An 8-month-old infant is receiving Digoxin. The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which of the following?
90 bpm
60 bpm
120 bpm
100 bpm
The Correct Answer is D
A. 90 bpm is too low for an 8-month-old infant and not the standard threshold for withholding digoxin in this age group.
B. 60 bpm is the cutoff for adults, not infants.
C. 120 bpm is normal for an infant and does not warrant holding digoxin.
D. Correct. For infants, digoxin should be withheld and the provider notified if the apical heart rate is less than 100 beats per minute, due to the risk of bradycardia and digoxin toxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Aortic stenosis affects blood flow from the left ventricle to the aorta, but it is not a component of Tetralogy of Fallot.
B. A patent ductus arteriosus (PDA) is a separate congenital defect and not part of Tetralogy of Fallot.
C. Mitral valve regurgitation is related to left-sided heart valve dysfunction and is not a feature of this condition.
D. One of the four components of Tetralogy of Fallot is a ventricular septal defect (VSD). The VSD, along with pulmonary stenosis, leads to right-to-left shunting of deoxygenated blood, which bypasses the lungs and enters systemic circulation, causing cyanosis.
Correct Answer is B
Explanation
A. Physical abuse typically presents with visible signs of injury, inconsistent explanations for trauma, or fearfulness around caregivers. While abuse may coexist, the pattern here involves medical fabrication rather than physical harm.
B. Munchausen by proxy (also known as factitious disorder imposed on another) occurs when a caregiver—usually a parent—exaggerates, fabricates, or induces illness in a child to gain attention or sympathy. The repeated vague complaints, specialist seeking, and now unconscious presentation strongly raise this concern.
C. Severe organic failure to thrive results from an underlying physical condition affecting growth and development, not from caregiver behavior. It also doesn't typically include extensive medical seeking behavior for vague, shifting symptoms.
D. Ingestion of a toxin is possible in any unconscious child, but in this context, without clear evidence of accidental exposure, it may actually be a result of the caregiver's actions in Munchausen by proxy. Thus, it is a potential symptom, not the root concern.
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