Nokea
A 6-month-old infant is prescribed digoxin for the treatment of congestive heart failure. Which observation by the practical nurse (PN) warrants immediate intervention for signs of digoxin toxicity?
- A. Apical heart rate of 60 beats/min
- B. Sweating across the forehead
- C. Poor sucking effort
- D. Respiratory rate of 30 breaths/min
Correct Answer: A
Rationale: A heart rate of 60 beats/min for a 6-month-old infant warrants immediate intervention as it falls below the normal range. The normal heart rate for a 6-month-old is 80 to 150 beats/min when awake, and a rate of 70 beats/min while sleeping is considered within normal limits. Bradycardia (heart rate <60 beats/min) in infants can be a sign of digoxin toxicity, necessitating prompt evaluation and intervention to prevent adverse effects.
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The healthcare provider is evaluating the effectiveness of metaproterenol for... how do you know it's been effective?
- A. Increased heart rate and blood pressure
- B. Decreased white blood cell count
- C. Decreased wheezing upon auscultation
- D. Decreased respiratory rate
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client is prescribed nitroglycerin sublingual tablets. The practical nurse should reinforce which instruction?
- A. Store the tablets in a cool, dry place.
- B. Take one tablet every 5 minutes until pain is relieved, up to three tablets.
- C. Swallow the tablets whole.
- D. Chew the tablets for faster relief.
Correct Answer: A
Rationale: Nitroglycerin sublingual tablets are sensitive to heat and moisture, so they should be stored in a cool, dry place to maintain their efficacy. Choice B is incorrect because nitroglycerin tablets should be taken as directed by the healthcare provider. Choice C is incorrect because sublingual tablets should be placed under the tongue to dissolve, not swallowed. Choice D is incorrect because sublingual tablets should not be chewed; they are meant to be absorbed through the tissues under the tongue.
When a client with hepatic encephalopathy is receiving lactulose, which parameter is essential to monitor for a response to the drug?
- A. Serum hepatic enzymes
- B. Fingerstick glucose
- C. Stool color and character
- D. Serum electrolytes and ammonia
Correct Answer: D
Rationale: In hepatic encephalopathy, the goal of lactulose therapy is to reduce blood ammonia levels by promoting its excretion in the stool. Therefore, monitoring serum electrolytes and ammonia levels is crucial to assess the effectiveness of lactulose in lowering ammonia levels and improving the client's condition.
A client is taking levodopa-carbidopa for Parkinson's disease. The nurse should include which instruction when educating the client about this medication?
- A. Increase fluid intake to prevent dehydration.
- B. Take medication at bedtime to avoid daytime drowsiness.
- C. Take medication with food to improve absorption.
- D. It can cause nausea and dizziness.
Correct Answer: A
Rationale: The correct instruction for a client taking levodopa-carbidopa for Parkinson's disease is to increase fluid intake to prevent dehydration. Levodopa-carbidopa should be taken with food to reduce gastrointestinal upset and improve absorption. Taking medication at bedtime is not necessary to avoid daytime drowsiness, and it is essential to prevent dehydration due to the medication's side effects.
A client is prescribed lisinopril for hypertension. What potential adverse effect should the practical nurse (PN) instruct the client to monitor for?
- A. Persistent cough
- B. Constipation
- C. Increased appetite
- D. Dry skin
Correct Answer: A
Rationale: Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. This cough is distinctive and different from other causes of cough. It is essential for the client to be aware of this potential side effect as it can indicate a serious issue. Instructing the client to monitor for a persistent cough and report it to the healthcare provider promptly is crucial to ensure timely intervention and management.