Page 1808 - Saunders Comprehensive Review For NCLEX-RN

Test-Taking Strategy: Focus on the subject, a concern related to administration of
hydrochlorothiazide. Recall that thiazide diuretics chemical make-up carry a sulfa
ring.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Pharmacology: Cardiovascular Medications: Diuretics
Health Problem: Adult Health: Cardiovascular: Hypertension
Priority Concepts: Clinical Judgment; Safety
Reference: Burchum, Rosenthal (2016), pp. 452-453.

633. Answer: 4

Rationale: Nicotinic acid, even an over-the-counter form, should be avoided
because it may lead to liver abnormalities. All lipid-lowering medications also can
cause liver abnormalities, so a combination of nicotinic acid and cholestyramine
resin needs to be avoided. Constipation and bloating are the 2 most common adverse
effects. Walking and the reduction of fats in the diet are therapeutic measures to
reduce cholesterol and triglyceride levels.
Test-Taking Strategy: Note the strategic words, need for further teaching. These
words indicate a negative event query and ask you to select an option that is an
incorrect statement. Remembering that over-the-counter medications should be
avoided when a client is taking a prescription medication will direct you to the
correct option.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Cardiovascular Medications: Antilipemics
Health Problem: Adult Health: Cardiovascular: Coronary Artery Disease
Priority Concepts: Client Education; Safety
References: Hodgson, Kizior (2015), pp. 244-245; Burchum, Rosenthal (2016), p.
573.

634. Answer: 2, 4, 5

Rationale: Digoxin is a cardiac glycoside. The risk of toxicity can occur with the
use of this medication. Toxicity can lead to life-threatening events and the nurse
needs to monitor the client closely for signs of toxicity. Early signs of toxicity include
gastrointestinal manifestations such as anorexia, nausea, vomiting, and diarrhea.
Subsequent manifestations include headache; visual disturbances such as diplopia,
blurred vision, yellow-green halos, and photophobia; drowsiness; fatigue; and
weakness. Cardiac rhythm abnormalities can also occur. The nurse also monitors the
digoxin level. The optimal therapeutic range for digoxin is 0.5 to 2.0 ng/mL (0.63 to
2.56 nmol/L).
Test-Taking Strategy: Focus on the subject, digoxin toxicity. Specific knowledge
regarding the characteristics of digoxin toxicity is needed to answer this question.
Recall that the early signs are gastrointestinal manifestations. Next, recall that visual

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