What is the primary action of digoxin when prescribed to a patient with heart failure?

Correct Answer: C

Rationale: The primary action of digoxin in heart failure is to strengthen cardiac contractions. Digoxin inhibits the sodium-potassium pump, leading to an increase in intracellular calcium levels, which enhances the force of myocardial contractions. This helps improve cardiac output and symptoms of heart failure. Explanation: A: Incorrect - Digoxin does not increase heart rate, it mainly affects the strength of contractions. B: Incorrect - Digoxin does not decrease cardiac output; it actually helps improve it by enhancing contractility. D: Incorrect - Digoxin may have a slight effect on lowering blood pressure, but its primary action in heart failure is to strengthen cardiac contractions, not lower blood pressure.

Correct Answer: C

Rationale: The correct answer is C: Decrease heart rate. Carvedilol is a beta-blocker that works by blocking the beta-adrenergic receptors in the heart, leading to a decrease in heart rate. This helps reduce the workload of the heart and improve its efficiency in patients with heart failure. Choice A is incorrect because carvedilol may not necessarily increase cardiac output directly. Choice B is incorrect because carvedilol focuses more on improving heart function rather than directly reducing fluid retention. Choice D is incorrect because while carvedilol may lower blood pressure as a secondary effect, its primary purpose in heart failure is to improve cardiac function by decreasing heart rate.

Correct Answer: A

Rationale: The correct answer is A: Take folic acid supplements as prescribed. Methotrexate can lead to folic acid deficiency, causing side effects. Supplementing with folic acid can help manage these side effects. It is crucial for the nurse to emphasize the importance of taking folic acid as prescribed to prevent adverse effects. Summary of Incorrect Choices: B: Avoid alcohol completely - While alcohol should be limited or avoided due to potential liver toxicity with methotrexate, complete avoidance may not be necessary for all patients. C: Expect to see immediate results - Methotrexate takes time to work, and patients should not expect immediate results. Patience is necessary. D: Limit fluid intake to 1 liter per day - There is no specific guideline to limit fluid intake with methotrexate. Adequate hydration is important for overall health.

Correct Answer: C

Rationale: The correct answer is C: Before meals. Omeprazole is a proton pump inhibitor that works best when taken before meals to inhibit acid secretion before food intake. Taking it with meals (choice A) may decrease its effectiveness as it needs time to be absorbed. Taking it at bedtime (choice B) may not provide optimal coverage throughout the day. Taking it after meals (choice D) may not allow enough time for the medication to start working before the next meal.

Correct Answer: C

Rationale: The correct answer is C: Promote red blood cell production. Erythropoietin is a hormone that stimulates the production of red blood cells in the bone marrow. This is crucial for patients with CKD who often develop anemia due to decreased erythropoietin production. A: Stimulating white blood cell production is the function of other medications, such as colony-stimulating factors, not erythropoietin. B: Erythropoietin does not have an effect on platelet count. D: Enhancing clotting factor production is not the primary action of erythropoietin.