A nurse is assessing a client who has heart failure and is taking digoxin. Which of the following manifestations should the nurse report to the provider as an indication of digoxin toxicity?
Vomiting.
Dilated pupils.
Bruising.
Peripheral edema.
The Correct Answer is A
Choice A rationale
Vomiting is a common sign of digoxin toxicity. Other symptoms include nausea, confusion, and visual disturbances.
Choice B rationale
Dilated pupils are not a typical sign of digoxin toxicity. Symptoms are more related to gastrointestinal and cardiac effects.
Choice C rationale
Bruising is not directly associated with digoxin toxicity. It may indicate other issues such as coagulopathy.
Choice D rationale
Peripheral edema is not a specific sign of digoxin toxicity. It is more commonly associated with heart failure.
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Correct Answer is B
Explanation
Choice A rationale
Repeating up to four doses until pain is relieved is incorrect. The correct instruction is to take one tablet at the onset of pain and repeat every 5 minutes if needed, up to a maximum of three tablets in 15 minutes.
Choice B rationale
Storing unused tablets at room temperature is correct. Nitroglycerin tablets should be stored in their original container at room temperature, away from moisture and heat.
Choice C rationale
Taking two tablets at the onset of pain is incorrect. The correct instruction is to take one tablet at the onset of pain and repeat every 5 minutes if needed, up to a maximum of three tablets in 15 minutes.
Choice D rationale
Taking the medication two hours prior to exercise is incorrect. Nitroglycerin should be taken 5 to 10 minutes before an activity that may cause chest pain.
Correct Answer is B
Explanation
Choice A rationale
Crushing tadalafil is not recommended as it can alter the medication’s effectiveness and absorption. Tadalafil should be taken whole to ensure proper dosage and efficacy.
Choice B rationale
Tadalafil can decrease blood pressure by relaxing blood vessels, which allows for increased blood flow. This is a known effect of phosphodiesterase type 5 (PDE5) inhibitors like tadalafil.
Choice C rationale
Tadalafil should not be taken more than once a day. Taking it twice a day can increase the risk of side effects and is not recommended.
Choice D rationale
The effects of tadalafil can last up to 36 hours, not just 4 hours. This prolonged duration is one of the reasons it is preferred by some patients.