Chapter 24: Heart Failure Drugs
Chapter 24: Heart Failure Drugs MULTIPLE CHOICE 1. A patient about to receive a morning dose of digoxin has an apical pulse of 53 beats/min. What
will the nurse do next? a. Administer the dose. b. Administer the dose, and notify the prescriber. c. Check the radial pulse for 1 full minute. d. Withhold the dose, and notify the prescriber. ANS: D
Digoxin doses are held and the prescriber notified if the apical pulse is 60 beats/min or lower or is higher than 100 beats/min. The other options are incorrect. DIF: COGNITIVE LEVEL: Applying (Application) TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 2. A patient is taking digoxin (Lanoxin) and a loop diuretic daily. When the nurse enters the room
with the morning medications, the patient states, “I am seeing a funny yellow color around the lights.” What is the nurse’s next action? a. Assess the patient for symptoms of digoxin toxicity. b. Withhold the next dose of the diuretic. c. Administer the digoxin and diuretic together as ordered. d. Document this finding, and reassess in 1 hour. ANS: A
Seeing colors around lights is one potential indication of developing digoxin toxicity. If a patient complains of this, the nurse needs to assess for other signs and symptoms of digoxin toxicity including bradycardia, headache, dizziness, confusion, nausea, and blurred vision, and then notify the prescriber. Administering the drug or withholding the diuretic are incorrect options. DIF: COGNITIVE LEVEL: Analyzing (Analysis) TOP: NURSING PROCESS: Assessment MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential 3. While assessing a patient who is receiving intravenous digitalis, the nurse recognizes that the
drug has a negative chronotropic effect. How would this drug effect be evident in the patient? a. Decreased blood pressure b. Decreased heart rate c. Decreased conduction d. Decreased ectopic beats ANS: B
A negative chronotropic effect results in a decreased heart rate; this is one effect of cardiac glycosides. The other options are incorrect. DIF: COGNITIVE LEVEL: Applying (Application)
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