A nurse is in a clinic caring for a client who has a prescription for digoxin (Lanoxin). Which of the following statements by the client indicates the client is experiencing digoxin (Lanoxin) toxicity?
"I am starting to see white halos around objects.”.
"My tongue is red and beefy.”.
"I am constipated.”.
"I am gaining weight.”. —
The Correct Answer is A
Choice A rationale
Seeing "white halos around objects" is a classic visual disturbance, specifically termed chromatopsia or xanthopsia (yellow-green halos), which is a key sign of digoxin toxicity. Digoxin, a cardiac glycoside, affects visual pathways. Other early signs include gastrointestinal upset, fatigue, and bradycardia, indicating drug accumulation above the therapeutic range of 0.5 to 2.0 nanograms per milliliter.
Choice B rationale
A red, beefy tongue, or glossitis, is primarily a sign of a severe deficiency in B vitamins, such as B12, folate, or niacin, which is associated with conditions like pernicious anemia. This is not a characteristic sign or symptom of toxicity resulting from the cardiac glycoside medication digoxin, which exerts its effects on the heart muscle and central nervous system.
Choice C rationale
Digoxin toxicity commonly manifests with early gastrointestinal symptoms, but these typically include nausea, vomiting, anorexia, and sometimes diarrhea, which reflect central nervous system stimulation. Constipation, which is the decreased frequency of bowel movements, is not a common or expected side effect or sign of drug toxicity.
Choice D rationale
Weight gain, especially rapid gain, can indicate fluid retention due to worsening heart failure, a condition digoxin is used to treat. While toxicity can cause anorexia (loss of appetite), it does not typically cause weight gain. Therefore, weight gain may suggest therapeutic failure or worsening disease, not necessarily digoxin toxicity itself. —.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Hypothermia, which is a body temperature below 35 degrees C (95 degrees F), is not a typical finding with simple diarrhea. Diarrhea, especially if caused by an infectious agent, is more likely to cause a slight fever or a normal temperature as the body mounts an immune response. Severe dehydration may cause slight fluctuations, but not reliably hypothermia.
Choice B rationale
Decreased or hypoactive bowel sounds indicate reduced intestinal motility, which is commonly associated with an obstruction, paralytic ileus, or constipation. Diarrhea, conversely, is characterized by increased, hyperactive bowel sounds as a result of the rapid movement of intestinal contents through the gastrointestinal tract due to increased peristalsis.
Choice C rationale
Protracted diarrhea leads to a significant loss of water and electrolytes, primarily sodium and potassium, from the gastrointestinal tract. This loss exceeds fluid intake, resulting in extracellular fluid volume deficit, known as dehydration. Clinical signs include poor skin turgor, dry mucous membranes, and concentrated urine (normal urine specific gravity is 1.005 to 1.030).
Choice D rationale
A rigid abdomen is a critical sign of peritoneal inflammation or irritation, often indicating a serious acute condition like peritonitis, appendicitis, or a perforated viscus, which may or may not be the direct cause of the diarrhea. Simple diarrhea typically does not cause a rigid abdomen; the abdomen is usually soft and potentially distended or tender. —.
Correct Answer is ["0.5"]
Explanation
Step 1 is: Determine the volume required by dividing the ordered dose by the dose available on the label.
Step 2 is: 25 mg ÷ (50 mg/tab).
Step 3 is: 0.5 tab. The nurse should administer 0.5 tablet(s) per dose.
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