The nurse is assessing a patient for possible evidence of digitalis toxicity. Which of these is included in the signs and symptoms for digitalis toxicity?

Correct Answer: D

Rationale: The correct answer is D because a low apical pulse rate (bradycardia) with an irregular rhythm is a classic sign of digitalis toxicity due to its effect on the heart's conduction system. Digitalis can cause bradycardia and various conduction disturbances. Choices A, B, and C do not specifically reflect the characteristic bradycardia seen in digitalis toxicity.

Correct Answer: A

Rationale: The correct answer is A because it provides comprehensive and appropriate instructions for managing the thickly white-coated tongue associated with fluphenazine. First, advising to avoid foods high in sugar helps prevent further irritation. Second, emphasizing good oral hygiene by brushing teeth and tongue, flossing, and gargling with mouthwash helps to reduce the coating. Third, encouraging daily tongue checks and prompt physician notification ensures monitoring and timely intervention if needed. Choice B is incorrect because it lacks the comprehensive approach of Choice A, omitting the importance of flossing and daily tongue checks. Choice C is incorrect as it dismisses the issue without providing any guidance on how to manage the side effect. Choice D is incorrect as it introduces irrelevant information about nasal inhalants that can confuse the patient and is not directly related to managing the white-coated tongue.

Correct Answer: C

Rationale: The correct answer is C because interrupted wake-sleep patterns can indeed influence mood. Night shift work disrupts the body's natural circadian rhythm, leading to sleep disturbances and affecting the production of neurotransmitters that regulate mood. This disruption can contribute to feelings of depression. Choice A is incorrect as there is a known connection between shift work and mental health. Choice B is incorrect because medication may not address the root cause of the depression in this case. Choice D is incorrect as adjustment to new sleep patterns can vary among individuals and may not necessarily take 4 months.

Correct Answer: B

Rationale: The correct answer is B: Self-injury or suicidal tendencies. This is because during the early stages of SSRI antidepressant therapy, there is an increased risk of suicidal ideation and behavior before the full therapeutic effects are achieved. This is known as the "suicidal ideation paradox." The other options are incorrect because hypertensive crisis is not a common side effect of SSRI therapy, extrapyramidal symptoms are typically associated with antipsychotic medications, and loss of appetite is a common side effect but not specific to the early stages of SSRI therapy.

Correct Answer: C

Rationale: The correct answer is C: Administer the furosemide in a separate intravenous line. This is the correct approach to prevent potential drug interactions between milrinone and furosemide. Mixing the two drugs in the same IV line can lead to incompatibility issues or chemical reactions that may reduce the effectiveness of both medications. Administering furosemide in a separate IV line ensures that each medication is delivered as intended without compromising their therapeutic effects. Additionally, this method reduces the risk of line contamination and minimizes the potential for errors in drug administration. Therefore, it is crucial for the nurse to follow this protocol to ensure the safety and efficacy of the patient's treatment.