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Based on a client's serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement?
- A. Give digoxin by another route to slow absorption.
- B. Begin cardioversion to stabilize heart rhythm.
- C. Administer potassium to stabilize the heart rate.
- D. Check acid-base and electrolyte values.
Correct Answer: D
Rationale: Checking acid-base and electrolyte values is critical to manage digoxin toxicity, as imbalances like hypokalemia exacerbate toxicity. Changing routes, cardioversion, or potassium administration are not immediate actions without further assessment.
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A young adult female client who is planning to become pregnant asks the nurse if she can continue taking isotretinoin for cystic acne. Which information is most important for the nurse to provide this client?
- A. Breastfeeding is not recommended while taking this medication.
- B. Do not take multiple vitamins that contain vitamin A while taking this drug.
- C. Baseline liver function results must be obtained during therapy.
- D. Discontinue this medication one month before attempting to conceive.
Correct Answer: D
Rationale: Isotretinoin is highly teratogenic, requiring discontinuation at least one month before conception to prevent birth defects. Breastfeeding, vitamin A, and liver monitoring are secondary concerns.
A client who experiences migraine headaches reports having fewer headaches since using the herbal remedy feverfew. Which information is most important for the nurse to include in a teaching plan for this client?
- A. Increased anxiety and nervousness have been reported by those taking feverfew.
- B. Those with allergies to chamomile, ragweed, or yarrow should not take feverfew.
- C. Abdominal pain, gas, nausea, vomiting, and diarrhea can occur when taking feverfew.
- D. Feverfew may interact with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs).
Correct Answer: B
Rationale: Feverfew can cause allergic reactions in individuals allergic to chamomile, ragweed, or yarrow, making this critical to prevent serious reactions. Anxiety, GI effects, or NSAID interactions are less urgent.
A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?
- A. Hypercholesterolemia.
- B. Bronchitis.
- C. Diabetes mellitus.
- D. Hypertension.
Correct Answer: D
Rationale: Methylphenidate, a stimulant, can exacerbate hypertension, requiring careful review of blood pressure history. Hypercholesterolemia, bronchitis, and diabetes are less critical concerns.
The nurse is administering sucralfate to a client with stomatitis secondary to chemotherapy. The client wants to take the medication after breakfast. How should the nurse respond?
- A. Explain the need to take the medication at least 1 hour before meals.
- B. Allow the client to take the medication up to 1 hour after breakfast.
- C. Document the client's refusal of the medication at this time.
- D. Instruct the client to take it when the meal tray is delivered.
Correct Answer: A
Rationale: Sucralfate must be taken on an empty stomach, at least 1 hour before meals, to effectively coat the mucosa. Post-meal administration, refusal documentation, or meal-time dosing are incorrect.
A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?
- A. Stores the medication at room temperature.
- B. Primes the inhaler with 7 pumps.
- C. Attaches spacer device to the inhaler.
- D. Rinses the mouth after each use.
Correct Answer: B
Rationale: Priming an ipratropium inhaler with 7 pumps is excessive; typically, 2–3 pumps are needed if unused for a period. Room temperature storage, spacer use, and mouth rinsing are correct practices.