A nurse is preparing to administer a new prescription for digoxin 0.125 mg orally once daily to a client who has heart failure. Which of the following actions should the nurse take before giving the medication?

Check the client's apical pulse for one full minute.

Check the client's serum potassium level.

Check the client's blood pressure in both arms.

Check the client's serum digoxin level.

Answer and Explanation

The Correct Answer is A

A) Correct. The nurse should check the client's apical pulse for one full minute before giving digoxin as this drug can cause bradycardia and heart block. The nurse should withhold the medication and notify the provider if the pulse is less than 60 beats/min or irregular.

B) Incorrect. The nurse should check the client's serum potassium level periodically while taking digoxin as this drug can cause hypokalemia or hyperkalemia, which can affect its therapeutic effect and toxicity. However, this is not a priority action before giving each dose of digoxin.

C) Incorrect. The nurse should check the client's blood pressure in both arms periodically while taking digoxin as this drug can cause hypotension or hypertension, which can affect its efficacy and safety. However, this is not a priority action before giving each dose of digoxin.

D) Incorrect. The nurse should check the client's serum digoxin level periodically while taking digoxin as this drug has a narrow therapeutic range and can cause toxicity if the level is above 2 ng/mL. However, this is not a priority action before giving each dose of digoxin.

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Correct Answer is A

Explanation

A) Incorrect. The client should not avoid eating foods that are high in vitamin K, such as leafy greens, broccoli, and soybeans. These foods can interfere with the anticoagulant effect of warfarin and increase the risk of clotting. The client should eat a consistent amount of vitamin K-rich foods and avoid sudden changes in their intake.

B) Correct. The client should use a soft-bristled toothbrush to prevent bleeding from the gums. Warfarin can impair the blood's ability to clot and increase the risk of bleeding from minor injuries.

C) Correct. The client should monitor their blood pressure regularly at home and report any abnormal readings to their provider. Warfarin can affect blood pressure and increase the risk of stroke or bleeding.

D) Correct. The client should report any signs of bruising or bleeding to their provider, such as nosebleeds, blood in urine or stool, heavy menstrual bleeding, or prolonged bleeding from cuts. These signs may indicate that the warfarin dose is too high and needs adjustment.

A. The nurse injects air into the NPH vial first, then into the regular vial. B. The nurse draws up regular insulin first, then NPH insulin. C. The nurse rolls the NPH vial between their palms before drawing up insulin. D. The nurse wipes the rubber stoppers of both vials with alcohol swabs.

Correct Answer is B

Explanation

A) Incorrect. The nurse should inject air into the regular vial first, then into the NPH vial. This can prevent contamination of the regular insulin with NPH insulin and ensure accurate dosing.

B) Correct. The nurse should draw up regular insulin first, then NPH insulin. This can prevent contamination of the regular insulin with NPH insulin and ensure accurate dosing. Regular insulin is clear and NPH insulin is cloudy.

C) Correct. The nurse should roll the NPH vial between their palms before drawing up insulin. This can resuspend the insulin particles that may have settled at the bottom of the vial and ensure uniform concentration.

D) Correct. The nurse should wipe the rubber stoppers of both vials with alcohol swabs before inserting needles. This can reduce the risk of infection and contamination.

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A nurse is preparing to administer a new prescription for digoxin 0.125 mg orally once daily to a client who has heart failure. Which of the following actions should the nurse take before giving the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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