Nokea
A nurse teaches a client who is prescribed digoxin (Lanoxin) therapy. Which statement should the nurse include in this client's teaching?
- A. Hold the next dose of Imdur
- B. Increase your intake of foods that are high in potassium
- C. Hold this medication if your pulse rate is below 90 beats per minute
- D. Do not take this medication within 1 hour of taking an antacid
Correct Answer: D
Rationale: Digoxin should not be taken within 1 hour of antacids, as antacids can decrease its absorption. Holding Imdur is irrelevant to digoxin therapy. Potassium intake needs monitoring, but hypokalemia (not high potassium) is a concern with digoxin. The pulse rate threshold for holding digoxin is typically below 60 beats per minute, not 90.
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A nurse assesses a client after administering isosorbide mononitrate (Imdur). The client reports a headache. Which action should the nurse take?
- A. Initiate oxygen therapy
- B. Hold the next dose of Imdur
- C. Instruct the client to drink water
- D. Administer PRN acetaminophen
Correct Answer: D
Rationale: The vasodilating effects of isosorbide mononitrate frequently cause headaches during the initial period of therapy. Clients should be told about this side effect and encouraged to take the medication with food. Some clients obtain relief with mild analgesics, such as acetaminophen. The headache is not related to hypoxia or dehydration, so oxygen or water would not help. Holding the medication is not warranted.
The presence of an S3 gallop is noted in a client. What should the nurse do?
- A. Assess for symptoms of left-sided heart failure
- B. Document this as a normal finding
- C. Call the health care provider immediately
- D. Transfer the client to the intensive care unit
Correct Answer: A
Rationale: The presence of an S3 gallop is an early diastolic filling sound indicative of increasing left ventricular pressure and left ventricular failure. The other actions are not warranted.
A nurse teaches a client recovering from a heart transplant who is prescribed cyclosporine (Sandimmune). Which statement should the nurse include for this client's discharge teaching?
- A. Use a soft-bristled toothbrush and avoid flossing
- B. Avoid large crowds and people who are sick
- C. Monitor your heart rate before taking the medication
- D. Take the medication with a high-fat meal
Correct Answer: B
Rationale: Cyclosporine causes immune suppression, leaving the client more vulnerable to infection. Avoiding large crowds and sick people reduces infection risk. The medication does not increase bleeding risk, affect heart rate, or require a high-fat meal.
After teaching a client with congestive heart failure (CHF), the nurse assesses the client's understanding. Which client statements indicate correct understanding of the teaching related to nutritional intake?
- A. I should limit my fluid intake to 2 liters per day
- B. I need to avoid adding salt to my foods
- C. I should eat foods high in potassium, like bananas
- D. I must avoid foods high in vitamin K
- E. I will check food labels for sodium content
Correct Answer: A,B,C,E
Rationale: Clients with CHF should limit fluid intake (typically to 2 liters/day), avoid adding salt, eat potassium-rich foods (especially if on diuretics), and check sodium content. Avoiding vitamin K is specific to clients on warfarin, not a general CHF requirement.
A nurse is assessing a client with left-sided heart failure. For which clinical manifestations should the nurse assess?
- A. Pulmonary crackles
- B. Confusion, restlessness
- C. Pulmonary hypertension
- D. Dependent edema
- E. Cough that worsens at night
Correct Answer: A,B,E
Rationale: Left-sided heart failure leads to pulmonary congestion, causing pulmonary crackles, confusion, restlessness (due to hypoxia), and cough that worsens at night. Pulmonary hypertension and dependent edema are associated with right-sided heart failure.