Nokea
A nurse is caring for a client receiving digoxin. The client's most recent digitalis level was 2.5 ng/mL (0.5-2 ng/mL). The nurse should take which action? Select all that apply.
- A. Withhold the client's scheduled dose
- B. Administer the dose, as prescribed
- C. Assess the client's 24-hour urinary output
- D. Assess the client's most recent sodium level
- E. Assess the client's heart rate and rhythm
- F. Obtain a prescription for an echocardiogram
Correct Answer: A,E
Rationale: A digitalis level of 2.5 ng/mL indicates toxicity, so the nurse should withhold the dose (A) and assess heart rate and rhythm (E) for signs like bradycardia. Urinary output, sodium levels, and echocardiograms are not directly related to immediate toxicity management.
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The nurse is reviewing discharge teaching with a client who was newly prescribed digoxin. Which statement, if made by the client, would require follow-up? Select all that apply.
- A. I should take my pulse before taking each dose.
- B. This medication will require me to take my weight daily.
- C. This medication will require me to have periodic blood work.
- D. I will ensure I get plenty of potassium in my diet.
- E. If I notice visual changes, I will call my eye doctor.
Correct Answer: B,E
Rationale: Daily weighing (B) is not required for digoxin but for diuretics in heart failure. Visual changes (E) should be reported to the prescriber, not an eye doctor, as they indicate digoxin toxicity. Pulse monitoring, blood work, and potassium intake are appropriate.
The nurse is caring for a client receiving a continuous infusion of norepinephrine. The nurse should plan to monitor which of the following for the client? Select all that apply.
- A. Blood pressure
- B. Intracranial pressure
- C. Intravenous site
- D. Urine output
- E. Blood glucose
Correct Answer: A,C,D,E
Rationale: Norepinephrine, a vasopressor, requires monitoring blood pressure (to assess efficacy), IV site (for extravasation risk), urine output (to evaluate perfusion), and blood glucose (as it can cause hyperglycemia). Intracranial pressure is not typically monitored unless neurological issues are present.
Cardiovascular Pharmacology NCLEX RN
The nurse is caring for a client newly diagnosed with an abdominal aortic aneurysm. The nurse should anticipate a prescription for which of the following medications?
- A. naproxen
- B. digoxin
- C. prednisone
- D. atenolol
Correct Answer: D
Rationale: Atenolol, a beta-blocker, is often prescribed to manage blood pressure and reduce stress on the aortic wall in clients with an abdominal aortic aneurysm to prevent rupture. Naproxen (an NSAID), digoxin (a cardiac glycoside), and prednisone (a corticosteroid) are not typically used for this condition.
The nurse is caring for a three-year-old who is receiving digoxin for congestive heart failure. Which of the following manifestations is an early sign of digoxin toxicity?
- A. dizziness
- B. tachycardia
- C. vomiting
- D. failure to thrive
Correct Answer: C
Rationale: Vomiting is an early sign of digoxin toxicity in children. Dizziness is less common in young children, tachycardia is not typical, and failure to thrive is a chronic issue, not an early sign.
The nurse is teaching a client about newly prescribed nitroglycerin (NTG) sublingual tablets. Which statement, if made by the client, would indicate a correct understanding of the teaching?
- A. I should allow this tablet to dissolve in my cheek.
- B. I should keep the tablets in the dark bottle.
- C. I should take this medication standing up to prevent indigestion.
- D. I should take one tablet every 7 to 10 minutes if I get chest pain.
Correct Answer: B
Rationale: Nitroglycerin sublingual tablets should be kept in a dark bottle to protect from light degradation, indicating correct understanding. They dissolve under the tongue, not in the cheek, are taken every 5 minutes for chest pain (up to 3 doses), and standing is not required.