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Which of the following is a rare but serious condition where the pulmonary arteries become narrowed, increasing the blood pressure in the lungs?
- A. Pulmonary hypertension
- B. Pulmonary embolism
- C. Pulmonary fibrosis
- D. Aortic stenosis
Correct Answer: A
Rationale: The correct answer is A: Pulmonary hypertension. This condition is characterized by narrowing of the pulmonary arteries, leading to increased blood pressure in the lungs. Pulmonary embolism (B) is a blockage in one of the pulmonary arteries, not narrowing. Pulmonary fibrosis (C) involves scarring of lung tissue, not artery narrowing. Aortic stenosis (D) is a narrowing of the aortic valve, not the pulmonary arteries. Therefore, the correct choice is A.
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What structure separates the left and right sides of the heart?
- A. Interventricular septum
- B. Endocardium
- C. Epicardium
- D. Pericardium
Correct Answer: A
Rationale: The correct answer is A: Interventricular septum. This structure separates the left and right sides of the heart, forming a barrier between the two ventricles. It ensures that oxygenated and deoxygenated blood do not mix within the heart chambers. The endocardium (B) is the inner layer of the heart's chambers, the epicardium (C) is the outer layer of the heart, and the pericardium (D) is the sac surrounding the heart. These structures do not specifically separate the left and right sides of the heart.
The client on digoxin has a potassium level of 2.7 mEq/L. What is the nurse's priority action?
- A. Hold the digoxin and notify the healthcare provider.
- B. Administer the digoxin as ordered.
- C. Increase the dose of digoxin.
- D. Administer potassium supplements.
Correct Answer: A
Rationale: The correct answer is A: Hold the digoxin and notify the healthcare provider. A potassium level of 2.7 mEq/L is below the normal range (3.5-5.0 mEq/L), which can increase the risk of digoxin toxicity. Holding the digoxin and informing the healthcare provider is crucial to prevent potential harm. Administering the digoxin (choice B) can exacerbate toxicity symptoms. Increasing the dose of digoxin (choice C) is contraindicated due to the low potassium level. Administering potassium supplements (choice D) may be necessary, but the priority is to address the digoxin therapy first.
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.
The client is receiving intravenous dopamine. What is the most important nursing assessment?
- A. Monitor heart rate and rhythm
- B. Monitor blood pressure
- C. Monitor respiratory rate
- D. Monitor oxygen saturation
Correct Answer: A
Rationale: The correct answer is A: Monitor heart rate and rhythm. Dopamine is a medication that can affect the heart rate and rhythm. Monitoring these parameters is crucial to detect any potential adverse effects such as tachycardia or arrhythmias. Monitoring blood pressure is also important, but assessing heart rate and rhythm takes precedence due to the direct impact of dopamine on cardiac function. Respiratory rate and oxygen saturation are generally not directly affected by dopamine administration.
The client is receiving digoxin and complains of nausea. What is the nurse's priority action?
- A. Check the client's digoxin level.
- B. Continue the current dose of digoxin.
- C. Administer an antiemetic for nausea.
- D. Discontinue the digoxin immediately.
Correct Answer: A
Rationale: The correct answer is A: Check the client's digoxin level. The priority action is to assess the digoxin level to determine if it is within the therapeutic range, as nausea can be a sign of digoxin toxicity. Checking the level will guide further actions. Continuing the dose without assessment (B) may worsen toxicity. Administering an antiemetic (C) only addresses the symptom, not the underlying cause. Discontinuing digoxin immediately (D) without assessing the level can be harmful if the client actually needs the medication.