A patient with heart failure is prescribed digoxin. What is the most important instruction the nurse should provide?

Correct Answer: C

Rationale: The correct answer is C: Report any visual disturbances. This is important because digoxin can cause visual disturbances, such as blurred or yellow-tinted vision, which may indicate toxicity. By reporting these symptoms promptly, the nurse can prevent serious complications. A: Taking an extra dose if a dose is missed can lead to overdose and toxicity. B: Avoiding high-potassium foods is important for patients taking potassium-sparing diuretics, not digoxin. D: Stopping the medication if the pulse is normal is incorrect as it should be taken as prescribed for heart failure management.

Correct Answer: A

Rationale: The correct answer is A: Take folic acid supplements as prescribed. Methotrexate can lead to folic acid deficiency, so supplementing with folic acid helps prevent side effects. It is important for the nurse to educate the patient on the importance of taking folic acid to maintain overall health. Choice B is incorrect. While it is generally recommended to limit alcohol consumption with methotrexate, avoiding it completely may not be necessary for all patients. Choice C is incorrect. Methotrexate takes time to work, often several weeks to months, so immediate results should not be expected. Choice D is incorrect. Limiting fluid intake to 1 liter per day is not a standard recommendation for patients taking methotrexate. Adequate hydration is important for overall health.

Correct Answer: B

Rationale: The correct answer is B: Expect orange-red discoloration of body fluids. Rifampin is known to cause a harmless side effect of discoloration of body fluids, such as urine, sweat, saliva, and tears, turning them orange-red. This is a common occurrence and should be expected by the patient. Incorrect choices: A: Limit intake of green leafy vegetables - This advice is not necessary with rifampin. C: Avoid exposure to sunlight - There is no direct association between rifampin and sunlight exposure. D: Take the medication with antacids - Rifampin should not be taken with antacids as they can interfere with its absorption. In summary, the correct answer is B because it aligns with a known side effect of rifampin, while the other choices are not relevant to the medication.

Correct Answer: A

Rationale: The correct answer is A: Avoid foods high in vitamin K. Warfarin is a vitamin K antagonist, so consuming high-vitamin K foods can counteract its effects. By avoiding such foods, the medication can work effectively in preventing further blood clot formation. Choice B is incorrect because dairy products do not directly interact with warfarin. Choice C is incorrect as citrus fruits do not have a significant impact on warfarin therapy. Choice D is incorrect as sodium intake is not directly related to the action of warfarin.

Correct Answer: B

Rationale: The correct answer is B: Hyperkalemia. Spironolactone is a potassium-sparing diuretic commonly used in patients with heart failure. It works by blocking the aldosterone receptor, leading to potassium retention and potential hyperkalemia. Monitoring potassium levels is crucial as hyperkalemia can increase the risk of arrhythmias and other cardiac complications in heart failure patients. A: Hypokalemia is incorrect because spironolactone typically causes potassium retention. C: Hyponatremia and D: Hypernatremia are incorrect as spironolactone does not directly affect sodium levels. In summary, monitoring for hyperkalemia is essential in patients with heart failure taking spironolactone to prevent adverse cardiac events.