The nurse is giving the client digoxin for heart failure and recognizes that the drug has what type of effect on the heart?

Correct Answer: B

Rationale: The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin is a positive inotrope, meaning it increases the force of myocardial contraction, which helps improve cardiac output in heart failure. It has a negative chronotropic effect, meaning it decreases the heart rate by slowing down the electrical conduction in the heart, which can be beneficial in certain heart conditions. Choice A (Negative inotropic, negative chronotropic effect) is incorrect because digoxin is a positive inotrope, not a negative inotrope. Choice C (Negative inotropic, positive chronotropic effect) is incorrect because digoxin does not have a positive chronotropic effect. Choice D (Positive inotropic, positive chronotropic effect) is incorrect because digoxin has a negative chronotropic effect, not a positive one. Therefore, the correct choice is B due to the combination of positive inotropic effect and negative chronotropic effect of digoxin on the heart

Correct Answer: A

Rationale: The correct answer is A. Sublingual nitroglycerin is taken under the tongue to quickly relieve chest pain. The nurse should instruct the client to take one tablet every 5 minutes during an episode of chest pain, up to a maximum of three tablets. This is because nitroglycerin works rapidly to dilate blood vessels and improve blood flow to the heart, helping to relieve angina symptoms. Taking one tablet every hour or two tablets immediately may not provide adequate relief and could lead to an overdose. Taking the tablet with water is unnecessary as the medication is absorbed through the mucous membranes under the tongue.

Correct Answer: A

Rationale: The correct answer is A: Hypokalemia. Furosemide is a loop diuretic that increases potassium excretion in the urine, leading to low potassium levels (hypokalemia). This can cause muscle weakness, cramps, and cardiac arrhythmias. Hypernatremia (B) is high sodium levels, unrelated to furosemide. Hyperkalemia (C) is the opposite of what furosemide causes. Hyponatremia (D) is low sodium levels, not typically associated with furosemide use.

Correct Answer: A

Rationale: The correct answer is A: Monitor the client's heart rate. When administering an IV bolus of heparin, it is crucial to monitor the client's heart rate because heparin can cause serious side effects such as bleeding and heparin-induced thrombocytopenia, which can lead to changes in heart rate. Checking blood pressure (B) is also important but not as critical as monitoring heart rate. Checking for signs of bleeding (C) is necessary but should be done after monitoring the heart rate. Monitoring the client's respiratory rate (D) is not directly related to heparin administration.

Correct Answer: A

Rationale: The correct answer is A: Monitor heart rate and rhythm. Dopamine is a medication that can affect the heart rate and rhythm. Monitoring these parameters is crucial to detect any potential adverse effects such as tachycardia or arrhythmias. Monitoring blood pressure is also important, but assessing heart rate and rhythm takes precedence due to the direct impact of dopamine on cardiac function. Respiratory rate and oxygen saturation are generally not directly affected by dopamine administration.