©BRIGHTSTARS EXAM SOLUTIONS
11/17/2024 10:19 AM
Cardiovascular drugs and medications Exam
Questions And Answers 100% Pass
What is the MOST appropriate action for the nurse to take before administering digoxin?
a. monitor potassium level
b. assess blood pressure
c. evaluate urinary output
d. avoid giving with thiazide diuretic - answer✔a. monitor potassium level
Monitoring potassium is especially important because hypokalemia potentiates digoxin toxicity.
Digoxin exhibits its therapeutic and toxic effects by poisoning the sodium-potassium ATPase.
The subsequent increase in intracellular sodium leads to increased intracellular calcium by
decreasing calcium expulsion through the sodium-calcium, cation exchanger. Blood pressure
and urinary output are incorrect because these data reflect overall CV status but are not
specific for digoxin.
Which of the following clients is at greatest risk for digital toxicity?
A. a 25 yr old client with congenital heart disease.
B. a 50 yr old client with CHF
C. a 60 yr old client after myocardial infarction
D. an 80 yr old with CHF - answer✔D. an 80 yr old with CHF
Extremely old clients are at greater risk for digitalis toxicity. Remember when it comes to
adversity, the very old and very young are always at the highest risk. There are no evidence-
based guidelines for the management of mild to moderate toxicity so there is a wide variation
in treatment. Severe toxicity requires hospital admission and consideration of the need for
digoxin-specific antibody fragments. Although digoxin-specific antibody fragments are safe and
effective, randomized trials have not been performed.
1|Page
, ©BRIGHTSTARS EXAM SOLUTIONS
11/17/2024 10:19 AM
Which of the following is a contraindication for digoxin administration?
A. blood pressure of 140/90
B. heart rate above 80
C. heart rate below 60
D. repiratory rate above 20 - answer✔C. heart rate below 60
The apical heart rate must be monitored during therapy with digoxin, and the drug held for a
pulse below 60 and above 120. Remember that digoxin lowers the heart rate; therefore, the
choice that reflects a low heart rate is the best selection. Digoxin toxicity is clinically relevant as
it can lead to fatal cardiac arrhythmias. The estimated frequency is at about 0.8 to 4% of
patients on steady digoxin therapy. The rate of toxicity increases as serum digoxin
concentration reaches over 2.0 ng/ml.
The action of medication is inotropic when it: - answer✔increases the force of contraction
Inotropic drugs increase the force of contraction. Preload, not afterload, is decreased.
Chronotropic drugs increase heart rate. Treatment of CHF is an indication for use not an action
of the inotropic drug. Inotropes increase cardiac contractility which improves cardiac output
(CO), aiding in maintaining MAP and perfusion to the body.
The therapeutic drug level for digoxin is:
A. 0 1-2.0 ng/mg
B. 1.0-2.0 ng/mg
C. 0.1-0.5 ng/mg
D. 0.5-2.0 ng/mg - answer✔D. 0.5-2.0 ng/mg
Blurred vision or halos are signs of:
A. subtherapeutic digoxin levels
B. digoxin toxicity
C. nothing related to digoxin
D. corneal side effects of digoxin - answer✔B. digoxin toxicity
2|Page
, ©BRIGHTSTARS EXAM SOLUTIONS
11/17/2024 10:19 AM
Halos is a hallmark sign of digoxin toxicity. Digoxin exhibits its therapeutic and toxic effects by
poisoning the sodium-potassium ATPase. The subsequent increase in intracellular sodium leads
to increased intracellular calcium by decreasing calcium expulsion through the sodium-calcium,
cation exchanger. A, C and D are incorrect because subtherapeutic digoxin levels have no such
effects.
Class IA antiarrhythmic agents have little effect on:
A. AV node.
B. SA node.
C. Purkinje fibers.
D. Bundle of His. - answer✔B. SA node
Class IA antiarrhythmics have little effect on the SA node. It causes moderate degree blockage
of fast sodium channels. Drugs include quinidine, procainamide, and disopyramide. These are
the most pro-arrhythmic of the sodium channel blockers due to prolonged QTc interval; use is
limited due to proarrhythmic potential.
Which of the following blood tests will tell the nurse that an adequate amount of drug is
present in the blood to prevent arrhythmias?
A. Serum chemistries.
B. Complete blood counts.
C. Drug levels.
D. None of the above. - answer✔C. drug levels
Knowing drug levels (peak and trough) is the only way to ensure there is enough drug in the
body to work. Other choices do not demonstrate drug effect. Screening may have an important
role in the epidemiological assessment of poisoning as it is a common finding that more
substances are detected in urine than are recorded from history. Specific qualitative tests (e.g.
amatoxins, paraquat) may be of clinical assistance in determining evidence of exposure.
Clinicians are better served by relying on a careful interpretation of the history and clinical
3|Page
11/17/2024 10:19 AM
Cardiovascular drugs and medications Exam
Questions And Answers 100% Pass
What is the MOST appropriate action for the nurse to take before administering digoxin?
a. monitor potassium level
b. assess blood pressure
c. evaluate urinary output
d. avoid giving with thiazide diuretic - answer✔a. monitor potassium level
Monitoring potassium is especially important because hypokalemia potentiates digoxin toxicity.
Digoxin exhibits its therapeutic and toxic effects by poisoning the sodium-potassium ATPase.
The subsequent increase in intracellular sodium leads to increased intracellular calcium by
decreasing calcium expulsion through the sodium-calcium, cation exchanger. Blood pressure
and urinary output are incorrect because these data reflect overall CV status but are not
specific for digoxin.
Which of the following clients is at greatest risk for digital toxicity?
A. a 25 yr old client with congenital heart disease.
B. a 50 yr old client with CHF
C. a 60 yr old client after myocardial infarction
D. an 80 yr old with CHF - answer✔D. an 80 yr old with CHF
Extremely old clients are at greater risk for digitalis toxicity. Remember when it comes to
adversity, the very old and very young are always at the highest risk. There are no evidence-
based guidelines for the management of mild to moderate toxicity so there is a wide variation
in treatment. Severe toxicity requires hospital admission and consideration of the need for
digoxin-specific antibody fragments. Although digoxin-specific antibody fragments are safe and
effective, randomized trials have not been performed.
1|Page
, ©BRIGHTSTARS EXAM SOLUTIONS
11/17/2024 10:19 AM
Which of the following is a contraindication for digoxin administration?
A. blood pressure of 140/90
B. heart rate above 80
C. heart rate below 60
D. repiratory rate above 20 - answer✔C. heart rate below 60
The apical heart rate must be monitored during therapy with digoxin, and the drug held for a
pulse below 60 and above 120. Remember that digoxin lowers the heart rate; therefore, the
choice that reflects a low heart rate is the best selection. Digoxin toxicity is clinically relevant as
it can lead to fatal cardiac arrhythmias. The estimated frequency is at about 0.8 to 4% of
patients on steady digoxin therapy. The rate of toxicity increases as serum digoxin
concentration reaches over 2.0 ng/ml.
The action of medication is inotropic when it: - answer✔increases the force of contraction
Inotropic drugs increase the force of contraction. Preload, not afterload, is decreased.
Chronotropic drugs increase heart rate. Treatment of CHF is an indication for use not an action
of the inotropic drug. Inotropes increase cardiac contractility which improves cardiac output
(CO), aiding in maintaining MAP and perfusion to the body.
The therapeutic drug level for digoxin is:
A. 0 1-2.0 ng/mg
B. 1.0-2.0 ng/mg
C. 0.1-0.5 ng/mg
D. 0.5-2.0 ng/mg - answer✔D. 0.5-2.0 ng/mg
Blurred vision or halos are signs of:
A. subtherapeutic digoxin levels
B. digoxin toxicity
C. nothing related to digoxin
D. corneal side effects of digoxin - answer✔B. digoxin toxicity
2|Page
, ©BRIGHTSTARS EXAM SOLUTIONS
11/17/2024 10:19 AM
Halos is a hallmark sign of digoxin toxicity. Digoxin exhibits its therapeutic and toxic effects by
poisoning the sodium-potassium ATPase. The subsequent increase in intracellular sodium leads
to increased intracellular calcium by decreasing calcium expulsion through the sodium-calcium,
cation exchanger. A, C and D are incorrect because subtherapeutic digoxin levels have no such
effects.
Class IA antiarrhythmic agents have little effect on:
A. AV node.
B. SA node.
C. Purkinje fibers.
D. Bundle of His. - answer✔B. SA node
Class IA antiarrhythmics have little effect on the SA node. It causes moderate degree blockage
of fast sodium channels. Drugs include quinidine, procainamide, and disopyramide. These are
the most pro-arrhythmic of the sodium channel blockers due to prolonged QTc interval; use is
limited due to proarrhythmic potential.
Which of the following blood tests will tell the nurse that an adequate amount of drug is
present in the blood to prevent arrhythmias?
A. Serum chemistries.
B. Complete blood counts.
C. Drug levels.
D. None of the above. - answer✔C. drug levels
Knowing drug levels (peak and trough) is the only way to ensure there is enough drug in the
body to work. Other choices do not demonstrate drug effect. Screening may have an important
role in the epidemiological assessment of poisoning as it is a common finding that more
substances are detected in urine than are recorded from history. Specific qualitative tests (e.g.
amatoxins, paraquat) may be of clinical assistance in determining evidence of exposure.
Clinicians are better served by relying on a careful interpretation of the history and clinical
3|Page
