Nokea
A client has received digoxin 0.25 mg po daily for 2 weeks. Which of the following digoxin levels indicates toxicity?
- A. 0.5 ng/mL
- B. 1.0 ng/mL
- C. 2.0 ng/mL
- D. 3.0 ng/mL
Correct Answer: D
Rationale: Digoxin's therapeutic level is 0.8-2.0 ng/mL. Digoxin's toxic level is >2.0 ng/mL.
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The client is admitted with a diagnosis of abruptio placenta. Which diagnostic test is most likely to be ordered?
- A. Ultrasound
- B. Fetal heart monitoring
- C. Both A and B
- D. Neither A nor B
Correct Answer: C
Rationale: Ultrasound can confirm placental separation in abruptio placenta and fetal heart monitoring assesses for distress due to hypoxia. Both tests are critical for diagnosis and management.
An alcoholic client who is completing the inpatient segment of a substance abuse program was placed on disulfiram (Antabuse) drug therapy. What should the nurse include in the discharge instructions?
- A. If disulfiram is taken and alcohol ingested, the client experiences nausea, vomiting and elevated blood pressure.
- B. Disulfiram is most effective when prescribed as late as possible in a recovery program.
- C. Disulfiram works on the desensitization principle.
- D. The effects of disulfiram can be triggered by alcohol 5 days to 2 weeks after the drug is discontinued.
Correct Answer: D
Rationale: When alcohol is ingested with disulfiram therapy, the client experiences nausea, vomiting, and a potentially serious drop in blood pressure. Disulfiram is most successful when used early in the recovery process while the individual makes major lifestyle changes necessary for long-term recovery. Disulfiram works on the classical conditioning principle. The effects of disulfiram can be felt when alcohol is ingested 1-2 weeks after disulfiram is discontinued.
The nurse is caring for a client with a history of asthma who is receiving Albuterol (Proventil). The nurse should monitor the client for:
- A. Tachycardia
- B. Hypotension
- C. Hypokalemia
- D. Hyperglycemia
Correct Answer: A
Rationale: Albuterol, a beta-agonist, commonly causes tachycardia as a side effect due to sympathetic stimulation. Hypotension, hypokalemia, and hyperglycemia are less frequent.
The nurse is evaluating the client's pulmonary artery pressure (PAP). The nurse is aware that PAP evaluates:
- A. Pressure in the left ventricle
- B. Systolic, diastolic, and mean pressure in the pulmonary artery
- C. Pressure in the pulmonary veins
- D. Pressure in the right ventricle
Correct Answer: B
Rationale: Pulmonary artery pressure (PAP), measured via a pulmonary artery catheter, reflects systolic, diastolic, and mean pressures in the pulmonary artery, indicating right ventricular function and pulmonary circulation status.
The client is admitted with a diagnosis of hypovolemic shock. Which fluid is most appropriate for initial resuscitation?
- A. 0.9% Normal saline
- B. 5% Dextrose in water
- C. 3% Sodium chloride
- D. Lactated Ringer’s
Correct Answer: A
Rationale: 0.9% Normal saline is the preferred isotonic fluid for initial resuscitation in hypovolemic shock to restore intravascular volume. Dextrose is hypotonic, 3% saline is hypertonic, and lactated Ringer’s is used in specific cases like burns.