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."
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. The PPD test is typically evaluated 48 to 72 hours after administration, so returning in another 48 hours is not necessary at this point.
B. The frequency of PPD testing depends on the individual's risk factors and exposure to tuberculosis (TB), not necessarily on an annual basis.
C. The test does not need to be repeated at this time. A 12 mm induration is a positive result for individuals with certain risk factors, and further evaluation is needed rather than repeating the test.
D. A 12 mm induration is considered a positive result for the PPD test in individuals with moderate risk factors for TB. The nurse should instruct the client to follow up with their provider for further evaluation, which may include a chest X-ray or other diagnostic tests.
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).
- DKA
- 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.
- DKA
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