What is the priority assessment for a 54 year old patient with heart failure who is receiving digoxin?

INR level

Temperature

Apical heart rate

Blood pressure

Answer and Explanation

The Correct Answer is C

Choice A reason: This is incorrect. INR level is a measure of blood clotting time and is not directly affected by digoxin. It is more relevant for patients who are taking anticoagulants, such as warfarin.

Choice B reason: This is incorrect. Temperature is not a priority assessment for a patient receiving digoxin. It may indicate an infection or inflammation, but it is not related to the action or toxicity of digoxin.

Choice C reason: This is correct. Apical heart rate is the priority assessment for a patient receiving digoxin. Digoxin is a cardiac glycoside that increases the force and efficiency of the heart contractions, but also slows down the heart rate. The nurse should monitor the apical pulse for one full minute before administering digoxin and withhold the dose if the pulse is below 60 beats per minute for adults or below the age-specific normal range for children. A low or irregular pulse may indicate digoxin toxicity, which can be life-threatening.

Choice D reason: This is incorrect. Blood pressure is not a priority assessment for a patient receiving digoxin. Digoxin does not have a direct effect on blood pressure, although it may improve the cardiac output and reduce the fluid retention in patients with heart failure. Blood pressure should be monitored regularly, but it is not as critical as the apical heart rate.

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Correct Answer is A

Explanation

Choice A reason: This is correct because high lipid levels, such as cholesterol and triglycerides, are a risk factor for cardiovascular disease. HMG-CoA reductase inhibitors, also known as statins, lower the production of cholesterol in the liver and reduce the risk of heart attack and stroke.

Choice B reason: This is incorrect because blood glucose of 60 is not related to the need for an HMG-CoA reductase inhibitor. Blood glucose of 60 is below the normal range and may indicate hypoglycemia, which is a low blood sugar level. Hypoglycemia can cause symptoms such as dizziness, confusion, sweating, and hunger.

Choice C reason: This is incorrect because platelets over 150,000 are not related to the need for an HMG-CoA reductase inhibitor. Platelets are blood cells that help with clotting and prevent bleeding. The normal range of platelets is 150,000 to 450,000 per microliter of blood. Platelets over 150,000 are within the normal range and do not indicate a problem.

Choice D reason: This is incorrect because low INR is not related to the need for an HMG-CoA reductase inhibitor. INR stands for international normalized ratio and is a measure of how long it takes the blood to clot. The normal range of INR is 0.8 to 1.2. Low INR means the blood clots faster than normal and may indicate a risk of thrombosis, which is a blood clot in a vein or artery.

Correct Answer is ["2 ml"]

Explanation

To calculate the amount of ampicillin the nurse should administer per dose in milliliters (mL) for a 500 mg IM dose, we can use the following steps:

Given:

Ampicillin dose: 500 mg

Available concentration after reconstitution: 250 mg/mL

Volume of sterile water to be added: 1.8 mL

Step 1: Calculate the amount of ampicillin to be administered per dose in mL

First, we need to reconstitute the ampicillin vial to yield the desired concentration of 250 mg/mL.

The concentration after reconstitution is 250 mg/mL, and the total dose required is 500 mg. Therefore, the nurse needs to administer:

Volume = Ampicillin dose / Concentration

Volume = 500 mg / 250 mg/mL

Volume = 2 mL

Rounding to the nearest whole number:

Volume = 2 mL

Therefore, the nurse should administer 2 mL of the reconstituted ampicillin solution per dose.

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What is the priority assessment for a 54 year old patient with heart failure who is receiving digoxin?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What labs would indicate a client may need a prescription for an HMG-CoA reductase inhibitor, such as atorvastatin?

Correct Answer is A

Explanation

Correct Answer is ["2 ml"]

Explanation

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