The nurse is caring for a client on digoxin. What is the most important assessment before administering this medication?

Correct Answer: A

Rationale: The correct answer is A: Check the client's heart rate. Before administering digoxin, it is crucial to assess the client's heart rate as digoxin can cause bradycardia or arrhythmias. Monitoring the heart rate helps to determine if the client is at risk of experiencing these adverse effects. Checking blood pressure, respiratory rate, or oxygen saturation is important but not as crucial as assessing the heart rate when administering digoxin. Bradycardia is a common adverse effect of digoxin, so assessing the heart rate is the priority.

Correct Answer: A

Rationale: The correct answer is A: Hold the beta blocker and notify the healthcare provider. A blood pressure of 90/60 mm Hg is considered low and may be a sign of hypotension, which can be a serious side effect of beta blockers. Holding the medication and notifying the healthcare provider is the priority action to prevent further complications. Administering the beta blocker (choice B) can worsen the hypotension. Administering a diuretic (choice C) may further lower the blood pressure. Continuing to monitor and reassess (choice D) is not appropriate in this situation as immediate action is needed due to the low blood pressure reading.

Correct Answer: C

Rationale: The correct answer is C: Increased cardiac output. ACE inhibitors work by dilating blood vessels and reducing the workload on the heart. This leads to improved cardiac output, as the heart can pump more efficiently. Decreased blood pressure (choice A) is a common side effect due to vasodilation. Increased heart rate (choice B) and decreased heart rate (choice D) are not expected outcomes of ACE inhibitor use. Therefore, the most appropriate and expected outcome of administering an ACE inhibitor in heart failure is an increase in cardiac output, making choice C the correct answer.

Correct Answer: A

Rationale: Rationale: 1. Furosemide is a loop diuretic that can cause potassium loss. 2. Potassium level of 2.9 mEq/L indicates hypokalemia, which can lead to serious complications. 3. Priority is to address low potassium levels to prevent adverse effects like cardiac arrhythmias. 4. Administering potassium supplements helps to normalize potassium levels promptly. Summary: B: Holding furosemide without addressing low potassium can worsen the imbalance. C: Continuing the current dose without addressing low potassium can lead to further depletion. D: Decreasing furosemide dose before addressing low potassium can delay correcting the imbalance.

Correct Answer: A

Rationale: The correct answer is A: Blood pressure. When administering dobutamine, a medication that increases heart contractility, the most important parameter to assess is blood pressure. This is because dobutamine can cause significant changes in blood pressure, including hypotension or hypertension, which can have serious implications for the client's hemodynamic stability. Monitoring blood pressure allows for timely intervention and adjustment of the medication dosage to ensure optimal cardiovascular function. Heart rate (B), oxygen saturation (C), and respiratory rate (D) are also important parameters to monitor but are not the primary concern when administering dobutamine, as its effects on blood pressure are more critical for patient safety and treatment efficacy.