Nokea
A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following predisposes this client to developing digoxin toxicity?
- A. Taking a high ceiling diuretic
- B. Having a 10-year history of COPD
- C. Having a prolapsed mitral valve
- D. Taking an HMG CoA reductase inhibitor
Correct Answer: A
Rationale: The correct answer is A: Taking a high ceiling diuretic. High ceiling diuretics, such as furosemide, can lead to hypokalemia, which increases the risk of digoxin toxicity. Digoxin competes with potassium for binding sites on the Na+/K+-ATPase pump in the heart, so low potassium levels can lead to an increased concentration of digoxin in the body, predisposing the client to toxicity. Choices B, C, and D are incorrect as they do not directly impact digoxin levels or toxicity. A history of COPD (B) or a prolapsed mitral valve (C) do not specifically predispose a client to digoxin toxicity. Taking an HMG CoA reductase inhibitor (D) does not interact directly with digoxin.
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Complete the following sentence by using the lists of options. Upon analyzing the assessment findings, the nurse identifies that the client is at risk for Select... due to the Select...
- A. concurrent medication use
- B. recent illness
- C. activity level
Correct Answer: A
Rationale: The correct answer is A: concurrent medication use. The nurse identifies the client is at risk for adverse drug interactions or side effects due to the potential interactions between medications. Recent illness (B) may impact the client's health but does not specifically relate to medication use. Activity level (C) is important but does not directly indicate medication risk. Without options D, E, F, and G, they cannot be considered as potential correct choices.
A nurse is planning care for a client who requires treatment for high cholesterol. Which of the following prescriptions should the nurse expect to administer?
- A. Colchicine
- B. Cimetidine
- C. Colesevelam (Welchol)
- D. Chlorpromazine
Correct Answer: C
Rationale: The correct answer is C: Colesevelam (Welchol). This medication is a bile acid sequestrant commonly used to treat high cholesterol by binding to bile acids in the intestine, preventing their reabsorption, thus lowering LDL cholesterol levels. Colchicine (A) is used to treat gout, Cimetidine (B) for ulcers, and Chlorpromazine (D) for psychotic disorders. These medications are not indicated for high cholesterol.
A nurse is assessing a client who is taking an osmotic laxative. Which of the following findings should the nurse identify as an indication of fluid volume deficit?
- A. Nausea
- B. Weight gain
- C. Headache
- D. Oliguria
Correct Answer: D
Rationale: The correct answer is D: Oliguria. Osmotic laxatives, such as lactulose or polyethylene glycol, work by drawing water into the colon to soften the stool. If a client on osmotic laxatives is experiencing oliguria (decreased urine output), it can be a sign of fluid volume deficit due to the body trying to conserve water. Nausea (A) is a common side effect of osmotic laxatives but not a specific indicator of fluid volume deficit. Weight gain (B) is not associated with fluid volume deficit. Headache (C) can be caused by various factors and is not a specific sign of fluid volume deficit.
A nurse is assessing a client's IV infusion site and notes that the site is cool and edematous. Which of the following actions should the nurse take?
- A. Slow the IV solution rate
- B. Initiate a new IV distal to the initial site
- C. Maintain the extremity below the level of the heart
- D. Apply a warm, moist compress
Correct Answer: D
Rationale: The correct action is to apply a warm, moist compress (Choice D). This helps improve circulation and reduce edema by promoting vasodilation and enhancing tissue perfusion. Cooling and edematous IV sites indicate impaired circulation, which can lead to complications like phlebitis. Slowing the IV rate (Choice A) may not address the underlying issue. Initiating a new IV distal to the initial site (Choice B) may not improve circulation in the affected area. Maintaining the extremity below heart level (Choice C) can worsen edema.
A nurse is caring for a client who has a prescription for total parenteral nutrition (TPN). Which of the following routes of administration should the nurse use?
- A. Subcutaneous
- B. Intravenous
- C. Central venous access device
- D. Midline catheter
Correct Answer: C
Rationale: The correct answer is C: Central venous access device. TPN is a highly concentrated solution that provides all the nutrients a person needs intravenously. A central venous access device allows for the infusion of TPN into a large central vein, such as the superior vena cava, ensuring immediate access to the bloodstream for rapid absorption. Using other routes like subcutaneous (A), intravenous (B), or midline catheter (D) may not be suitable due to the high osmolarity of TPN, which can cause irritation and damage to smaller veins. Therefore, a central venous access device is the most appropriate and safe route for administering TPN.