A nurse is providing discharge teaching for a client who has heart failure and is to start therapy with digoxin. Which of the following statements by the client indicates an understanding of the teaching?
"I will notify my provider if I experience muscle weakness."
"I will take this medication with fiber to prevent constipation."
"I will increase my dose if my vision becomes blurred."
"I will take my digoxin if my pulse is less than 50 beats per minute."
The Correct Answer is A
A. Muscle weakness can be a sign of digoxin toxicity, especially if it is accompanied by other symptoms like nausea, vomiting, or blurred vision. The client should notify the provider immediately if these symptoms occur.
B. Taking digoxin with fiber is not necessary and may interfere with its absorption. The client should take digoxin on an empty stomach, or as directed by the provider, but not specifically with fiber to prevent constipation.
C. Increasing the dose of digoxin if the client experiences blurred vision could be dangerous. Blurred vision is actually a symptom of digoxin toxicity, and the client should not increase the dose but should notify the provider immediately.
D. The nurse should advise the client to hold the digoxin if their pulse is less than 60 beats per minute (not 50), as this could indicate bradycardia caused by digoxin. The client should contact their provider before taking the medication if their pulse is too low.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. The nurse should recommend that the client avoid using a toothbrush that is not regularly disinfected. However, washing the toothbrush in the dishwasher may not be sufficient. The client should replace the toothbrush regularly and disinfect it appropriately.
B. Changing the pet's litter box daily is not safe for clients with an impaired immune system. The nurse should advise the client to avoid cleaning the litter box or, if necessary, to wear gloves and a mask while performing the task, and ask someone else to do it if possible.
C. Changing the water in the drinking glass every 4 hours is an important infection control measure for clients with compromised immune systems. Stagnant water can promote bacterial growth, which poses an increased risk for infection in immunocompromised clients.
D. Washing the perineal area two times each day with antimicrobial soap is unnecessary and may cause irritation or disrupt the natural flora of the skin. The nurse should recommend gentle cleansing with mild soap and water instead. Overuse of antimicrobial products can lead to skin damage or resistance.
Correct Answer is D
Explanation
A. Dry brown eschar is a sign of necrotic tissue, which indicates that the wound is not healing properly. Eschar needs to be removed for proper healing to occur.
B. Wound tissue firm to palpation is not a typical sign of healing. Healing tissue tends to be softer, while firm tissue could indicate fibrosis or an abnormal healing process.
C. Light yellow exudate can indicate the presence of infection or the early stages of healing, but it is not as specific a sign of healing as granulation tissue. Granulation tissue is a more definitive sign of healing.
D. Dark red granulation tissue is a sign of healthy healing tissue. It consists of new blood vessels and is an indication that the wound is in the proliferative phase of healing, which is a positive sign.
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