Question 1

A patient about to receive his morning dose of digoxin (Lanoxin)has an apical pulse of 70 beats per minute.What should the nurse do?

Accepted Answer

A) Administer the dose 
B) Withhold the dose and notify the physician 
C) Notify the physician and monitor the patient's vital signs 
D) Recheck the pulse, making sure to count for 1 full minute 
A) Administer the dose 
B) Withhold the dose and notify the physician 
C) Notify the physician and monitor the patient's vital signs 
D) Recheck the pulse, making sure to count for 1 full minute A

Question 2

A patient has been taking digoxin (Lanoxin)at home but has developed toxicity.The physician has ordered digoxin immune Fab.The patient asks the nurse why the medication has been changed.Which is the nurse's best response?

Accepted Answer

A) "It works faster than digoxin." 
B) "It is safer than digoxin and can be taken orally." 
C) "It helps to convert the fibrillating atria to a more normal rhythm." 
D) "This new drug is an antidote to digoxin and will help to lower the blood levels." 
A) "It works faster than digoxin." 
B) "It is safer than digoxin and can be taken orally." 
C) "It helps to convert the fibrillating atria to a more normal rhythm." 
D) "This new drug is an antidote to digoxin and will help to lower the blood levels." D

Question 3

The nurse who is assessing a patient who is receiving intravenous (IV)digitalis recognizes that the drug has a negative chronotropic effect.How is a negative chronotropic effect evident in a patient?

Accepted Answer

A) By an increased heart rate 
B) By a decreased heart rate 
C) By decreased conduction 
D) By increased ectopic beats 
A) By an increased heart rate 
B) By a decreased heart rate 
C) By decreased conduction 
D) By increased ectopic beats B

Question 4

When a patient is experiencing digoxin toxicity,which clinical situations necessitate the use of digoxin immune Fab? (Select all that apply.)
(Answer with small letters,followed by a comma and a space [e.g.,a,b,c,d])

Accepted Answer

A) The patient reports seeing colourful halos around lights. 
B) The patient's serum potassium level is above 5 mmol/L. 
C) The patient is experiencing nausea and anorexia. 
D) The patient's heart rhythm is atrial flutter with a rate of 115 per minute. 
E) The patient is experiencing long runs of ventricular tachycardia.
F)The patient is experiencing severe sinus bradycardia that does not respond to cardiac pacing.
G)The patient has taken an overdose of greater than 10 mg of digoxin.
H)The patient reports fatigue and headaches. 
A) The patient reports seeing colourful halos around lights. 
B) The patient's serum potassium level is above 5 mmol/L. 
C) The patient is experiencing nausea and anorexia. 
D) The patient's heart rhythm is atrial flutter with a rate of 115 per minute. 
E) The patient is experiencing long runs of ventricular tachycardia.
F)The patient is experiencing severe sinus bradycardia that does not respond to cardiac pacing.
G)The patient has taken an overdose of greater than 10 mg of digoxin.
H)The patient reports fatigue and headaches.

Question 5

Which medication results in a drug interaction if given to a patient taking digitalis?

Accepted Answer

A) acetylsalicylic acid (Aspirin) 
B) acetaminophen (Tylenol) 
C) quinidine sulphate 
D) Vitamin K 
A) acetylsalicylic acid (Aspirin) 
B) acetaminophen (Tylenol) 
C) quinidine sulphate 
D) Vitamin K

Question 6

Which condition predisposes a patient to digitalis toxicity?

Accepted Answer

A) Hypercalcemia and advanced age 
B) Hyperthyroidism and liver dysfunction 
C) Ventricular fibrillation and hyperkalemia 
D) Dysrhythmias and hypernatremia 
A) Hypercalcemia and advanced age 
B) Hyperthyroidism and liver dysfunction 
C) Ventricular fibrillation and hyperkalemia 
D) Dysrhythmias and hypernatremia

Question 7

The nurse is administering the phosphodiesterase inhibitor milrinone.
What is the drug's positive inotropic effect?

Accepted Answer

A) Increased heart rate 
B) Increased blood vessel dilation 
C) Increased force of cardiac contraction 
D) Increased conduction of electrical impulses across the heart 
A) Increased heart rate 
B) Increased blood vessel dilation 
C) Increased force of cardiac contraction 
D) Increased conduction of electrical impulses across the heart

Question 8

A patient is beginning digoxin (Lanoxin)therapy.Which food should the nurse tell this patient to avoid when taking the digoxin dose?

Accepted Answer

A) Cooked vegetables 
B) Canned fruits 
C) Fried foods 
D) Bran muffins 
A) Cooked vegetables 
B) Canned fruits 
C) Fried foods 
D) Bran muffins

Question 9

A patient with atrial fibrillation has been started on digoxin (Lanoxin),and 1 week later a digoxin level is drawn.Which result is within the normal therapeutic levels for digoxin?

Accepted Answer

A) 0.1-0.6 ng/mL 
B) 0.7-1.5 ng/mL 
C) 2.0-2.5 ng/mL 
D) 2.5-3.0 ng/mL 
A) 0.1-0.6 ng/mL 
B) 0.7-1.5 ng/mL 
C) 2.0-2.5 ng/mL 
D) 2.5-3.0 ng/mL

Question 10

Which assessment result is the most important indicator of an exacerbation of heart failure?

Accepted Answer

A) Increased weight 
B) Hypokalemia 
C) Increased pulse 
D) Increased oxygen saturation 
A) Increased weight 
B) Hypokalemia 
C) Increased pulse 
D) Increased oxygen saturation

Question 11

A patient has been placed on a milrinone infusion as part of the therapy for end-stage heart failure.What risk should the nurse keep in mind while assessing this patient during the infusion?

Accepted Answer

A) Hypotension 
B) Hyperkalemia 
C) Hypertension 
D) Decreased urine output 
A) Hypotension 
B) Hyperkalemia 
C) Hypertension 
D) Decreased urine output

Question 12

The nurse is assessing the patient before administration of a cardiac glycoside.Which condition can predispose a patient to digitalis toxicity?

Accepted Answer

A) Hypokalemia 
B) Hyperkalemia 
C) Hypocalcemia 
D) Heart failure 
A) Hypokalemia 
B) Hyperkalemia 
C) Hypocalcemia 
D) Heart failure

Question 13

The nurse is assessing a patient before administration of a cardiac glycoside.Which laboratory result can increase the toxicity of the drug?

Accepted Answer

A) Potassium level of 2.8 mmol/L 
B) Potassium level of 4.9 mmol/L 
C) Sodium level of 140 mmol/L 
D) Calcium level of 10 mmol/L 
A) Potassium level of 2.8 mmol/L 
B) Potassium level of 4.9 mmol/L 
C) Sodium level of 140 mmol/L 
D) Calcium level of 10 mmol/L

Exam 25: Heart Failure Drugs

A patient about to receive his morning dose of digoxin (Lanoxin)has an apical pulse of 70 beats per minute.What should the nurse do?

A patient has been taking digoxin (Lanoxin)at home but has developed toxicity.The physician has ordered digoxin immune Fab.The patient asks the nurse why the medication has been changed.Which is the nurse's best response?

The nurse who is assessing a patient who is receiving intravenous (IV)digitalis recognizes that the drug has a negative chronotropic effect.How is a negative chronotropic effect evident in a patient?

When a patient is experiencing digoxin toxicity,which clinical situations necessitate the use of digoxin immune Fab? (Select all that apply.) (Answer with small letters,followed by a comma and a space [e.g.,a,b,c,d])

Which medication results in a drug interaction if given to a patient taking digitalis?

Which condition predisposes a patient to digitalis toxicity?

The nurse is administering the phosphodiesterase inhibitor milrinone. What is the drug's positive inotropic effect?

A patient is beginning digoxin (Lanoxin)therapy.Which food should the nurse tell this patient to avoid when taking the digoxin dose?

A patient with atrial fibrillation has been started on digoxin (Lanoxin),and 1 week later a digoxin level is drawn.Which result is within the normal therapeutic levels for digoxin?

Which assessment result is the most important indicator of an exacerbation of heart failure?

A patient has been placed on a milrinone infusion as part of the therapy for end-stage heart failure.What risk should the nurse keep in mind while assessing this patient during the infusion?

The nurse is assessing the patient before administration of a cardiac glycoside.Which condition can predispose a patient to digitalis toxicity?

The nurse is assessing a patient before administration of a cardiac glycoside.Which laboratory result can increase the toxicity of the drug?

Nursing Practice in Canada and Drug Therapy

Pharmacological Principles

Legal and Ethical Considerations

Patient Focused Considerations

Gene Therapy and Pharmacogenomics

Medication Errors: Preventing and Responding

Patient Education and Drug Therapy

Over-the-Counter Drugs and Natural Health Products

Vitamins and Minerals

Principles of Drug Administration

Analgesic Drugs

General and Local Anaesthetics

Central Nervous System Depressants and Muscle Relaxants

Central Nervous System Stimulants and Related Drugs

Antiepileptic Drugs

Antiparkinsonian Drugs

Psychotherapeutic Drugs

Substance Misuse

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Antihypertensive Drugs

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Coagulation Modifier Drugs

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Fluids and Electrolytes

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Antibiotics, Part 1: Sulfonamides, Penicillins, Cephalosporins, Macrolides, and Tetracyclines

Antibiotics Part 2: Aminoglycosides, Fluoroquinolones, and Other Drugs

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Anti-Inflammatory and Antigout Drugs

Immunosuppressant Drugs

Immunizing Drugs and Pandemic Preparedness

Antineoplastic Drugs Part 1: Cancer Overview and Cell Cycle–Specific Drugs

Antineoplastic Drugs Part 2: Cell Cycle–Nonspecific and Miscellaneous Drugs

Biological Response–Modifying Drugs

Anemia Drugs

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