The nurse is auscultating a 56-year-old adult client's apical heart rate before giving
digoxin and notes that the heart rate is 48 beats/minute. Which action should the
nurse take?
A) Withhold the digoxin, and reevaluate the heart rate in 4 hours.
B) Administer half of the prescribed dose to avoid a further decrease in heart rate.
C) Withhold the digoxin, and assess for signs of decreased cardiac output and digoxin
toxicity.
D)Administer the digoxin; the heart rate would be considered normal because of the
client's age.
Give this one a try later!
Answer- C
Rationale:The normal heart rate is 60 to 100 beats/minute in an adult. If the
nurse notes a heart rate that is less than 60 beats/minute, the nurse would
not administer the digoxin and would further evaluate the client for signs
and symptoms of digoxin toxicity. When clients are bradycardic, they may
, have symptoms of decreased cardiac output, so this would also be
assessed.
The nurse is monitoring a client who is taking digoxin for adverse effects. Which
findings are characteristic of digoxin toxicity? Select all that apply.
A) Tremors
B) Diarrhea
C) Irritability
D) Blurred vision
E) Nausea and vomiting
Give this one a try later!
Answer- B, D, E
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 0.8 ng/mL.
The nurse is monitoring a client who is taking propranolol. Which assessment finding
indicates a potential adverse complication associated with this medication?
A) The development of complaints of insomnia
B) The development of audible expiratory wheezes
C) A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of
138/72 mm Hg after 2 doses of the medication
, D) A baseline resting heart rate of 88 beats/minute followed by a resting heart rate of
72 beats/minute after 2 doses of the medication
Give this one a try later!
answer B
Rationale:Audible expiratory wheezes may indicate a serious adverse
reaction, bronchospasm. Beta blockers may induce this reaction,
particularly in clients with chronic obstructive pulmonary disease or
asthma. Normal decreases in blood pressure and heart rate are expected.
Insomnia is a frequent mild side effect and should be monitored.
A client who has begun taking betaxolol demonstrates an effective response to the
medication as indicated by which nursing assessment finding?
A) Increase in edema to 3+
B) Weight gain of 5 lb
C) Decrease in pulse rate from 74 beats/min to 58 beats/min
D) Decrease in blood pressure from 142/94 mm Hg to 128/82 mm Hg
Give this one a try later!
Answer- D
Rationale: Betaxolol is a beta-adrenergic blocking agent used to lower
blood pressure, relieve angina, or decrease the occurrence of
dysrhythmias. Side and adverse effects include bradycardia and signs and
symptoms of heart failure, such as increased edema and weight gain.
digoxin and notes that the heart rate is 48 beats/minute. Which action should the
nurse take?
A) Withhold the digoxin, and reevaluate the heart rate in 4 hours.
B) Administer half of the prescribed dose to avoid a further decrease in heart rate.
C) Withhold the digoxin, and assess for signs of decreased cardiac output and digoxin
toxicity.
D)Administer the digoxin; the heart rate would be considered normal because of the
client's age.
Give this one a try later!
Answer- C
Rationale:The normal heart rate is 60 to 100 beats/minute in an adult. If the
nurse notes a heart rate that is less than 60 beats/minute, the nurse would
not administer the digoxin and would further evaluate the client for signs
and symptoms of digoxin toxicity. When clients are bradycardic, they may
, have symptoms of decreased cardiac output, so this would also be
assessed.
The nurse is monitoring a client who is taking digoxin for adverse effects. Which
findings are characteristic of digoxin toxicity? Select all that apply.
A) Tremors
B) Diarrhea
C) Irritability
D) Blurred vision
E) Nausea and vomiting
Give this one a try later!
Answer- B, D, E
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 0.8 ng/mL.
The nurse is monitoring a client who is taking propranolol. Which assessment finding
indicates a potential adverse complication associated with this medication?
A) The development of complaints of insomnia
B) The development of audible expiratory wheezes
C) A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of
138/72 mm Hg after 2 doses of the medication
, D) A baseline resting heart rate of 88 beats/minute followed by a resting heart rate of
72 beats/minute after 2 doses of the medication
Give this one a try later!
answer B
Rationale:Audible expiratory wheezes may indicate a serious adverse
reaction, bronchospasm. Beta blockers may induce this reaction,
particularly in clients with chronic obstructive pulmonary disease or
asthma. Normal decreases in blood pressure and heart rate are expected.
Insomnia is a frequent mild side effect and should be monitored.
A client who has begun taking betaxolol demonstrates an effective response to the
medication as indicated by which nursing assessment finding?
A) Increase in edema to 3+
B) Weight gain of 5 lb
C) Decrease in pulse rate from 74 beats/min to 58 beats/min
D) Decrease in blood pressure from 142/94 mm Hg to 128/82 mm Hg
Give this one a try later!
Answer- D
Rationale: Betaxolol is a beta-adrenergic blocking agent used to lower
blood pressure, relieve angina, or decrease the occurrence of
dysrhythmias. Side and adverse effects include bradycardia and signs and
symptoms of heart failure, such as increased edema and weight gain.
