Correct Answer: A

Rationale: Low blood flow in veins increases the risk for the development of a thrombus. When blood flow is slow or stagnant in veins, it can lead to the formation of blood clots or thrombi. This risk is further heightened in individuals who have conditions that affect blood flow, such as being sedentary or having a condition that impairs circulation. Thrombi can pose serious health risks if they break off and travel to other parts of the body, potentially causing blockages or even life-threatening complications like pulmonary embolism. Thus, low blood flow in veins is a key characteristic that increases the risk for thrombus formation.

Correct Answer: C

Rationale: Based on the blood pressure categories defined by the American Heart Association, hypertension is classified as having a systolic blood pressure (top number) of 130 mm Hg or higher and/or a diastolic blood pressure (bottom number) of 80 mm Hg or higher. The client's blood pressure reading of 150/90 mm Hg falls within the range of hypertension, indicating elevated blood pressure levels that may require monitoring and/or intervention to reduce the risk of cardiovascular complications.

Correct Answer: B

Rationale: Atorvastatin (Lipitor) is a medication commonly used to treat high cholesterol levels. One of the serious side effects associated with atorvastatin use is muscle pain and weakness. This could be a sign of a rare but serious condition known as rhabdomyolysis, which is the breakdown of muscle tissue that can lead to kidney damage. Therefore, it is crucial for the client to report any muscle pain or weakness promptly to their healthcare provider to prevent any serious complications. Headaches and nausea are common side effects that may not require urgent attention. Bruising and excessive bleeding usually indicate a different issue, such as a bleeding disorder or anticoagulant medication effect. Shortness of breath and coughing are not typically associated with atorvastatin use and may suggest other health problems that require evaluation by a healthcare provider.

Correct Answer: A

Rationale: A. Muscle spasms: Nitroprusside infusion can lead to cyanide toxicity, which can cause muscle spasms as a symptom. It is essential for the nurse to monitor the client for any signs of muscle spasms during the infusion.

Correct Answer: C

Rationale: For an older patient with heart failure prescribed digoxin (Lanoxin) 125 mcg by mouth three times a week, the nurse should administer the drug as prescribed while monitoring for manifestations of toxicity. Digoxin is a medication commonly used in heart failure, but it has a narrow therapeutic index, meaning that the difference between a therapeutic dose and a toxic dose is small. Older patients are more susceptible to digoxin toxicity due to age-related changes in pharmacokinetics and pharmacodynamics, as well as potential comorbidities. Therefore, close monitoring for signs and symptoms of digoxin toxicity, such as nausea, vomiting, visual disturbances, and cardiac arrhythmias, is essential. It is important for the nurse to be vigilant for any early signs of toxicity and communicate any concerns to the healthcare provider promptly.