The nurse is preparing to administer digoxin to a client with heart failure. The nurse obtains an apical pulse rate for 1 minute and determines a rate of 52 beats/minute. What is the first action by the nurse?

Administer the medications and then notify the health care provider.

Administer atropine to speed the heart rate and then administer the digoxin.

Administer the medication and inform the charge nurse about the rate.

Withhold the medication and notify the health care provider of the heart rate.

Answer and Explanation

The Correct Answer is D

A. Administer the medications and then notify the health care provider: Administering digoxin with a heart rate below 60 bpm can worsen bradycardia and lead to complications like heart block. The drug should be withheld first.
B. Administer atropine to speed the heart rate and then administer the digoxin: Atropine is not given prophylactically without a provider's order. It is used in emergency settings for symptomatic bradycardia, not as a pre-treatment for digoxin.
C. Administer the medication and inform the charge nurse about the rate: This does not follow safe medication guidelines. Administering digoxin without addressing the low heart rate may lead to serious adverse effects.
D. Withhold the medication and notify the health care provider of the heart rate: This is the safest and most appropriate action. Digoxin should be withheld if the apical pulse is below 60 bpm, and the provider must be informed for further evaluation.

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Correct Answer is ["A","D","E"]

Explanation

A. Eroded teeth enamel: Frequent vomiting in bulimia nervosa exposes teeth to stomach acid, leading to enamel erosion. This is a classic physical sign associated with purging behavior.
B. Younger onset than anorexia nervosa: Bulimia nervosa typically has a later onset than anorexia nervosa, often emerging in late adolescence or early adulthood. This statement is inaccurate for distinguishing between the two disorders.
C. Denial of abnormal eating habits: Clients with bulimia nervosa are often aware of their disordered eating behaviors and may express guilt or shame. Denial is more characteristic of anorexia nervosa.
D. Overweight or normal weight: Unlike individuals with anorexia, those with bulimia usually maintain a normal or slightly above-average weight, due to cycles of binge eating and purging rather than extreme caloric restriction.
E. Admits to purging and binging: Admission of binging and purging episodes is a key behavioral characteristic of bulimia nervosa. Clients may describe eating large amounts of food followed by self-induced vomiting or use of laxatives.
F. Appears thin but feels fat: This perception is more commonly associated with anorexia nervosa, where body image distortion is profound despite extreme thinness. Bulimia clients often have less severe weight loss.

A. Respiratory rate of 16 breaths/minute B. Heart rate of 120 beats/minute C. Oxygen saturation of 95% D. Blood pressure of 140/90 mm Hg

Correct Answer is B

Explanation

A. Respiratory rate of 16 breaths/minute: A normal respiratory rate does not reflect the body's compensatory response to anemia. In moderate to severe anemia, the body typically increases respiratory effort to improve oxygen delivery.
B. Heart rate of 120 beats/minute: Tachycardia is a common compensatory mechanism in anemia. With reduced hemoglobin and oxygen-carrying capacity, the heart pumps faster to maintain adequate oxygen delivery to tissues.
C. Oxygen saturation of 95%: Oxygen saturation measures the percentage of hemoglobin saturated with oxygen, not the actual amount of hemoglobin. A normal reading can still occur despite overall reduced oxygen-carrying capacity.
D. Blood pressure of 140/90 mm Hg: This elevated blood pressure may be unrelated to anemia. Anemia often causes a drop in blood pressure or no significant change, depending on severity and fluid status.

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The nurse is preparing to administer digoxin to a client with heart failure. The nurse obtains an apical pulse rate for 1 minute and determines a rate of 52 beats/minute. What is the first action by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is B

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