The nurse is preparing to administer digoxin (Lanoxin) to a client with heart failure. The client's heart rate is 58 beats per minute. What is the nurse's best action?

Correct Answer: B

Rationale: Digoxin slows heart rate via vagal stimulation, treating heart failure but risking bradycardia if the rate drops too low. A heart rate of 58 bpm is below the typical threshold (60 bpm) for holding digoxin, indicating potential toxicity or excessive effect, especially in heart failure where compensatory tachycardia may mask issues. Holding the dose and notifying the physician allows reassessment of digoxin levels or need for adjustment, prioritizing safety. Administering as ordered risks worsening bradycardia, potentially leading to hemodynamic instability. Half-dosing lacks protocol support and delays medical input. Blood pressure informs but doesn't address the primary concern. Holding and notifying aligns with nursing judgment and digoxin's narrow therapeutic index, making B the best action to prevent adverse outcomes.

Correct Answer: B

Rationale: Alprazolam is a medication commonly used in treating anxiety disorders, panic disorders, and anxiety associated with depression. It belongs to a class of drugs known as benzodiazepines, which act on the central nervous system to produce a calming effect. Alprazolam helps to reduce feelings of anxiety and promote relaxation by enhancing the activity of certain neurotransmitters in the brain. It is not used for relief of drowsiness, bronchospasms, or cardiac arrest.

Correct Answer: C

Rationale: Alpha1-selective adrenergic blocking agents block smooth muscle receptors in the prostate, prostatic capsule, prostatic urethra, and urinary bladder neck, which leads to a relaxation of the bladder and prostate and improved flow of urine in male patients. Although they also block the postsynaptic alpha1-receptor sites, causing a decrease in vascular tone and vasodilation that leads to a fall in blood pressure without the reflex tachycardia that occurs when the presynaptic alpha2-receptor sites are blocked, this is not the purpose for administering the drug to a patient with BPH. They do not reduce the size of the prostate.

Correct Answer: D

Rationale: A sudden increase in temperature in a client receiving Pentamidine IV for the treatment of Pneumocystis carinii is most likely an indication that the client has developed another infection. Pentamidine is an antiparasitic medication used to treat Pneumocystis carinii pneumonia in immunocompromised individuals such as those with HIV/AIDS. An increase in temperature could be a sign of a new or worsening infection, especially in patients who are already immunocompromised. It is important for the nurse to monitor the client closely for signs of infection and notify the healthcare provider if there are any concerning symptoms.

Correct Answer: B

Rationale: Angioedema is a potentially serious side effect of ACE inhibitors. It involves swelling of the deeper layers of the skin and submucosal tissues and can affect areas such as the face, lips, tongue, throat, and extremities. One of the key signs of angioedema is difficulty breathing, or dyspnea. Other signs may include swelling, itching, and hives. It is crucial for nurses to monitor patients taking ACE inhibitors for any signs of angioedema as it can rapidly progress and lead to airway compromise and respiratory distress. Prompt recognition and intervention are essential to prevent any serious complications.