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The LPN/LVN is assisting in the care of a client with chronic heart failure who is receiving digoxin (Lanoxin). Which sign should the nurse monitor for that could indicate digoxin toxicity?
- A. Bradycardia
- B. Tachycardia
- C. Hypertension
- D. Hyperglycemia
Correct Answer: A
Rationale: Bradycardia is a common sign of digoxin toxicity and should be closely monitored. Digoxin toxicity can lead to various cardiac dysrhythmias, with bradycardia being a significant indicator. Monitoring the client's heart rate is crucial to detect and manage digoxin toxicity promptly. Tachycardia, hypertension, and hyperglycemia are not typically associated with digoxin toxicity. Tachycardia is more commonly seen with inadequate treatment of heart failure, hypertension is a possible but less common effect, and hyperglycemia is not a typical sign of digoxin toxicity.
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A client is admitted to the hospital with a diagnosis of myocardial infarction (MI). Which diagnostic test is most likely to be ordered to confirm this diagnosis?
- A. Echocardiogram
- B. Electrocardiogram (ECG)
- C. Chest X-ray
- D. Complete blood count (CBC)
Correct Answer: B
Rationale: An Electrocardiogram (ECG) is the primary diagnostic tool used to confirm a myocardial infarction. An ECG provides immediate information on cardiac function and can show characteristic changes indicative of a myocardial infarction, such as ST-segment elevation or depression. An echocardiogram (Choice A) is useful for assessing heart structure and function but is not typically used as the primary test for confirming an acute myocardial infarction. Chest X-ray (Choice C) may show certain changes in heart size or pulmonary congestion but is not the primary diagnostic test for MI. A Complete Blood Count (CBC) (Choice D) provides information about the cellular components of blood and is not specific to confirming a myocardial infarction.
A client has a new prescription for propranolol. Which of the following instructions should be included?
- A. Take the medication with food.
- B. Monitor heart rate daily.
- C. Increase intake of potassium-rich foods.
- D. Avoid consuming dairy products.
Correct Answer: B
Rationale: The correct answer is to monitor heart rate daily. Propranolol is a beta-blocker that can lower heart rate and blood pressure, so it is essential to monitor heart rate regularly to detect any signs of bradycardia, a potential side effect of the medication. Choice A is incorrect because propranolol can be taken with or without food. Choice C is incorrect as increasing potassium-rich foods is not specifically required with propranolol. Choice D is also incorrect as there is no need to avoid consuming dairy products with propranolol.
A client with hypertension is prescribed a thiazide diuretic. What instruction should the nurse reinforce to the client?
- A. Take the medication in the morning.
- B. Increase potassium intake in the diet.
- C. Weigh yourself daily.
- D. Limit fluid intake to 2 liters per day.
Correct Answer: C
Rationale: The correct answer is to weigh oneself daily. This instruction is important as daily weights help monitor fluid loss and are crucial for detecting early signs of fluid imbalance when taking a diuretic. Weighing daily allows for timely adjustments in treatment and helps prevent complications associated with fluid imbalance. Choice A is not directly related to the client's need for monitoring fluid balance. Choice B, although important for some diuretics, is not specific to thiazide diuretics. Choice D is not appropriate as limiting fluid intake without proper monitoring can lead to dehydration, especially when taking diuretics.
The healthcare provider is reinforcing instructions to a client with heart failure who is prescribed a low-sodium diet. The provider should advise the client to choose which food item?
- A. Canned soup
- B. Fresh vegetables
- C. Processed cheese
- D. Pickled vegetables
Correct Answer: B
Rationale: Fresh vegetables are a suitable choice for clients on a low-sodium diet as they are naturally low in sodium and provide essential nutrients. In contrast, canned soup, processed cheese, and pickled vegetables tend to be high in sodium, which is not recommended for individuals with heart failure and on a low-sodium diet. Fresh vegetables are also rich in fiber, vitamins, and minerals, making them a healthier option compared to the other choices provided.
The client is reinforcing instructions for a low-sodium diet. Which statement by the client indicates a need for further teaching?
- A. I will avoid adding salt to my food while cooking.
- B. I will use salt substitutes instead of regular salt.
- C. I can eat as much processed food as I like since it's usually low in sodium.
- D. I will read food labels to check for sodium content.
Correct Answer: C
Rationale: The correct answer is C. Processed foods often contain high amounts of sodium, so they should be limited or avoided on a low-sodium diet. Choosing processed foods can lead to increased sodium intake, counteracting the purpose of following a low-sodium diet. Option A shows an understanding of avoiding added salt, Option B suggests using alternatives to regular salt, and Option D indicates a willingness to check food labels for sodium content, all of which are appropriate for a low-sodium diet. Therefore, the client's statement about eating processed foods freely is incorrect and requires further teaching.