A patient is about to receive a morning dose of digoxin and has an apical pulse of 53 beats/minute. Which of the following actions should the nurse do first?

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Question 1 of 5

A patient is about to receive a morning dose of digoxin and has an apical pulse of 53 beats/minute. Which of the following actions should the nurse do first?

Correct Answer: A

Rationale: Digoxin should be withheld if the apical pulse is below 60 beats/minute in adults, as it can exacerbate bradycardia and lead to serious cardiac complications. The nurse should hold the dose and notify the healthcare provider for further instructions. Administering the dose (B) or contacting the charge nurse (C) without holding the dose is inappropriate.

Question 2 of 5

A patient is beginning isoniazid and rifampin treatment for tuberculosis. The nurse gives the patient which instruction?

Correct Answer: A

Rationale: Adherence to the prescribed regimen is critical in tuberculosis treatment to prevent resistance and ensure efficacy. Skipping doses can lead to treatment failure and drug-resistant TB. Isoniazid and rifampin are typically taken once daily, not three times daily. Antacids can interfere with the absorption of these drugs and should be avoided. There is no specific requirement to take rifampin initially; both drugs should be taken as prescribed.

Question 3 of 5

What is the therapeutic levels for digoxin?

Correct Answer: B

Rationale: The therapeutic levels for digoxin are typically considered to be between 0.5 % 2 ng/mL. This range is associated with optimal therapeutic effects of digoxin in managing heart conditions such as heart failure and atrial fibrillation. Levels below 0.5 ng/mL may be subtherapeutic while levels above 2 ng/mL can lead to toxicity symptoms like nausea, vomiting, visual disturbances, and cardiac arrhythmias. Monitoring digoxin levels within the therapeutic range ensures the medication is effective and safe for the patient.

Question 4 of 5

Which assessment should the nurse prioritize for a client receiving total parenteral nutrition (TPN)?

Correct Answer: A

Rationale: When a client receives total parenteral nutrition (TPN), monitoring blood glucose levels is critical due to the high glucose content in TPN solutions, which can lead to hyperglycemia. This condition arises because TPN delivers concentrated nutrients directly into the bloodstream, bypassing the digestive system, and the body may struggle to regulate sugar levels effectively without proper insulin response. Potassium levels, while important in overall electrolyte balance, are less immediately impacted by TPN compared to glucose, as potassium imbalances typically develop over time rather than acutely from TPN initiation. Mental status assessments are valuable for neurological conditions but lack direct relevance to TPN's metabolic effects. Similarly, blood pressure monitoring is essential for cardiovascular health but isn't the primary concern with TPN, as it doesn't directly influence hypertension or hypotension in the same way glucose dysregulation does. The focus on glucose stems from its rapid impact on the client's metabolic state, making it the priority assessment to prevent complications like hyperglycemia, which can escalate to severe outcomes if unaddressed. Regular monitoring ensures timely intervention, aligning with TPN's nutritional goals.

Question 5 of 5

The pregnant patient plans to breastfeed her baby. She asks the nurse about the use of herbal products during breastfeeding. What is the best response by the nurse?

Correct Answer: B

Rationale: Herbals (e.g., St. John's wort) transfer to breast milk, risking infant effects (e.g., sedation), so avoiding them is safest, per pharmacokinetics. Labels lack consistent breastfeeding data. ‘Natural' doesn't mean safe-some are toxic. Timing doesn't eliminate transfer. Transfer risk advises caution, protecting the baby.

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