An older patient with heart failure is prescribed digoxin (Lanoxin) 125 mg by mouth three times a week. What action should the nurse take regarding this prescribed medication?

Questions 15

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Fundamental Concepts and Skills for Nursing Test Bank Questions

Question 1 of 9

An older patient with heart failure is prescribed digoxin (Lanoxin) 125 mg by mouth three times a week. What action should the nurse take regarding this prescribed medication?

Correct Answer: C

Rationale: For an older patient with heart failure prescribed digoxin (Lanoxin) 125 mcg by mouth three times a week, the nurse should administer the drug as prescribed while monitoring for manifestations of toxicity. Digoxin is a medication commonly used in heart failure, but it has a narrow therapeutic index, meaning that the difference between a therapeutic dose and a toxic dose is small. Older patients are more susceptible to digoxin toxicity due to age-related changes in pharmacokinetics and pharmacodynamics, as well as potential comorbidities. Therefore, close monitoring for signs and symptoms of digoxin toxicity, such as nausea, vomiting, visual disturbances, and cardiac arrhythmias, is essential. It is important for the nurse to be vigilant for any early signs of toxicity and communicate any concerns to the healthcare provider promptly.

Question 2 of 9

An older adult client is diagnosed with cardiomyopathy and a cardiac dysrhythmia. What would the nurse expect to be prescribed for this client?

Correct Answer: A

Rationale: A beta blocker would likely be prescribed for an older adult client diagnosed with cardiomyopathy and a cardiac dysrhythmia. Beta blockers are commonly used to manage dysrhythmias by slowing down the heart rate, reducing the workload of the heart, and improving its efficiency. They can also help in preventing arrhythmias and improving overall cardiac function in individuals with cardiomyopathy. Additionally, beta blockers have been shown to reduce mortality and improve symptoms in patients with various cardiac conditions. Therefore, it is a suitable medication choice for this client's condition.

Question 3 of 9

The nurse is reviewing a patient’s manifestations to determine if dementia is present. What information will help the nurse with this determination? Select all that apply.

Correct Answer: A

Rationale: A. Dementia causes impaired short- and long-term memory: Impaired memory is a common symptom of dementia, affecting both short-term and long-term memory. Patients may struggle to remember recent events or past memories, which can significantly impact their daily functioning.

Question 4 of 9

A nurse is educating a client with cardiomyopathy about diet choices that are appropriate for the client's condition. Which statement is inappropriate for the nurse to include in the teaching session?

Correct Answer: B

Rationale: While it is important for individuals with cardiomyopathy to maintain a well-balanced diet that includes adequate protein, stating that increasing dietary protein specifically helps with cardiac cell repair may not be entirely accurate. The primary focus for individuals with cardiomyopathy should be on overall heart-healthy choices such as monitoring sodium intake, avoiding high-fat, high-cholesterol foods, and following a well-rounded diet plan. Protein can be a part of this plan but it should not be emphasized as the main component for cardiac cell repair. Consulting with a dietitian who can provide personalized guidance and recommendations based on the individual's specific condition is crucial.

Question 5 of 9

A client is receiving intravenous nitroprusside (Nipride) for shock. Which adverse reactions will the nurse assess this client for when administering the infusion? Select all that apply.

Correct Answer: A

Rationale: A. Muscle spasms: Nitroprusside infusion can lead to cyanide toxicity, which can cause muscle spasms as a symptom. It is essential for the nurse to monitor the client for any signs of muscle spasms during the infusion.

Question 6 of 9

The nurse suspects that an older female patient has a health problem affecting the renal system. Which statement did the patient make that caused the nurse to come to this conclusion?

Correct Answer: D

Rationale: The statement "My doctor told me I have a slight amount of protein in my urine" suggests that the patient has proteinuria, which is a condition where abnormal amounts of protein are found in the urine. Proteinuria can be an indication of a health problem affecting the renal system, such as kidney disease or dysfunction. This made the nurse suspect that the older female patient may have an issue with her renal system. Statements A, B, and C are common experiences related to urinary habits but do not specifically point towards a renal health problem like proteinuria does.

Question 7 of 9

How would this blood pressure be categorized for this client?

Correct Answer: C

Rationale: Based on the blood pressure categories defined by the American Heart Association, hypertension is classified as having a systolic blood pressure (top number) of 130 mm Hg or higher and/or a diastolic blood pressure (bottom number) of 80 mm Hg or higher. The client's blood pressure reading of 150/90 mm Hg falls within the range of hypertension, indicating elevated blood pressure levels that may require monitoring and/or intervention to reduce the risk of cardiovascular complications.

Question 8 of 9

The nurse is assessing a client being treated for congestive heart failure (CHF). Which physical findings would indicate that the client's condition is not improving? Select all that apply.

Correct Answer: D

Rationale: Wheezing breath sounds in all lobes indicate airway obstruction or narrowing, which may be a sign of worsening heart failure leading to pulmonary congestion. Wheezing can be a result of fluid accumulation in the lungs (pulmonary edema) due to inadequate pumping of the heart in CHF. Monitoring for respiratory symptoms such as wheezing is crucial in assessing the effectiveness of treatment for congestive heart failure. In this case, the presence of wheezing suggests that the client's condition is not improving and requires further evaluation and intervention.

Question 9 of 9

The nurse caring is caring for a client who is recovering from a hysterectomy. Which clinical manifestation supports that the client is experiencing a pulmonary embolism (PE)?

Correct Answer: C

Rationale: Pulmonary embolism (PE) is a serious condition where a blood clot travels to the lungs and blocks blood flow, which can be life-threatening. Common clinical manifestations of PE include sudden onset of dyspnea (difficulty breathing), chest pain (sharp, stabbing pain that may worsen with deep breaths), tachypnea (rapid breathing), tachycardia (rapid heart rate), and possibly cough or hemoptysis (coughing up blood). In the context of a client recovering from a hysterectomy, it is crucial to recognize the signs of PE as early intervention is essential to prevent serious complications. Nausea, decreased urine output, and activity intolerance are not typical clinical manifestations of a pulmonary embolism and should not be the primary focus when suspecting a PE in this scenario.

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