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 C

Explanation

A. Metabolic acidosis is not typically associated with excessive ingestion of antacids. Antacids, especially those containing aluminum, calcium, or magnesium, are more likely to cause alkalosis, not acidosis.

B. Respiratory acidosis is caused by impaired gas exchange (e.g., in conditions like COPD or hypoventilation) and is unrelated to antacid ingestion.

C. Metabolic alkalosis is the correct answer. Excessive ingestion of antacids, particularly those containing sodium bicarbonate or calcium carbonate, can lead to an increase in bicarbonate levels, resulting in metabolic alkalosis. Symptoms can include confusion, muscle twitching, and respiratory depression.

D. Respiratory alkalosis is caused by hyperventilation, not antacid ingestion. It results from excessive loss of carbon dioxide, which is not associated with the use of antacids.

A. Encourage the client to cough. B. Initiate seizure precautions. C. Elevate the head of the bed. D. Keep the client's head in a midline position. E. Decrease oxygen to 1.5 L/min via nasal cannula. F. Assist the client to the bathroom.

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

Explanation

Rationale

Interpretation of Actions:

Encourage the client to cough:
- Nonessential
  Encouraging the client to cough is not a priority in this situation. The client's neurological status is deteriorating, and the focus should be on managing intracranial pressure and ensuring airway patency rather than promoting coughing.
Initiate seizure precautions:
- Anticipated
  Seizure precautions are appropriate due to the client's declining neurological status, as seizures can occur with increased intracranial pressure or other neurological changes.
Elevate the head of the bed:
- Anticipated
  Elevating the head of the bed to 30 degrees promotes venous drainage and helps reduce intracranial pressure, which is critical given the client's symptoms.
Keep the client's head in a midline position:
- Anticipated
  Maintaining a midline head position prevents obstruction of venous outflow and helps reduce intracranial pressure.
Decrease oxygen to 1.5 L/min via nasal cannula:
- Contraindicated
  Reducing oxygen is inappropriate in this situation. The client's altered mental status and vomiting suggest potential hypoxia or increased intracranial pressure, requiring close monitoring of oxygenation rather than decreasing it.
Assist the client to the bathroom:
- Contraindicated
  Assisting the client to the bathroom is unsafe due to their altered mental status, restlessness, and risk of falls or further neurological compromise. Instead, measures to prevent overexertion, such as using a bedpan, should be implemented.

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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 in an emergency department is caring for a client who is receiving treatment for excessive ingestion of antacids. The nurse should identify that this client is at risk for which of the following acid-base imbalances?

Correct Answer is C

Explanation

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

Explanation

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