The practical nurse (PN) administers digoxin to a 9-month-old infant with an apical heart rate of 160 beats/minute.
Which apical heart rate indicates that the therapeutic effect of the medication has been achieved?
60 beats/minute.
120 beats/minute.
80 beats/minute.
180 beats/minute.
The Correct Answer is B
Choice A rationale
A heart rate of 60 beats/minute for a 9-month-old infant is significantly below the normal physiological range (90-140 beats/minute). Digoxin primarily acts to slow the heart rate and increase contractility, but such a low rate indicates severe bradycardia, a potentially dangerous adverse effect of digoxin toxicity due to excessive parasympathetic stimulation and impaired atrioventricular conduction.
Choice B rationale
A heart rate of 120 beats/minute is within the normal resting range for a 9-month-old infant, which typically falls between 90-140 beats/minute. Digoxin’s therapeutic effect in infants with cardiac conditions often aims to bring the heart rate to a more efficient and less tachycardic rate, thereby improving cardiac output without causing bradycardia.
Choice C rationale
A heart rate of 80 beats/minute is below the typical normal range for a 9-month-old infant (90-140 beats/minute). While digoxin can decrease heart rate, 80 beats/minute suggests an excessive therapeutic effect, potentially indicating mild bradycardia which could compromise cardiac output and tissue perfusion.
Choice D rationale
A heart rate of 180 beats/minute is significantly above the normal physiological range for a 9-month-old infant (90-140 beats/minute). This elevated rate indicates persistent tachycardia, suggesting that the digoxin has not achieved its therapeutic effect of slowing the heart rate, or that the underlying cardiac issue is not adequately controlled.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Impulsive and hyperactive behaviors are typically associated with conditions such as attention-deficit/hyperactivity disorder (ADHD), which involves neurodevelopmental differences affecting executive function and impulse control. While these behaviors can sometimes lead to accidents, they are not a direct sign of secondary enuresis.
Choice B rationale
Involuntary passage of feces, known as encopresis, is a distinct elimination disorder characterized by the repeated passage of stool into inappropriate places, often due to chronic constipation and overflow incontinence. It is a separate condition from enuresis, which specifically refers to involuntary urination.
Choice C rationale
Increased thirst, or polydipsia, is a common symptom of conditions like diabetes mellitus or diabetes insipidus, where the body attempts to compensate for fluid imbalances or high glucose levels. While some medical conditions causing enuresis might also involve increased thirst, it is not a direct sign of enuresis itself.
Choice D rationale
Declining invitations for sleepovers is a behavioral manifestation often observed in children with enuresis. The fear of embarrassment and shame associated with involuntary urination during sleep can lead them to avoid situations where their condition might be exposed, such as overnight stays at friends' houses.
Correct Answer is ["0.7"]
Explanation
Step 1 is: Convert pounds to kilograms. 58 pounds ÷ 2.2 pounds/kg = 26.36 kg.
Step 2 is: Calculate the total milligrams per dose. 1 mg/kg × 26.36 kg = 26.36 mg.
Step 3 is: Calculate the volume to administer per dose. 26.36 mg ÷ (40 mg/mL) = 0.659 mL.
Step 4 is: Round to the nearest tenth. 0.7 mL.
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