In the context of Interprofessional Care of the Client and Family Across the Lifespan, a nurse is planning discharge teaching for a patient with chronic heart failure who has been prescribed digoxin (Lanoxin) and hydrochlorothiazide.
What instruction should the nurse include in the teaching?
The patient should take the digoxin if their pulse is below 60 beats/min.
The patient should notify the health care provider if they develop nausea.
The patient should limit their dietary intake of potassium.
The patient should take the hydrochlorothiazide at bedtime.
The Correct Answer is B
Choice A rationale
Digoxin slows the heart rate and increases the force of heart contractions, which can be beneficial in heart failure. However, if the pulse is below 60 beats/min, taking digoxin could further slow the heart rate and potentially lead to bradycardia.
Choice B rationale
Nausea can be a side effect of digoxin and hydrochlorothiazide. If the patient develops nausea, they should notify their healthcare provider as this could indicate that the medication dose needs adjustment.
Choice C rationale
Hydrochlorothiazide can cause the body to lose potassium, so limiting dietary intake of potassium could potentially lead to hypokalemia, a condition characterized by low potassium levels in the blood.
Choice D rationale
Taking hydrochlorothiazide at bedtime could potentially lead to nocturia, which is the need to wake up at night to urinate. This could disrupt the patient’s sleep.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Idiopathic vasospasm, or spontaneous constriction of the blood vessels, can cause myocardial ischemia. However, this is a relatively rare cause compared to atherosclerosis.
Choice B rationale
Atherosclerosis, a condition characterized by the buildup of fatty plaques in the arteries, is the most common cause of myocardial ischemia. These plaques can restrict blood flow to the heart muscle, leading to ischemia.
Choice C rationale
Venous emboli, or blood clots that form in the veins, typically do not cause myocardial ischemia. These clots are more likely to cause problems in the lungs (pulmonary embolism) if they travel through the bloodstream.
Choice D rationale
Arterial emboli from a heart valve can cause myocardial ischemia, but this is less common than atherosclerosis. These emboli, or blood clots, can block blood flow to the heart muscle if they travel through the bloodstream.
Correct Answer is C
Explanation
Choice A rationale
This sequence is incorrect because it suggests that blood goes from the lungs to the pulmonary artery, which is not accurate. The pulmonary artery carries deoxygenated blood from the heart to the lungs.
Choice B rationale
This sequence is incorrect because it suggests that blood goes from the pulmonary vein to the lungs, which is not accurate. The pulmonary vein carries oxygenated blood from the lungs to the heart.
Choice C rationale
This sequence correctly describes the direction of blood flow through the heart and lungs. Deoxygenated blood enters the right atrium, goes to the right ventricle, then is sent to the lungs via the pulmonary artery. After picking up oxygen in the lungs, the blood returns to the heart via the pulmonary vein, entering the left atrium, then the left ventricle, from where it is pumped out to the rest of the body.
Choice D rationale
This sequence is incorrect because it suggests that blood goes from the pulmonary vein to the pulmonary artery, which is not accurate. The pulmonary vein carries oxygenated blood from the lungs to the heart, and the pulmonary artery carries deoxygenated blood from the heart to the lungs.

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