A nurse is preparing to administer digoxin to a client.
For which of the following findings should the nurse withhold the medication?

Apical pulse 54/min.

Respiratory rate 14/min.

BP 179/89 mm Hg.

Temperature 37.8° C (100° F)

Answer and Explanation

The Correct Answer is A

Choice A rationale:

An apical pulse of 54/min is below the normal range for adults. Digoxin, a cardiac medication, can lower the heart rate. Therefore, it’s crucial to hold the medication if the resting pulse for an adult is less than 60 bpm. This is to prevent further lowering of the heart rate which could lead to bradycardia, a potentially dangerous condition.

Choice B rationale:

A respiratory rate of 14/min is within the normal adult range of 12-20 breaths per minute. This would not be a reason to withhold digoxin.

Choice C rationale:

A blood pressure (BP) of 179/89 mm Hg indicates hypertension, which is not a direct contraindication for digoxin. However, it’s important to monitor BP levels in clients taking digoxin as the medication can affect blood pressure.

Choice D rationale:

A temperature of 37.8° C (100° F) is slightly elevated but would not be a reason to withhold digoxin unless it’s indicative of an underlying infection that needs to be addressed first.

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Correct Answer is D

Explanation

Choice A rationale:

A negative mammogram is not a requirement of the iPLEDGE program. Mammograms are used to screen for breast cancer and are not related to isotretinoin therapy.

Choice B rationale:

Regular Papanicolaou tests, which screen for cervical cancer, are not a requirement of the iPLEDGE program. These tests are not related to isotretinoin therapy.

Choice C rationale:

There is no requirement for clients to begin a daily supplement of vitamin A prior to initiating therapy. In fact, taking additional vitamin A while on isotretinoin can increase the risk of vitamin A toxicity.

Choice D rationale:

Sexually active female clients must use two forms of birth control during treatment. This is because isotretinoin can cause severe birth defects.

A. The nurse asks the client to demonstrate dose delivery. B. The nurse administers a PCA dose for the client. C. The nurse reassures the client that the PCA device will not cause an overdose. D. The nurse monitors the client for oversedation.

Correct Answer is B

Explanation

Choice A rationale:

Asking the client to demonstrate dose delivery can be part of patient education and helps ensure that the client understands how to use the PCA device. This action does not require intervention.

Choice B rationale:

The nurse administering a PCA dose for the client requires intervention. PCA stands for “Patient-Controlled Analgesia,” meaning that only the patient should administer doses to themselves. This prevents overdosing and ensures that pain medication is administered according to the patient’s needs.

Choice C rationale:

Reassuring the client that the PCA device will not cause an overdose is appropriate because PCA devices are designed with safety measures to prevent overdosing.

Choice D rationale:

Monitoring for oversedation is an important part of care for a client using a PCA device. This action does not require intervention.

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A nurse is preparing to administer digoxin to a client.For which of the following findings should the nurse withhold the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching about the iPLEDGE program with a female client who has a new prescription for isotretinoin.The nurse should tell the client that which of the following is a requirement of the program?

Correct Answer is D

Explanation

A charge nurse is evaluating a newly licensed nurse caring for a client who is using a PCA device.Which of the following actions by the nurse requires intervention by the charge nurse?

Correct Answer is B

Explanation

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A nurse is preparing to administer digoxin to a client.
For which of the following findings should the nurse withhold the medication?