A patient about to receive a morning dose of digoxin has an apical pulse of 53 beats/min. What will the nurse do next?

Correct Answer: D

Rationale: A low apical pulse rate of 53 beats/min indicates bradycardia, which is a side effect of digoxin. Before administering digoxin, the nurse should always check the patient's pulse rate. If the apical pulse is below the facility's specified parameters (typically below 60 beats/min), the nurse should withhold the dose and notify the prescriber immediately. Bradycardia can be an indication of digoxin toxicity, which can be potentially life-threatening, so it is crucial to follow the protocol and seek further guidance before administering the medication.

Correct Answer: A

Rationale: Omitting a dose of transdermal nitroglycerin therapy once a week is often recommended to help reduce tolerance. Tolerance to nitroglycerin can develop with continuous use, limiting its effectiveness. By omitting a dose once a week, you are essentially giving the body a break from the medication and preventing tolerance from developing. This strategy can help maintain the efficacy of the nitroglycerin therapy over time. It is important to follow the guidance of a healthcare provider when making any changes to the dosing regimen of nitroglycerin to ensure safety and effectiveness.

Correct Answer: B

Rationale: 0.9% sodium chloride (NS), also known as normal saline, is the correct intravenous solution to use with packed red blood cell (PRBC) transfusion. NS is isotonic and compatible with blood products, making it the preferred solution for blood transfusions to prevent hemolysis of red blood cells. Other solutions such as D5W, D5NS, and D5LR are not recommended for use with PRBC transfusions due to their potential to cause hemolysis or affect the stability of the blood product.

Correct Answer: C

Rationale: The correct nursing intervention when administering Nitroglycerine to a patient like Samuel is to remove the transdermal patch 10-12 hours every night to prevent tolerance. Tolerance can develop rapidly with Nitroglycerine, leading to decreased effectiveness in managing anginal attacks. By removing the patch at night, the body has a chance to "reset" and reduce the likelihood of tolerance development. This practice helps maintain the drug's effectiveness and ensures better symptom control for the patient.

Correct Answer: A

Rationale: A. You must limit certain types of food or concurrent administration of certain types of drugs: Some foods can interact with certain medications, either reducing their effectiveness or causing potentially harmful side effects. Therefore, it may be necessary to limit or avoid specific foods when taking certain medications.