The nurse is preparing a patient’s daily dose of digoxin (Lanoxin), an inotropic drug. The adult patient has an apical pulse of 48/min.
What should the nurse do next?
Withhold the dose and notify the health care provider.
Notify the health care provider and monitor the patient’s vital signs.
Recheck the pulse, making sure to count for 1 full minute.
Administer the dose.
The Correct Answer is A
Digoxin is a medication that can help the heart pump more blood and slow down the heart rate in certain conditions, such as heart failure and atrial fibrillation. However, digoxin has a narrow therapeutic range, which means that too much or too little of it can be harmful. The therapeutic range of digoxin levels in the blood is 0.5-2 ng/mL, and the toxic level is >2.4 ng/mL. Digoxin should be held if the resting apical pulse of an infant is <90 bpm, an older child is <70 bpm, or an adult is <60 bpm. A pulse of 48/min in an adult is too low and could indicate digoxin toxicity, which can cause life-threatening arrhythmias. Therefore, the nurse should withhold the dose and notify the health care provider immediately.
Choice B is wrong because notifying the health care provider and monitoring the patient’s vital signs are not enough.
The nurse should also withhold the dose to prevent further exposure to digoxin.
Choice C is wrong because rechecking the pulse, making sure to count for 1 full minute, is not necessary. The nurse should already have counted the pulse for 1 full minute before administering digoxin, as per standard procedure.
Choice D is wrong because administering the dose could worsen the patient’s condition and increase the risk of digoxin toxicity and arrhythmias.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Alpha 1 adrenergic blocking agents have a vasodilating effect and can be used for the management of hypertension. They work by blocking the alpha 1 receptors on the vascular smooth muscle, which normally cause vasoconstriction when stimulated by catecholamines like epinephrine and norepinephrine.By preventing this constriction, alpha 1 blockers lower the peripheral resistance and blood pressure
Choice A is wrong because alpha 3 adrenergic blockers do not exist.There are only two types of alpha receptors: alpha 1 and alpha 2
Choice B is wrong because alpha 2 adrenergic antagonists do not have a vasodilating effect.
They block the alpha 2 receptors, which are located presynaptically on the sympathetic nerve terminals and postsynaptically on some vascular smooth muscle cells.Alpha 2 receptors inhibit the release of norepinephrine when activated, so blocking them would increase the sympathetic activity and vasoconstriction
Choice C is wrong because alpha 1 adrenergic agonists do not have a vasodilating effect.
They stimulate the alpha 1 receptors, which cause vasoconstriction and increase the blood pressure.Alpha 1 agonists are used to treat hypotension and nasal congestion
Correct Answer is A
Explanation
Atorvastatin is a type of statin, which are the most potent antilipidemic agents and have proven to lower the risk of myocardial infarction. Statins work by inhibiting an enzyme called HMG-CoA reductase, which is involved in the synthesis of cholesterol in the liver.By reducing the production of cholesterol, statins lower the levels of low-density lipoprotein (LDL) and triglycerides, and slightly increase the levels of high-density lipoprotein (HDL) in the blood.
Choice B, niacin, is wrong because niacin is not as effective as statins in lowering LDL and preventing cardiovascular events.Niacin is a water-soluble vitamin that can lower LDL and triglycerides, and increase HDL, but it can also cause flushing, itching, and liver toxicity.
Choice C, gemfibrozil, is wrong because gemfibrozil is a type of fibric acid derivative, which are mainly used to lower triglycerides and increase HDL, but have little effect on LDL.
Fibric acid derivatives work by activating a receptor called PPAR-alpha, which regulates the metabolism of lipids in the liver and muscle.Fibric acid derivatives can also increase the risk of gallstones and muscle damage.
Choice D, ezetimibe, is wrong because ezetimibe is a selective cholesterol absorption inhibitor, which blocks the absorption of dietary and biliary cholesterol in the intestine.Ezetimibe can lower LDL by about 15-20%, but it has not been shown to reduce the risk of myocardial infarction on its own.Ezetimibe is usually combined with a statin for better efficacy and safety.
Normal ranges for lipid levels are:
• Total cholesterol: less than 200 mg/dL
• LDL cholesterol: less than 100 mg/dL
• HDL cholesterol: more than 40 mg/dL for men and more than 50 mg/dL for women
• Triglycerides: less than 150 mg/dL
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