the walls of the arteries in the lungs become thickened and stiff, leading to increased blood pressure in the pulmonary arteries. This results in the heart having to work harder to pump blood through the lungs, causing potential damage to the heart and lungs over time.
B: Pulmonary fibrosis is a condition characterized by scarring of lung tissue, not thickening and stiffening of artery walls.
C: Pulmonary embolism is a blockage in one of the pulmonary arteries in your lungs, usually caused by a blood clot. It does not involve thickening and stiffening of artery walls.
D: Pulmonary edema is a condition where fluid builds up in the lungs, causing difficulty in breathing. It is not related to thickened and stiffened artery walls.
The laboratory tests for four patients show the following results. Which patient should the nurse teach first about preventing CAD because the patient is at the greatest risk for CAD even without other risk factors?
- A. Total cholesterol: 152 mg/dL, triglycerides: 148 mg/dL, LDL: 148 mg/dL, HDL: 52 mg/dL
- B. Total cholesterol: 160 mg/dL, triglycerides: 102 mg/dL, LDL: 138 mg/dL, HDL: 56 mg/dL
- C. Total cholesterol: 200 mg/dL, triglycerides: 150 mg/dL, LDL: 160 mg/dL, HDL: 48 mg/dL
- D. Total cholesterol: 250 mg/dL, triglycerides: 164 mg/dL, LDL: 172 mg/dL, HDL: 32 mg/dL
Correct Answer: D
Rationale: Low HDL and high LDL increase CAD risk.