A nurse is caring for a group of toddlers receiving digoxin therapy. For which of the following toddlers should the nurse revise the plan of care?
A toddler who has an apical pulse of 100/min
A toddler who has a potassium level of 4.0 mEq/L (3.4 to 4.7 mEq/L)
A toddler who has a digoxin level of 1.2 ng/mL (0.8 to 2 ng/mL)
A toddler who has vomited 2 times in the last hour
The Correct Answer is D
A. A normal apical pulse for a toddler is around 90-140 beats per minute. This toddler's heart rate is within normal range.
B. This toddler's potassium level is within the normal range.
C. This toddler's digoxin level is within the therapeutic range.
D. Vomiting can be a sign of digoxin toxicity. Digoxin has a narrow therapeutic index, meaning that even small increases in the drug level can lead to toxicity.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. During a 24-hour urine collection, all urine produced over the 24-hour period should be collected in a single container. The final specimen (the last urine voided at the end of the 24 hours) should be added to the same container as the rest of the collected urine, not saved separately.
B. For a 24-hour urine collection, there is no need to cleanse the perineum with a povidone-iodine solution before each collection. The focus should be on collecting all urine over the 24-hour period in the designated container. However, proper hygiene practices are important to avoid contamination.
C. The 24-hour urine collection starts after the first void of the day, which should be discarded. The collection begins with the second void and continues until the same time the next day, including the final void. Discarding the first void is essential to ensure that the collection accurately reflects the urine produced over a full 24-hour period.
D. During a 24-hour urine collection, the client should void as needed but collect all urine produced over the 24 hours in the designated container. There is no requirement to void every hour; the key is to ensure that every drop of urine is collected and included in the total 24-hour collection period.
Correct Answer is A
Explanation
A. Logrolling is a specific turning technique used to maintain spinal alignment post-operatively. It requires two nurses to prevent injury to the spine.
B. While elevating the head of the bed is important to prevent respiratory complications, a 30° angle is too high for a patient with spinal instrumentation. A lower angle is typically recommended to maintain spinal alignment.
C. Early ambulation is encouraged after surgery, but 12 hours is too soon. The adolescent will likely be on bed rest for several days to allow the fusion to stabilize.
D. Clear liquids are often introduced earlier than 4 hours post-surgery, once bowel sounds return and there is no evidence of nausea or vomiting.
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