a 6 month old infant is prescribed digoxin for the treatment of congestive heart failure which observation by the practical nurse pn warrants immediat
Logo

Nursing Elites

HESI LPN

Pharmacology HESI 2023

1. A 6-month-old infant is prescribed digoxin for the treatment of congestive heart failure. Which observation by the practical nurse (PN) warrants immediate intervention for signs of digoxin toxicity?

Correct answer: A

Rationale: A heart rate of 60 beats/min for a 6-month-old infant warrants immediate intervention as it falls below the normal range. The normal heart rate for a 6-month-old is 80 to 150 beats/min when awake, and a rate of 70 beats/min while sleeping is considered within normal limits. Bradycardia (heart rate <60 beats/min) in infants can be a sign of digoxin toxicity, necessitating prompt evaluation and intervention to prevent adverse effects. Sweating across the forehead (Choice B) is a non-specific symptom and may not directly indicate digoxin toxicity. Poor sucking effort (Choice C) and a respiratory rate of 30 breaths/min (Choice D) are not typically associated with digoxin toxicity and do not require immediate intervention in the context of this question.

2. A client with angina pectoris has been prescribed nitroglycerin tablets prn for chest pain. Which statement by the client causes the practical nurse (PN) to clarify instructions for this client?

Correct answer: D

Rationale: Nitroglycerin tablets should be taken at the onset of angina, and the client should stop activity and rest. One tablet should be placed under the tongue (sublingually), not chewed or swallowed. One tablet can be taken every 5 minutes, up to three doses. If pain relief not achieved after taking three pills, seek medical attention immediately. Nitroglycerin should be replaced every 3 to 6 months. Nitroglycerin pain relief should occur in 5 minutes and duration should last 30 minutes.

3. A client is prescribed metoprolol. The nurse should monitor for which common side effect of this medication?

Correct answer: A

Rationale: The correct answer is A: Dizziness. Metoprolol, a beta-blocker, can lead to dizziness as a common side effect due to its mechanism of action in reducing heart rate and blood pressure. This effect can cause a sensation of lightheadedness or unsteadiness, particularly when standing up quickly. While fatigue, orthostatic hypotension, and headache are potential side effects of metoprolol, dizziness is commonly observed and should be closely monitored by the nurse to ensure patient safety.

4. A client with a diagnosis of generalized anxiety disorder is prescribed buspirone. The nurse should include which instruction in the client's teaching plan?

Correct answer: B

Rationale: Buspirone may take several weeks to take effect, so clients should continue taking it as prescribed and not expect immediate relief.

5. Which action should be taken to assess for analgesic tolerance in a client who is unable to communicate?

Correct answer: C

Rationale: In clients who are unable to communicate, observing for pain behaviors is crucial in assessing analgesic tolerance. Changes in pain behaviors can indicate if the current analgesic regimen is effective or if tolerance has developed. Therefore, closely observing the client for pain behaviors before the next analgesic dose helps healthcare providers evaluate the client's response to pain management. Reviewing laboratory values may not directly reflect analgesic tolerance. Prolonging the interval between doses and monitoring vital signs may not provide direct information on analgesic tolerance. Relying solely on family members to report pain behaviors may not be as accurate or immediate as observing the client directly.

Similar Questions

The client is receiving vancomycin, and the nurse plans to draw blood for a peak and trough to determine... the best timing for these levels?
A client with a history of heart failure is prescribed spironolactone. The nurse should monitor for which potential side effect?
What is the primary nursing intervention that the practical nurse should perform before administering ampicillin to a client diagnosed with a urinary tract infection?
A client with a history of atrial fibrillation is prescribed rivaroxaban. The nurse should monitor for which potential side effect?
A client is prescribed an antibiotic for a urinary tract infection (UTI). What instruction should the practical nurse provide to the client to ensure the effectiveness of the medication?

Access More Features

HESI LPN Basic
$69.99/ 30 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

HESI LPN Premium
$149.99/ 90 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

Other Courses