BS-Nursing General Flashcards

A nurse is caring for a patient with heart failure who has dependent edema and crackles bilaterally. Which position is most therapeutic?

Answer: High Fowler's (90°)

High Fowler's position reduces preload by pooling blood in dependent extremities and eases breathing in heart failure patients.

Which electrolyte imbalance is most likely to precipitate digoxin toxicity?

Answer: Hypokalemia

Hypokalemia enhances digoxin binding to cardiac Na+/K+-ATPase receptors, increasing toxicity risk.

A patient's ABG results are: pH 7.28, PaCO2 52 mmHg, HCO3 24 mEq/L. What is the correct interpretation?

Answer: Respiratory acidosis

Elevated PaCO2 with low pH and normal HCO3 indicates uncompensated respiratory acidosis.

Under the HIPAA Privacy Rule, which action is permissible without patient authorization?

Answer: Disclosing PHI to law enforcement for a court order

HIPAA permits disclosure of PHI to law enforcement when required by a court order or subpoena.

A nurse administers the wrong medication dose. After notifying the physician, what is the nurse's next priority action?

Answer: File a variance/incident report

Filing an incident report per institutional policy is required to promote patient safety and system improvement after a medication error.

Which finding in a postoperative patient requires the most immediate nursing intervention?

Answer: Respiratory rate of 8 breaths/min with SpO2 90%

A respiratory rate of 8 with SpO2 of 90% indicates respiratory depression requiring immediate intervention to prevent hypoxic injury.

A patient with a serum potassium of 2.9 mEq/L is prescribed IV potassium chloride. Which nursing action is essential?

Answer: Infuse no faster than 10–20 mEq/hour via an infusion pump

IV potassium must never be given as a bolus; rates exceeding 20 mEq/hour risk fatal cardiac dysrhythmias.