The nurse should teach the client who is taking digoxin 0.125 mg PO daily to call the healthcare provider if which side effect is experienced?

Tinnitus

Constipation

Visual disturbances

Vertigo

Answer and Explanation

The Correct Answer is C

Choice A reason: Tinnitus is not a common or serious side effect of digoxin, a drug that strengthens the contraction of the heart and regulates the heart rhythm. ¹ Tinnitus is a ringing or buzzing sound in the ears that can be caused by many factors, such as ear infections, loud noises, or medications. ² However, digoxin is not known to cause tinnitus, and it is not a reason to call the healthcare provider.

Choice B reason: Constipation is not a common or serious side effect of digoxin. Digoxin does not affect the bowel function, and it is not a reason to call the healthcare provider. Constipation can be caused by many factors, such as dehydration, lack of fiber, or medications. ³ The client should drink plenty of fluids, eat high-fiber foods, and exercise regularly to prevent or relieve constipation.

Choice C reason: Visual disturbances are a common and serious side effect of digoxin, and they are a reason to call the healthcare provider. Digoxin can cause changes in vision, such as blurred vision, yellow or green halos around objects, or seeing spots or flashes. ¹ These are signs of digoxin toxicity, which is a potentially life-threatening condition that occurs when the level of digoxin in the blood is too high. The client should report any visual disturbances to the healthcare provider as soon as possible.

Choice D reason: Vertigo is not a common or serious side effect of digoxin. Vertigo is a sensation of spinning or losing balance that can be caused by many factors, such as inner ear problems, head injuries, or medications. However, digoxin is not known to cause vertigo, and it is not a reason to call the healthcare provider.

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Correct Answer is C

Explanation

Choice A reason: This is not the best nursing action. Documenting the pulse rate and administering the medications as prescribed may be harmful to the client. Atenolol and diltiazem are both medications that lower the blood pressure and the heart rate. Atenolol is a beta blocker that blocks the effects of adrenaline on the heart and blood vessels. Diltiazem is a calcium channel blocker that relaxes the muscles of the heart and blood vessels. Giving both medications to a client who already has a low and irregular heart rate may cause further bradycardia, which is a heart rate below 60 beats/minute, or arrhythmia, which is an abnormal heart rhythm. The nurse should check the parameters and the contraindications for the medications before administering them.

Choice B reason: This is not the best nursing action. Assessing for chest pain and administering atenolol if pain free may not be appropriate for the client. Chest pain can be a sign of angina or myocardial infarction, which are conditions where the blood flow to the heart is reduced or blocked. Atenolol can help relieve chest pain by reducing the oxygen demand of the heart, but it can also lower the heart rate and the blood pressure. The client already has a low and irregular heart rate, which may indicate a problem with the electrical conduction of the heart. The nurse should not give atenolol without checking the pulse rate and the blood pressure, and consulting the health care provider.

Choice C reason: This is the best nursing action. Holding the atenolol and administering the diltiazem is the most appropriate for the client. Atenolol can lower the heart rate and the blood pressure, which may worsen the client's condition. The nurse should hold the atenolol and notify the health care provider of the client's pulse rate and rhythm. Diltiazem can also lower the heart rate and the blood pressure, but it can also help regulate the heart rhythm by slowing down the electrical impulses in the heart. The nurse should administer the diltiazem as prescribed, and monitor the client's vital signs and cardiac status.

Choice D reason: This is not the best nursing action. Withholding the medications and reassessing the heart rate in 30 minutes may delay the treatment and the care of the client. The client has a low and irregular heart rate, which may indicate a serious cardiac problem that needs immediate attention. The nurse should not wait for 30 minutes to reassess the heart rate, but rather act promptly and notify the health care provider. The nurse should also administer the diltiazem as prescribed, unless there is a specific reason to withhold it.

A. 68-year-old male who smokes one pack of cigarettes per day. B. 47-year-old male construction foreman who takes atenolol. C. 35-year-old female who drinks a glass of wine with dinner. D. 43-year-old female with Crohn's disease.

Correct Answer is D

Explanation

Choice A reason: The 68-year-old male who smokes one pack of cigarettes per day is not likely to have folic acid deficiency. Smoking can increase the risk of many health problems, such as lung cancer, heart disease, and stroke, but it does not affect the absorption or metabolism of folic acid. ¹ Folic acid is a type of vitamin B that is essential for the production of red blood cells and DNA. ²

Choice B reason: The 47-year-old male construction foreman who takes atenolol is not likely to have folic acid deficiency. Atenolol is a drug that lowers blood pressure and heart rate by blocking the effects of adrenaline. ³ It does not interfere with the absorption or metabolism of folic acid.

Choice C reason: The 35-year-old female who drinks a glass of wine with dinner is not likely to have folic acid deficiency. Moderate alcohol consumption, defined as one drink per day for women and two drinks per day for men, does not affect the absorption or metabolism of folic acid. However, excessive alcohol intake can impair the absorption of folic acid from the intestine and increase its excretion from the urine, leading to folic acid deficiency.

Choice D reason: The 43-year-old female with Crohn's disease is the most likely to have folic acid deficiency. Crohn's disease is a chronic inflammatory condition that affects the digestive tract, causing symptoms such as diarrhea, abdominal pain, and weight loss. Crohn's disease can impair the absorption of folic acid from the intestine, especially if the disease affects the small intestine, where most of the folic acid is absorbed. Crohn's disease can also increase the demand for folic acid, as inflammation and tissue damage require more folic acid for repair and regeneration.

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The nurse should teach the client who is taking digoxin 0.125 mg PO daily to call the healthcare provider if which side effect is experienced?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is scheduled to receive atenolol 25 mg PO and diltiazem 60 mg PO at 0800. The nurse assesses the client's heart rate as 45 beats/minute and irregular. What is the best nursing action at this time?

Correct Answer is C

Explanation

The nurse is reviewing the past medical history of a group of clients. Which client would the nurse suspect as having folic acid deficiency? The:

Correct Answer is D

Explanation

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