A nurse is preparing to administer digoxin orally to a client. Identify the sequence of steps the nurse should take (Move the steps into the box on the right, placing them in the order of performance. Use all the steps)

Remove the medication from the dispensing system.

Compare the client’s wristband to the medication administration record.

Document administration of the medication.

Open the medication package.

Obtain the client’s apical heart rate.

Answer and Explanation

The Correct Answer is E, A, B, D, C

Before administering digoxin, the nurse should check the patient's apical heart rate. If the heart rate is below 60 beats per minute for an adult, or below the prescribed limit for a child, the nurse should hold the medication and notify the healthcare provider. This is the first step because the nurse needs to have the medication in hand before proceeding with the other steps. This step is crucial to ensure that the right medication is being given to the right patient. It's a part of the "five rights" of medication administration: right patient, right medication, right dose, right route, and right time. Once the nurse has confirmed the patient's identity and heart rate, the next step is to open the medication package. After administering the medication, the nurse should document it in the patient's medical record. This is important for maintaining an accurate record of the patient's medication history.

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Correct Answer is A,B,C,D

Explanation

A 12-year-old child with history of asthma who is wheezing and complaining of shortness of breath.

This client has the highest priority, as he or she may be experiencing an acute asthma atack that can compromise the airway and oxygenation. The PN should assess the client's respiratory status, administer bronchodilators, and monitor for improvement or deterioration.

A 7-year-old child who has type 1 diabetes mellitus and is experiencing extreme hunger and shakiness.

This client has the second highest priority, as he or she may be experiencing hypoglycemia, which is a low blood glucose level that can cause neurologic symptoms such as confusion, seizures, or coma. The PN should check the client's blood glucose level, provide a source of glucose, and monitor for recovery or complications.

A 10-year-old child with bleeding lacerations on both knees after falling on the playground.

This client has the third highest priority, as he or she may have a risk of infection or blood loss from the wounds. The PN should clean and dress the lacerations, apply pressure if needed, and check for signs of infection or inﬂammation.

A 5-year-old child who is crying uncontrollably because of an incontinent bowel episode.

This client has the lowest priority, as he or she does not have a life-threatening or urgent condition, but a psychosocial or emotional issue. The PN should provide comfort and reassurance to the child, change his or her clothes, and explore the possible causes of the incontinence.

A. Withhold next scheduled dose of treatment. B. Maintain the prescribed fluid restriction. C. Assess for increasing fluid volume overload. D. Increase neurologic checks to every 2 hours.

Correct Answer is B

Explanation

B. SIADH is characterized by excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. Fluid restriction is a key component of treatment for SIADH to restore serum sodium levels to normal. Maintaining the prescribed fluid restriction is important for preventing further dilution of serum sodium and promoting continued improvement in the client's condition.
A. Withholding the next scheduled dose of treatment may not be appropriate solely based on a mild increase in serum sodium level. While syndrome of inappropriate antidiuretic hormone (SIADH) can lead to hyponatremia (low sodium levels) due to excessive water retention, an increase in serum sodium within a narrow range may not necessarily warrant withholding treatment.
C. Assessing for increasing fluid volume overload may be relevant in the context of managing SIADH and monitoring the client's response to treatment. However, an increase in serum sodium level from 120 mEq/L to 125 mEq/L suggests a trend towards correction of hyponatremia rather than worsening fluid volume overload.
D. Increasing the frequency of neurologic checks to every 2 hours may not be necessary solely based on a mild increase in serum sodium level from 120 mEq/L to 125 mEq/L.

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A nurse is preparing to administer digoxin orally to a client. Identify the sequence of steps the nurse should take (Move the steps into the box on the right, placing them in the order of performance. Use all the steps)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A,B,C,D

Explanation

Correct Answer is B

Explanation

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