Before administering Digoxin, the nurse should complete which task?

Correct Answer: B

Rationale: Before administering Digoxin, the nurse should count the apical pulse for 1 minute. Digoxin is a cardiac medication that primarily works by increasing the force of contractions of the heart muscle. It is important to assess the patient's heart rate to ensure it is within the recommended range before administering Digoxin. This is because Digoxin can cause serious complications such as heart arrhythmias if given when the heart rate is too low. Counting the apical pulse for a full minute provides a more accurate assessment of the heart rate compared to shorter durations.

Correct Answer: A

Rationale: Altered nutrition is often the priority nursing diagnosis for clients undergoing chemotherapy because the treatment can cause side effects such as nausea, vomiting, anorexia, and mucositis, leading to malnutrition and weight loss. Proper nutrition is essential for maintaining strength, supporting the immune system, and promoting recovery. While fear, anxiety, and decreased cardiac output are valid concerns, addressing nutritional deficits is critical to the client's overall well-being and ability to tolerate treatment.

Correct Answer: C

Rationale: Nystatin is an antifungal medication used to treat fungal infections, such as candidiasis. Before administration, assessing whether the client could be pregnant is critical because nystatin's safety in pregnancy is not fully established (Category C), meaning potential risks to the fetus cannot be ruled out without further evaluation. This makes pregnancy status a key safety consideration to prevent harm to an unborn child, outweighing other factors in urgency. The type of diet or amount of fat might influence general health or drug absorption minimally but isn't directly critical to nystatin's administration. Height and weight could affect dosing in some medications, but nystatin's dosing is typically standard and not weight-based for most fungal infections. Thus, confirming pregnancy status ensures the drug's safety profile aligns with the client's condition, making choice C the most critical assessment data to review prior to administration.

Correct Answer: B

Rationale: Tricyclic antidepressants (TCAs) like imipramine block norepinephrine and serotonin reuptake, but their anticholinergic effects are significant. In glaucoma, particularly angle-closure type, these effects can increase intraocular pressure by dilating pupils and obstructing aqueous humor outflow, risking acute attacks—thus, they're contraindicated. TCAs lower seizure threshold, lacking anticonvulsant activity, and may exacerbate epilepsy. They don't enhance levodopa absorption; rather, they might interact via monoamine pathways, but this isn't a primary effect. Some TCAs (e.g., amitriptyline) have quinidine-like sodium channel blockade, giving antiarrhythmic properties, but this isn't their primary use. The glaucoma concern is critical due to the anticholinergic mechanism, making it a key clinical consideration and the most accurate statement here.

Correct Answer: C

Rationale: Chronic heart failure (CHF) decompensation needs optimization. Morphine relieves acute dyspnea but not chronic management here. Hydralazine/isosorbide reduces afterload/preload, useful in advanced CHF, but less immediate. Carvedilol, a beta-blocker, risks decompensation with low BP. Metolazone, a potent diuretic, aids fluid overload but overlaps with furosemide. Digoxin improves contractility and rate control in sinus rhythm CHF, reducing hospitalizations, most appropriate given his recurrent admissions and stable renal function. Its inotropic benefit stabilizes this patient, enhancing quality of life.

Correct Answer: A

Rationale: The patient's symptoms-runny nose and itchy eyes during spring-suggest seasonal allergic rhinitis, where histamine is the main chemical mediator released from mast cells. Cromolyn sodium stabilizes mast cells, preventing histamine release, making it a prophylactic agent ideal for this scenario. Diphenhydramine is an H1 antihistamine that blocks histamine receptors after release, not preventing its release, so it's incorrect. Ranitidine is an H2 blocker, affecting gastric acid secretion, not allergic histamine pathways. Loratadine is another H1 antihistamine, also acting post-release. Theophylline (E) is a bronchodilator, irrelevant here. The question emphasizes preventing release, not blocking effects, so Cromolyn sodium stands out. Its mechanism directly addresses the root cause by stabilizing mast cells before allergen exposure triggers histamine release, offering a preventative rather than symptomatic approach, which aligns with the patient's recurring seasonal issue.

Correct Answer: B

Rationale: Articaine is considered the most potent ester type of local anesthetic. It is known for its high efficacy in providing profound anesthesia due to its unique chemical structure that enhances its ability to penetrate tissues effectively. Articaine also has a rapid onset of action and a relatively long duration of action compared to other ester local anesthetics. These characteristics make it a popular choice for various dental and medical procedures where deep and long-lasting anesthesia is required.

Correct Answer: A

Rationale: Sleep trouble from exams is situational anxiety-transient, event-driven stress, per psychiatry. Social anxiety involves interaction fears, not events. OCD features obsessions/rituals, not sleep-specific. Performance anxiety ties to tasks, less sleep focus. Situational fits, triggered by circumstance.

Correct Answer: B

Rationale: Mitoxantrone for MS progression risks hepatitis . This chemotherapeutic damages liver cells, requiring monitoring. Anxiety , hypopyrexia , muscle strength , and leukocytosis (E) aren't primary. Hepatotoxicity, with cardiotoxicity, is a key concern in this worsening MS case.