The nurse is reviewing the client’s laboratory results. Based on a client’s serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement?

Begin cardioversion to stabilize heart rhythm.

Give digoxin by another route to slow absorption.

Administer potassium to stabilize the heart rate.

Check acid-base and electrolyte values.

Answer and Explanation

The Correct Answer is D

Begin cardioversion to stabilize heart rhythm: Cardioversion is not the appropriate intervention for digoxin toxicity. Digoxin toxicity can cause arrhythmias, but the initial action should be to assess and manage the underlying cause, rather than immediately proceeding to cardioversion.

B) Give digoxin by another route to slow absorption: Slowing the absorption of digoxin is not the appropriate action for treating digoxin toxicity. Instead, the focus should be on managing the existing toxicity and preventing further absorption by withholding additional doses.

C) Administer potassium to stabilize the heart rate: While potassium may be indicated as part of the treatment for digoxin toxicity, particularly if hypokalemia is contributing to the toxicity, it is not the initial action. The priority is to assess the client’s acid-base and electrolyte values to identify any abnormalities contributing to the toxicity.

D) Check acid-base and electrolyte values: This is the correct action. Digoxin toxicity can be exacerbated by electrolyte imbalances, particularly hypokalemia, hypercalcemia, and hypomagnesemia. Therefore, assessing the client’s acid-base and electrolyte values is essential to identify and correct any abnormalities contributing to the toxicity. Once identified, appropriate interventions can be implemented to manage the toxicity and stabilize the client’s condition.

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Correct Answer is B

Explanation

A) CT scan that was performed six months earlier: A previous CT scan performed six months earlier does not necessarily require follow-up by the nurse. However, it would be important to review the results of the previous CT scan to compare findings and assess for any changes over time.

B) Takes metformin hydrochloride for type 2 diabetes mellitus: This is the correct answer. Metformin is excreted by the kidneys, and contrast media used in CT scans can potentially cause kidney damage, particularly in clients with pre-existing renal impairment. Therefore, clients taking metformin may be at increased risk of developing lactic acidosis if renal function is compromised. It is essential for the nurse to follow up on this information and coordinate with the healthcare provider to determine whether metformin should be temporarily discontinued before the CT scan and when it can be safely resumed.

C) Report of client’s sobriety for the last five years: The client’s sobriety status for the last five years is not directly relevant to the CT scan with contrast for evaluating pulmonary embolism. While substance use history is important for overall health assessment, it does not specifically require follow-up related to the CT scan.

D) Metal hip prosthesis was placed twenty years ago: The presence of a metal hip prosthesis placed twenty years ago may be relevant for certain imaging studies, such as magnetic resonance imaging (MRI) or metal artifact reduction sequence (MARS) MRI, but it is not directly related to the CT scan with contrast for pulmonary embolism evaluation. Therefore, it does not require immediate follow-up by the nurse in this context.

A. Obtain another transdermal patch and position it on the client’s left upper chest. B. Withhold further doses of nitroglycerin until contacting the healthcare provider. C. Leave the patch in place and administer a PRN dose of sublingual nitroglycerin. D. Reassure the client that the patch will begin to take effect within a few minutes.

Correct Answer is C

Explanation

A) Applying another transdermal patch is not recommended without healthcare provider approval. Doubling the dose of nitroglycerin could increase the risk of hypotension and other adverse effects.

B) Withholding further doses of nitroglycerin without healthcare provider guidance may lead to inadequate control of angina symptoms. However, in this scenario, the client has already received a dose of transdermal nitroglycerin, so withholding further doses may not be appropriate if the client’s symptoms persist.

C) Leaving the patch in place and administering a sublingual dose of nitroglycerin is the correct action in this situation. Sublingual nitroglycerin provides rapid relief of angina symptoms by dilating blood vessels and improving myocardial oxygen supply. The transdermal patch may not have reached therapeutic levels yet, but the sublingual form can provide more immediate relief.

D) While it’s important to reassure the client, especially during an episode of chest pain, relying solely on the transdermal patch to take effect may not provide timely relief. Administering sublingual nitroglycerin allows for faster absorption and symptom relief.

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The nurse is reviewing the client’s laboratory results. Based on a client’s serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client’s history requires follow up by the nurse?

Correct Answer is B

Explanation

A client with a history of angina reports the onset of chest pain. The nurse determines that the heart rate is 104 beats/minute and the blood pressure is 138/86 mm Hg. A transdermal nitroglycerin patch was applied 30 minutes ago to the right upper chest. Which action should the nurse take?

Correct Answer is C

Explanation

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