A client is prescribed digoxin 0.125 mg daily for heart failure. Which of the following client reports should concern the nurse as a sign of digoxin toxicity?

Correct Answer: B

Rationale: Visual disturbances such as blurred vision or seeing halos around lights are common signs of digoxin toxicity. Increased appetite, weight gain, and constipation are not typically associated with digoxin toxicity. Weight gain could be a sign of worsening heart failure rather than digoxin toxicity. Increased appetite and constipation are not specific signs of digoxin toxicity and are less likely to be related.

Correct Answer: B

Rationale: The correct answer is B: Tendon rupture. Ciprofloxacin belongs to the fluoroquinolone class of antibiotics, which is associated with the adverse effect of tendon rupture. Tendon rupture is a severe but rare side effect that can occur with the use of ciprofloxacin. Educating the client about this potential adverse effect is crucial to promote awareness and early recognition of symptoms, such as tendon pain, swelling, or inflammation. Choices A, C, and D are not typically associated with ciprofloxacin use and are less relevant for client education in this scenario.

Correct Answer: C

Rationale: The correct answer is C: aPTT. The healthcare provider should monitor the activated partial thromboplastin time (aPTT) value during heparin therapy to assess the client's coagulation status. Heparin affects the intrinsic pathway of the coagulation cascade, and monitoring aPTT helps ensure that the client is within the therapeutic range to prevent bleeding or clotting issues. INR (Choice A) is used to monitor warfarin therapy, not heparin. Serum creatinine (Choice B) is not directly related to monitoring heparin therapy. Bilirubin (Choice D) is related to liver function, not heparin therapy.

Correct Answer: D

Rationale: In this scenario, option D, uncontrolled hypertension, is the correct answer as it is a contraindication for administering clopidogrel. Clopidogrel is an antiplatelet medication used to prevent blood clots. Uncontrolled hypertension can increase the risk of bleeding when taking antiplatelet medications like clopidogrel. Elevated blood pressure can weaken blood vessels and lead to easier bleeding, which can be exacerbated by the antiplatelet effects of the medication. Options A, B, and C are incorrect choices because recent surgery, peptic ulcer disease, and bleeding disorders are not direct contraindications for clopidogrel. In fact, clopidogrel is commonly prescribed after certain surgeries to prevent blood clots. However, it is essential to assess and monitor these conditions closely in patients taking clopidogrel to ensure their safety and adjust the treatment plan as needed. Educationally, understanding contraindications for medications is crucial for nurses to provide safe and effective care to their patients. It is necessary to have a comprehensive knowledge of both the therapeutic effects and potential risks of medications to make informed clinical decisions. By recognizing contraindications like uncontrolled hypertension for clopidogrel, nurses can prevent adverse events and promote positive patient outcomes.

Correct Answer: D

Rationale: The correct answer is D, Lactic acidosis. Lactic acidosis is a rare but serious adverse effect of metformin use. Metformin is not known to cause hyperglycemia or hypoglycemia. Diarrhea is a common gastrointestinal side effect of metformin but is not as serious as lactic acidosis, which requires immediate medical attention.