What's the normal range for therapeutic serum digo

Question 1 of 5

What's the normal range for therapeutic serum digoxin levels?

A. 0.5-2 ng/mL B. 1-2 ng/mL C. 0.2-0.5 ng/mL D. 0-1 ng/mL

Correct Answer: A

Rationale: The normal range for therapeutic serum digoxin levels is typically considered to be 0.5-2 ng/mL. This range is where the drug digoxin effectively treats heart conditions such as atrial fibrillation and heart failure without causing toxicity. Levels below 0.5 ng/mL may be subtherapeutic, while levels above 2 ng/mL can lead to digoxin toxicity, characterized by symptoms like nausea, vomiting, visual disturbances, and cardiac arrhythmias. Regular monitoring of serum digoxin levels is essential to ensure the drug is being used safely and effectively.

Question 2 of 5

Discharge planning for the client prescribed tetracycline will include which instruction?

A. Take the medication with antacids. B. Take the medication with iron supplements. C. Do not take the medication with milk. D. Decrease the amount of vitamins.

Correct Answer: C

Rationale: Tetracycline is a broad-spectrum antibiotic that can be rendered ineffective if taken with certain substances that interfere with its absorption. Dairy products, such as milk, contain calcium, which binds to tetracycline in the gastrointestinal tract, forming insoluble complexes that prevent the drug from being absorbed into the bloodstream. This interaction significantly reduces its therapeutic efficacy, making it crucial to instruct the client to avoid milk when taking the medication. Similarly, antacids (containing magnesium, aluminum, or calcium) and iron supplements also chelate tetracycline, decreasing its bioavailability, so choices A and B are incorrect and potentially harmful instructions. Reducing vitamin intake is unrelated to tetracycline's administration or efficacy, as vitamins do not typically interfere with its action unless specifically combined with minerals like iron or calcium. Therefore, the priority instruction is to avoid milk, ensuring the drug's effectiveness, which makes choice C the correct and most critical discharge teaching point.

Question 3 of 5

A patient who reports severe seasonal allergies has been prescribed fluticasone (Flonase). The nurse providing medication information would collaborate with the prescriber if the patient makes which statement?

A. I don't like licorice anyway.' B. My kids all have that head cold that is going around school.' C. Next appointment I want to talk about treatment for my psoriasis.' D. I have been eating lots of fresh fruits.'

Correct Answer: B

Rationale: Fluticasone risks immunosuppression with infections , requiring collaboration if exposed to a cold. Other statements (choices A, C, D) are irrelevant. B ensures safety, making it key.

Question 4 of 5

Select all when taking Iron Supplements.

A. One hour before or 2 hours after meal B. Full glass of water/ juice C. No caffeine D. Carry identification card saying you are on Iron Supplements

Correct Answer: A

Rationale: A. It is recommended to take iron supplements one hour before or two hours after a meal because food can interfere with the absorption of iron. By taking it on an empty stomach or away from meals, the body can absorb the iron more effectively.

Question 5 of 5

Regarding phenytoin, all the following are true EXCEPT:

A. oral bioavailability is variable B. binds poorly with plasma proteins C. metabolism is enhanced in presence of inducers of liver metabolism D. elimination kinetics shift from first order to zero order at moderate to high dose

Correct Answer: B

Rationale: Phenytoin's oral bioavailability varies due to formulation and absorption, a true statement. It's highly plasma protein-bound (~90%), not poorly, making that false and the exception. Hepatic enzyme inducers (e.g., rifampicin) enhance its metabolism, true. At higher doses, its elimination shifts to zero-order due to saturated metabolism, true. Half-life ranges from 12-36 hours, also true. High protein binding affects free drug levels, critical for therapeutic monitoring, especially in hypoalbuminemia.