ATI Comprehensive Exit Exam Test Bank Related

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A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following findings should the nurse report to the provider?

  • A. Heart rate of 60/min
  • B. Respiratory rate of 16/min
  • C. Sodium level of 138 mEq/L
  • D. Weight gain of 1.5 kg (3.3 lb) in 24 hours
Correct Answer: D

Rationale: The correct answer is D. A weight gain of 1.5 kg (3.3 lb) in 24 hours can indicate fluid retention and worsening heart failure in clients taking digoxin. This rapid weight gain could be due to fluid accumulation, a common sign of heart failure exacerbation. Reporting this finding to the provider is crucial for prompt intervention. Choices A, B, and C are within normal ranges and not directly indicative of worsening heart failure in this context, making them less urgent to report compared to the significant weight gain.