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HESI Comprehensive B Practice

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An 8-year-old child is receiving
digoxin (Lanoxin) for congestive heart
failure (CHF). In assessing the child,
the nurse finds that her apical heart
rate is 80 beats/min, she complains of
being slightly nauseated, and her
serum digoxin level is 1.2 ng/mL.
What action should the nurse take?
A.Because the child's heart rate and
digoxin level are within normal range,
assess for the cause of the nausea.
B.Hold the next dose of digoxin until
the health care provider can be
notified because the serum digoxin
level is elevated.
C.Administer the next dose of digoxin
and notify the health care provider
that the child is showing signs of
toxicity.
D.Notify the health care provider that
the child's pulse rate is below normal
for her age group.A
Rationale:
Nausea and vomiting are early signs
of digoxin toxicity. However, the
normal resting heart rate for a child 8
to 10 years of age is 70 to 110
beats/min and the therapeutic range
of serum digoxin levels is 0.5 to 2
ng/mL. Based on the objective data,
(A) is the best of the choices
provided because the serum digoxin
level is within normal levels. (B) is
not warranted by the data presented.
The digoxin level is within the
therapeutic range and the child is not
showing signs of toxicity (C). The
child's pulse rate is within normal
range for her age group (D).

2.A 12-year-old boy complains to the
nurse that he is "short" (4'5" [53
inches]). His twin sister is 5 inches
taller than he is (4'10" [58 inches]).
Based on these findings, what
conclusion should the nurse reach?
A.The boy is not growing as normally
expected.
B.The girl is experiencing a period of
unexpected growth.
C.A normal growth spurt occurs in
girls 1 to 2 years earlier than boys.
D.Male-female twins are not identical;
therefore, their growth cannot beC
Rationale:
Girls experience a growth spurt at
9.5 to 14.5 years of age and boys at
10.5 to 16 years of age (C). There
are insufficient data to support (A);
growth trends must be assessed to
reach such a conclusion. (B) is not
unexpected. The fact that the
children are twins has less to do
with their growth than the fact that
they are male and female (D)

 

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[Solved] HESI Comprehensive B Practice

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  • Submitted On 06 Oct, 2020 04:22:04
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An 8-year-old child is receiving digoxin (Lanoxin) for congestive heart failure (CHF). In assessing the child, the nurse finds that her apical heart rate is 80 beats/min, she complains of being slightly nauseated, and her serum digoxin level is 1.2 ng/mL. What action should the nurse take? A.Because the child's heart rate and digoxin level are within normal range, assess for the cause of the nausea. B.Hold the next dose of digoxin until the health care provider can be notified because the serum digoxin level is elevated. C.Adminis...
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