A client with heart failure is prescribed furosemide (Lasix). Which instruction should the nurse include in the client's teaching plan?

Correct Answer: B

Rationale: The correct answer is B: Report any weight gain of more than 2 pounds in a day. This instruction is crucial for a client with heart failure taking furosemide as sudden weight gain can indicate fluid retention, which can worsen heart failure. Monitoring weight daily can help detect early signs of fluid overload. A: Taking the medication before bedtime is not a critical instruction for furosemide as it is usually taken in the morning to prevent nocturia. C: Increasing intake of high-sodium foods contradicts the purpose of furosemide, which is a diuretic used to reduce fluid retention by promoting diuresis. D: Limiting fluid intake to less than 1 liter per day can lead to dehydration and electrolyte imbalances, which can be harmful for a client with heart failure.

Correct Answer: A

Rationale: The correct answer is A because avoiding prolonged sitting or standing helps improve venous return by preventing blood from pooling in the legs, reducing venous congestion. This behavior promotes circulation and decreases the risk of complications. Choices B, C, and D do not directly address venous congestion or circulation improvement, making them incorrect options. Avoiding trauma and irritation to the skin (B) is important for skin integrity but not specifically for venous congestion. Wearing protective shoes (C) is related to preventing foot injuries but does not directly impact venous congestion. Quitting smoking (D) is beneficial for overall health but does not directly target venous congestion.

Correct Answer: B

Rationale: The correct answer is B because it violates patient confidentiality. Reading a client's history and physical in a public area breaches the client's privacy rights. The other choices do not directly compromise patient confidentiality. A involves discussing a cure for AIDS, which is not a breach of confidentiality. C involves sharing personal experiences with the client, and D involves discussing a client's history of drug abuse in a visitor's lounge, which may not be overheard by the client or staff directly involved in the client's care.

Correct Answer: C

Rationale: The primary action of digoxin in heart failure is to strengthen cardiac contractions. Digoxin inhibits the sodium-potassium pump, leading to an increase in intracellular calcium levels, which enhances the force of myocardial contractions. This helps improve cardiac output and symptoms of heart failure. Explanation: A: Incorrect - Digoxin does not increase heart rate, it mainly affects the strength of contractions. B: Incorrect - Digoxin does not decrease cardiac output; it actually helps improve it by enhancing contractility. D: Incorrect - Digoxin may have a slight effect on lowering blood pressure, but its primary action in heart failure is to strengthen cardiac contractions, not lower blood pressure.

Correct Answer: B

Rationale: Correct Answer: B (Liver toxicity) Rationale: 1. Valproic acid is known to cause liver toxicity. 2. The nurse should monitor liver function tests regularly. 3. Signs of liver toxicity include jaundice, abdominal pain, and nausea. 4. Prompt detection is crucial to prevent serious complications. Summary: A: Hypertension - Not a common side effect of valproic acid. C: Hyperglycemia - More commonly associated with other medications like antipsychotics. D: Bradycardia - Not a typical side effect of valproic acid.

Correct Answer: A

Rationale: The correct answer is A: Take folic acid supplements as prescribed. Methotrexate can lead to folic acid deficiency, causing side effects. Supplementing with folic acid can help manage these side effects. It is crucial for the nurse to emphasize the importance of taking folic acid as prescribed to prevent adverse effects. Summary of Incorrect Choices: B: Avoid alcohol completely - While alcohol should be limited or avoided due to potential liver toxicity with methotrexate, complete avoidance may not be necessary for all patients. C: Expect to see immediate results - Methotrexate takes time to work, and patients should not expect immediate results. Patience is necessary. D: Limit fluid intake to 1 liter per day - There is no specific guideline to limit fluid intake with methotrexate. Adequate hydration is important for overall health.

Correct Answer: C

Rationale: The correct answer is C: Before meals. Omeprazole is a proton pump inhibitor that works best when taken before meals to inhibit acid secretion before food intake. Taking it with meals (choice A) may decrease its effectiveness as it needs time to be absorbed. Taking it at bedtime (choice B) may not provide optimal coverage throughout the day. Taking it after meals (choice D) may not allow enough time for the medication to start working before the next meal.

Correct Answer: C

Rationale: The correct answer is C: Decrease heart rate. Carvedilol is a beta-blocker that works by blocking the beta-adrenergic receptors in the heart, leading to a decrease in heart rate. This helps reduce the workload of the heart and improve its efficiency in patients with heart failure. Choice A is incorrect because carvedilol may not necessarily increase cardiac output directly. Choice B is incorrect because carvedilol focuses more on improving heart function rather than directly reducing fluid retention. Choice D is incorrect because while carvedilol may lower blood pressure as a secondary effect, its primary purpose in heart failure is to improve cardiac function by decreasing heart rate.

Correct Answer: B

Rationale: The correct answer is B because expelling the air bubble from the syringe before injection helps ensure accurate dosage delivery and prevents air from being injected into the patient. Administering the injection in the thigh (A) is incorrect as enoxaparin is typically given in the abdomen. Massaging the injection site (C) can cause bruising or hematoma formation. Alternating injection sites between arms (D) is not relevant as enoxaparin is usually given in the abdomen.