A nurse is providing discharge teaching for a client who has heart failure and is to start therapy with digoxin. Which of the following statements by the client indicates an understanding of the teaching?

"I will notify my provider if I experience muscle weakness."

"I will take this medication with fiber to prevent constipation."

"I will increase my dose if my vision becomes blurred."

"I will take my digoxin if my pulse is less than 50 beats per minute."

Answer and Explanation

The Correct Answer is A

A. Muscle weakness can be a sign of digoxin toxicity, especially if it is accompanied by other symptoms like nausea, vomiting, or blurred vision. The client should notify the provider immediately if these symptoms occur.

B. Taking digoxin with fiber is not necessary and may interfere with its absorption. The client should take digoxin on an empty stomach, or as directed by the provider, but not specifically with fiber to prevent constipation.

C. Increasing the dose of digoxin if the client experiences blurred vision could be dangerous. Blurred vision is actually a symptom of digoxin toxicity, and the client should not increase the dose but should notify the provider immediately.

D. The nurse should advise the client to hold the digoxin if their pulse is less than 60 beats per minute (not 50), as this could indicate bradycardia caused by digoxin. The client should contact their provider before taking the medication if their pulse is too low.

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Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A,B"},"D":{"answers":"A,B"},"E":{"answers":"A"}}

Explanation

Rationale

Interpretation of Assessment Findings:

Urine ketones:
- DKA
  The presence of urine ketones is a hallmark of diabetic ketoacidosis (DKA), as it indicates the body is breaking down fat for energy due to insufficient insulin. Ketones are typically not present in hyperglycemic-hyperosmolar state (HHS).
Blood glucose greater than expected reference range:
- DKA
- HHS
  Elevated blood glucose levels are consistent with both DKA and HHS. However, blood glucose levels tend to be higher in HHS than in DKA, often exceeding 600 mg/dL in HHS.
Skin turgor:
- DKA
- HHS
  Decreased skin turgor indicates dehydration, which is a common feature in both DKA and HHS due to osmotic diuresis caused by hyperglycemia.
Creatinine greater than expected reference range:
- DKA
- HHS
  Elevated creatinine reflects impaired renal function, often due to dehydration or acute kidney injury, which can occur in both DKA and HHS.
Blood pH:
- DKA
  A blood pH of 7.30 indicates metabolic acidosis, a defining feature of DKA. Blood pH is typically normal in HHS because it does not involve significant ketoacidosis.

A. "You will need to be monitored for 15 minutes after receiving each medication dose." B. "You will need to take an antiviral medication for 6 months." C. "You will need three follow-up blood tests within a 24-month period." D. "You will need cryotherapy for 1 to 2 weeks."

Correct Answer is C

Explanation

A. Monitoring the client for 15 minutes after receiving each medication dose is typically done for certain medications like vaccines or immunotherapy, but not for the treatment of syphilis. The treatment for primary syphilis is usually penicillin, and there is no need for extended observation unless the client has an allergy or reaction.

B. Antiviral medications are not used to treat syphilis. Syphilis is treated with antibiotics, usually penicillin.

C. Follow-up blood tests are necessary to ensure the syphilis infection has been successfully treated and to monitor for any potential recurrence. Clients with syphilis should have follow-up blood tests at 6, 12, and 24 months after treatment.

D. Cryotherapy is not used to treat syphilis. The primary treatment for syphilis is antibiotic therapy, specifically penicillin, and cryotherapy is typically used for conditions like warts or certain types of lesions, not syphilis.

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A nurse is providing discharge teaching for a client who has heart failure and is to start therapy with digoxin. Which of the following statements by the client indicates an understanding of the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client in the emergency department. Exhibits For each assessment finding, click to specify if the assessment finding is consistent with diabetic ketoacidosis (DKA) or hyperglycemic-hyperosmolar state (HHS). Each finding may support more than 1 disease process.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A,B"},"D":{"answers":"A,B"},"E":{"answers":"A"}}

Explanation

A nurse is providing instructions to a client who has primary syphilis. Which of the following instructions should the nurse include in the discharge plan?

Correct Answer is C

Explanation

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