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 take this medication with fiber to prevent constipation."

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

"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 B

B. Muscle weakness can be a sign of digoxin toxicity, and it is essential for the client to notify their healthcare provider if they experience this symptom. Muscle weakness is a potential adverse effect of digoxin, especially if the medication level in the blood becomes too high.
A. While constipation is a potential side effect of digoxin, taking it with fiber is not a recommended method for preventing constipation.
C. Blurred vision can be a sign of digoxin toxicity, and the client should not increase their dose if they experience this symptom. Instead, they should promptly notify their healthcare provider to assess for toxicity and adjust the medication regimen as needed.

D. Digoxin is a medication that can slow the heart rate, and a pulse rate less than 60 beats per minute is considered bradycardia. If the client's pulse is less than 60 beats per minute, they should hold the digoxin and promptly notify their healthcare provider.

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Correct Answer is D

Explanation

D. Capillary refill time greater than 2 seconds suggests impaired peripheral circulation, which could indicate vascular compromise or inadequate perfusion to the extremity. In a client with an external fixator, compromised circulation could lead to serious complications such as compartment syndrome or tissue necrosis.
A. This finding may be within the expected range for drainage following surgery, particularly if the client has undergone orthopedic surgery involving the placement of an external fixator. However, the nurse should continue to monitor the drainage and assess for any signs of increased bleeding or hematoma formation.
B. While a low-grade fever alone may not require immediate intervention, the nurse should assess the client further for other signs and symptoms of infection, such as increased pain, redness, warmth, or drainage at the surgical site.
C. While the client's pain level of 7 may require intervention to manage discomfort, it does not necessarily indicate an immediate threat to the client's safety or well-being.

A. "The elastic bandage will prevent a postoperative wound infection." B. "The elastic bandage will keep you from seeing the surgical site." C. "The elastic bandage will keep the sutures from loosening." D. "The elastic bandage will prevent excessive edema."

Correct Answer is D

Explanation

D. The primary purpose of maintaining an elastic bandage around the residual limb after a below-the- knee amputation is to provide compression and support, which helps minimize swelling (edema) of the residual limb. By reducing edema, the elastic bandage can promote proper wound healing, improve comfort, and facilitate the fitting of prosthetic devices in the future.
A. While maintaining proper wound care and hygiene can help prevent wound infections, an elastic bandage around the residual limb of a below-the-knee amputation primarily serves other purposes, such as providing compression and support, rather than directly preventing wound infections.
B. The purpose of an elastic bandage is not to conceal the surgical site. It is used primarily for compression, support, and minimizing swelling of the residual limb.
C. While an elastic bandage may help provide some pressure and support to the surgical site, its primary purpose is not to prevent sutures from loosening.

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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 who has just returned from surgery with an external fixator to the left tibia. Which of the following assessment findings requires immediate intervention by the nurse?

Correct Answer is D

Explanation

A nurse is caring for a client who is 2 days postoperative following a below-the-knee amputation and asks about the purpose of maintaining an elastic bandage around the residual limb of the extremity. Which of the following is an appropriate response by the nurse?

Correct Answer is D

Explanation

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