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)
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Levalbuterol is a bronchodilator that relaxes muscles in the airways and increases air flow to the lungs. Therefore, a decrease in wheezing is a therapeutic effect of the medication, making this the correct choice.
Choice B rationale:
While levalbuterol can cause an increase in respiratory rate as a side effect, it is not considered a therapeutic effect of the medication. The primary goal of levalbuterol is to improve breathing by relaxing the muscles of the airways, not to increase respiratory rate.
Choice C rationale:
Levalbuterol does not directly affect nausea. It is primarily used to treat conditions related to breathing such as asthma and chronic obstructive pulmonary disease.
Choice D rationale:
An increased heart rate is a potential side effect of levalbuterol, not a therapeutic effect.
Correct Answer is B
Explanation
Choice A rationale:
Prednisone does not need to be taken on an empty stomach. In fact, taking it with food can help reduce stomach upset.
Choice B rationale:
Prednisone suppresses the immune system, which can make users more susceptible to infections. Therefore, reporting symptoms like a sore throat to the provider is important.
Choice C rationale:
Prednisone can cause fluid retention and high blood pressure, so increasing sodium intake would not be advisable.
Choice D rationale:
Weight gain is a common side effect of prednisone due to increased appetite and fluid retention. Weight loss is not typically expected.
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