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The nurse is teaching a client about the toxicity of digoxin. Which one of the following statements made by the client to the nurse indicates more teaching is needed?
- A. I may experience a loss of appetite.'
- B. I can expect occasional double vision.'
- C. Nausea and vomiting may last a few days.'
- D. I must report a bounding pulse of 62 immediately.'
Correct Answer: D
Rationale: Slow heart rate is related to increased cardiac output and an intended effect of digoxin. The ideal heart rate is above 60 BPM with digoxin. The client needs further teaching.
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A teen hospitalized with anorexia nervosa is now permitted to leave her room and eat in the dining room. Which of the following nursing interventions should be included in the client's plan of care?
- A. Weighing the client after she eats
- B. Having a staff member remain with her for 1 hour after she eats
- C. Placing high-protein foods in the center of the client's plate
- D. Providing the client with child-sized utensils
Correct Answer: B
Rationale: Having a staff member stay with the client for 1 hour after eating prevents purging, a common behavior in anorexia nervosa.
The nurse is teaching a client with a new diagnosis of hyperlipidemia about atorvastatin (Lipitor). Which of the following statements by the client indicates a need for further teaching?
- A. I should report muscle pain to my doctor.
- B. I should take this medication at night.
- C. I should avoid drinking grapefruit juice.
- D. I should stop this medication if my cholesterol is normal.
Correct Answer: D
Rationale: Stopping atorvastatin when cholesterol is normal is incorrect, as hyperlipidemia often requires lifelong treatment to prevent cardiovascular events. Options A, B, and C are correct: muscle pain may indicate myopathy, nighttime dosing maximizes efficacy, and grapefruit juice increases drug levels.
The nurse caring for a client receiving intravenous magnesium sulfate must closely observe for side effects associated with drug therapy. An expected side effect of magnesium sulfate is:
- A. Decreased urinary output
- B. Hypersomnolence
- C. Absence of knee jerk reflex
- D. Decreased respiratory rate
Correct Answer: B
Rationale: Hypersomnolence is an expected side effect of magnesium sulfate due to its sedative properties, so B is correct. Decreased urinary output , absence of knee jerk reflex , and decreased respiratory rate are signs of toxicity, not expected effects.
Which of the following should the nurse implement to prepare a client for a kidney, ureter, bladder (KUB) radiograph test?
- A. Client must be NPO before the examination
- B. Enema to be administered prior to the examination
- C. Medicate client with Lasix 20 mg IV 30 minutes prior to the examination
- D. No special orders are necessary for this examination
Correct Answer: D
Rationale: No special orders are necessary for this examination. No special preparation is necessary for this examination.
The nurse is caring for a client with a history of type 1 diabetes who is receiving insulin lispro (Humalog) 8 units before meals. Which of the following symptoms should the nurse report immediately?
- A. Mild fatigue.
- B. Sweating and confusion.
- C. Occasional thirst.
- D. Mild headache.
Correct Answer: B
Rationale: Sweating and confusion indicate hypoglycemia, a medical emergency with insulin lispro. Options A, C, and D are less urgent.