Exhibits
The nurse calls the healthcare provider (HCP) to notify them that the digoxin level is above therapeutic range.
Place the nurse statements in Situation, Background, Assessment, Recommendation (SBAR) format. Each column must have only one response selected.
Do you want to recheck the digoxin level again tomorrow morning to see if we can restart it? I will keep the client on the monitor to assess for changes in heart rate.
The results came back for the digoxin level. It is currently 2.2 ng/mL (2.8 nmol/L). The client's heart rate was 79 beats/minute. She is alert. There are no signs and symptoms of decreased perfusion at this time.
I am holding the digoxin because the client's digoxin level is too high.
The client is a 61- year-old female with heart failure. She started digoxin 3 days ago.
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"C"},"C":{"answers":"D"},"D":{"answers":"A"}}
Rationale:
- Assessment: This describes the findings relevant to the current situation, such as the elevated digoxin level (2.2 ng/mL), the client’s heart rate (79 beats/minute), and the absence of symptoms such as decreased perfusion, indicating that the client is stable for now.
- Background: Provides necessary patient details, such as age, diagnosis (heart failure), and the fact that the client has been on digoxin for three days, so the nurse provides a brief clinical history relevant to the current issue.
- Recommendation: The nurse suggests rechecking the digoxin level the next day to assess if it has returned to the therapeutic range. Suggests an action to the healthcare provider (recheck digoxin level tomorrow) and indicates that the nurse will monitor the client closely for any changes.
- Situation: The nurse is holding the digoxin due to the elevated level, which exceeds the therapeutic range. This introduces the immediate reason for the call, explaining the context of the patient's condition and recent treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B","dropdown-group-3":"C"}
Explanation
Rationale for Correct Choices:
- Impaired physical mobility: Rheumatoid arthritis leads to joint inflammation, stiffness, and potential deformities. These symptoms may result in decreased range of motion and difficulty with physical movements, contributing to impaired mobility.
- Acute pain: RA causes acute inflammation in the joints, resulting in pain, especially during flare-ups. The client experiences pain and stiffness in the hands and wrists, which aligns with the acute pain risk associated with RA.
- Knowledge deficit: Newly diagnosed RA patients often lack understanding about the disease process, treatment options, and lifestyle modifications. The nurse needs to recognize that the client requires education to manage their condition effectively and understand the long-term implications.
Rationale for Incorrect Choices:
- Electrolyte imbalance: Electrolyte imbalances are not a typical complication of rheumatoid arthritis. While certain medications used to treat RA (like corticosteroids) can impact electrolyte levels, this is not an immediate concern or a direct risk associated with RA itself.
Correct Answer is ["1.3"]
Explanation
Rationale:
- Convert the infant's weight from pounds (lb) to kilograms (kg).
Weight in kg = 22 lb / 2.2 lb/kg
= 10 kg.
- Calculate the total daily desired dose in milligrams (mg).
Total daily desired dose (mg) = Desired dose (mg/kg/day) × Weight (kg)
= 20 mg/kg/day × 10 kg
= 200 mg/day.
- Determine the number of doses per day.
Doses are given every 8 hours, so Number of doses per day = 24 hours / 8 hours/dose
= 3 doses/day.
- Calculate the dose per administration in milligrams (mg).
Dose per administration (mg) = Total daily desired dose (mg) / Number of doses per day
= 200 mg / 3 doses
= 66.666 mg.
Available concentration of the medication = 250 mg / 5 mL.
- Calculate the volume in milliliters (mL) to administer per dose.
Volume (mL) = Desired dose per administration (mg) / (Available concentration (mg) / Available volume (mL))
= 66.666 mg / (250 mg / 5 mL)
= 66.666 mg / 50 mg/mL
= 1.333 mL.
- Round the answer to the nearest tenth.
= 1.3
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