A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following factors predisposes this client to developing digoxin toxicity?
Taking an HMG CoA reductase inhibitor.
Having a 10-year history of COPD.
Taking a high-ceiling diuretic.
Having a prolapsed mitral valve.
The Correct Answer is C
Taking a high-ceiling diuretic predisposes this client to developing digoxin toxicity because it can cause hypokalemia (low blood potassium level), which increases the sensitivity of the heart to digoxin. Digoxin is a medicine that is used to treat heart failure or arrhythmias (abnormal heart rhythms) by increasing cardiac contractility and controlling the heart rate. Digoxin toxicity happens when there is too much digoxin in the body and it becomes harmful, causing symptoms such as nausea, vomiting, headache, confusion, vision disturbance, and irregular heartbeat.
Choice A is wrong because taking an HMG CoA reductase inhibitor (also called a statin) does not increase the risk of digoxin toxicity.
Statins are lipid-lowering medications used to prevent coronary heart disease by blocking an enzyme involved in cholesterol synthesis.
Statins do not affect the blood potassium level or the sensitivity of the heart to digoxin.
Choice B is wrong because having a 10-year history of COPD (chronic obstructive pulmonary disease) does not increase the risk of digoxin toxicity. COPD is a lung condition that causes breathing difficulties and chronic inflammation.
COPD does not affect the blood potassium level or the sensitivity of the heart to digoxin.
Choice D is wrong because having a prolapsed mitral valve does not increase the risk of digoxin toxicity.
A prolapsed mitral valve is a condition where the valve between the left atrium and left ventricle of the heart does not close properly, allowing some blood to leak back into the atrium.
A prolapsed mitral valve does not affect the blood potassium level or the sensitivity of the heart to digoxin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Urticaria, also known as hives, is a common sign of an allergic reaction to penicillin. An allergic reaction is an abnormal response of the immune system to the drug. Other signs and symptoms of penicillin allergy may include skin rash, itching, fever, swelling, shortness of breath, wheezing, runny nose, itchy eyes, and anaphylaxis. Anaphylaxis is a rare but life-threatening condition that affects multiple body systems and requires immediate emergency treatment.
Choice A is wrong because pallor is not a typical sign of an allergic reaction to penicillin.
Pallor means pale skin and may be caused by other conditions such as anemia or shock.
Choice B is wrong because bradycardia is not a typical sign of an allergic reaction to penicillin.
Bradycardia means slow heart rate and may be caused by other conditions such as heart block or medication side effects.
Choice D is wrong because dyspepsia is not a typical sign of an allergic reaction to penicillin.
Dyspepsia means indigestion and may be caused by other conditions such as gastritis or peptic ulcer.
Correct Answer is B
Explanation
a.While weight changes can be concerning, they are not typically life-threatening and can occur as a common side effect of antidepressants, including citalopram. Monitoring is important, but it does not require immediate reporting.
b.This is the priority to report because confusion can indicate a serious reaction to the medication, such as serotonin syndrome, especially if it occurs in conjunction with other symptoms like agitation, hallucinations, or rapid heart rate. Confusion can also signal worsening mental status, which is critical for someone with major depression.
c.This refers to teeth grinding, which can occur with certain antidepressants. While it should be monitored and possibly addressed with interventions, it is generally not an immediate concern compared to confusion.
d.Sleep disturbances can be a side effect of citalopram and may need adjustment of treatment or recommendations for sleep hygiene, but they are not as urgent as confusion.
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