The nurse is caring for an adult client who is taking digoxin. Which laboratory value should be reported to the healthcare provider immediately?

Reference Range:
Sodium [Adult 136 to 145 mEq/L (136 to 145 mmol/L)]
Digoxin level (0.8 to 2.0 ng/mL (0.6 to 13 nmol/L)]
Potassium (K+) [Adult: 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)]
Creatinine [0.5 to 1.1 mg/dL (44 to 97 μmol/L)]

Digoxin level of 1.1 ng/mL (1.4 nmol/L).

Creatinine level of 0.8 mg/dL (70.72 μmol/L).

Potassium level of 3.2 mEq/L (3.2 mmol/L).

Sodium level of 135 mEq/L (135 mmol/L).

Answer and Explanation

The Correct Answer is C

A. Digoxin level of 1.1 ng/mL (1.4 nmol/L):
A digoxin level of 1.1 ng/mL is within the therapeutic range (0.8 to 2.0 ng/mL). While it is important to monitor digoxin levels, this value does not indicate an immediate concern.

B. Creatinine level of 0.8 mg/dL (70.72 μmol/L):
A creatinine level of 0.8 mg/dL is within the normal range (0.5 to 1.1 mg/dL) and does not indicate any renal impairment or immediate issue.

C. Potassium level of 3.2 mEq/L (3.2 mmol/L):
A potassium level of 3.2 mEq/L is below the normal range (3.5 to 5.0 mEq/L). Hypokalemia can increase the risk of digoxin toxicity and arrhythmias, making this an urgent issue that should be reported to the healthcare provider immediately.

D. Sodium level of 135 mEq/L (135 mmol/L):
A sodium level of 135 mEq/L is slightly below the normal range (136 to 145 mEq/L), but it is not as critical as a significantly abnormal potassium level in the context of digoxin use. While it should be monitored, it is less urgent compared to the potassium level.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. Many of the herbal preparations are helpful primarily because of their placebo effect:
While placebo effects can play a role, many herbal preparations, including echinacea, have been studied for their potential therapeutic benefits beyond placebo effects. This statement oversimplifies and may dismiss valid efficacy.

B. This product is essentially harmless but also is not very beneficial in treating skin infections:
Echinacea is generally considered safe for topical use and has been used for various infections, including canker sores. This statement underestimates the potential benefits of echinacea in treating certain conditions.

C. Topical echinacea is usually used to soothe burns and can cause damage to the skin:
Topical echinacea is commonly used for various skin conditions, but it is not typically associated with causing skin damage. The statement may create unnecessary concern.

D. Echinacea seems to be useful in the treatment of some infections, such as canker sores:
Echinacea has been used traditionally and in some studies for its antimicrobial properties, which may be beneficial for certain infections, including canker sores. This statement acknowledges its potential utility without dismissing its benefits.

A. Request a prescription to change the route of administration and use the available heparin. B. Advise the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately. C. Calculate and administer the equivalent dose of the available low molecular weight heparin. D. Dilute the available heparin in 250 mL of normal saline solution prior to IV administration.

Correct Answer is B

Explanation

A. Request a prescription to change the route of administration and use the available heparin:
Low molecular weight heparin (LMWH) and unfractionated heparin (UFH) are not interchangeable. LMWH is usually administered subcutaneously, whereas UFH is administered intravenously for acute situations. Changing the route of administration without a new prescription would not be appropriate.

B. Advise the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately:
Since the prescription is for intravenous heparin and the available syringes are of LMWH (which is not suitable for IV use), it is essential to contact the pharmacy to provide the correct formulation. Immediate action ensures that the client receives the correct medication promptly.

C. Calculate and administer the equivalent dose of the available low molecular weight heparin:
Calculating and administering LMWH instead of UFH is inappropriate because they are different types of heparin with different indications, dosing regimens, and routes of administration. Using LMWH for an IV prescription could result in ineffective treatment or complications.

D. Dilute the available heparin in 250 mL of normal saline solution prior to IV administration:
LMWH should not be diluted or used in place of UFH for IV administration. This action is incorrect because the available medication is not suitable for the prescribed route and dose. The proper medication needs to be obtained from the pharmacy.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The home health nurse observes that a female client is using a topical preparation that contains echinacea to treat a canker sore. Her husband expresses concern regarding the effectiveness and safety of using herbs. How should the nurse respond?

Correct Answer is D

Explanation

A client has a prescription for heparin 1,000 units IV STAT. Several pre filled syringes of low molecular weight heparin are available in the client's medication drawer. Which action should the nurse implement?

Correct Answer is B

Explanation

A female client starts a new prescription, oxybutynin, for symptoms of an overactive bladder. The client tells the nurse that she is training to run in a half-marathon. Which instruction should the nurse emphasize?

A client receives a prescription for penicillin 1.2 million units IM. The available vial is labeled, "600,000 units/2 mL." How many mL should the nurse administer? (Enter numeric value only.)

A client who is taking furosemide reports experiencing leg cramps, a cough, feeling tired, and palpitations. Which action should the nurse take first?

The nurse is educating a client about acetaminophen. Which information provided by the client requires additional instruction by the nurse?

A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective? Reference Range: Hemoglobin (Hgb) [14 to 18 g/dl. (8.7 to 11.2 mmol/L)]

A client receives a prescription for ciprofloxacin 400 mg intravenously (IV) every 12 hours to be infused over an hour. The IV bag contains ciprofloxacin 400 mg in dextrose 5% in water (DW) 200 mL. The nurse should program the infusion pump to deliver how many mL/hr? (Enter numerical value only.)

A client with generalized anxiety disorder (GAD) receives a new prescription for lorazepam. Which statement provided by the client requires additional instruction by the nurse?

The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. Which action should the nurse take?