A nurse in a provider's office is reviewing the laboratory results of four clients who take digoxin.
Which of the following clients is at risk for developing digoxin toxicity?
A client who takes glyburide for type 2 diabetes mellitus.
A client who takes furosemide for hypertension.
A client who takes cimetidine to reduce gastric acid secretion.
A client who takes azelastine for allergic rhinitis.
The Correct Answer is C
Choice A rationale:
A client who takes glyburide for type 2 diabetes mellitus is not at significant risk for developing digoxin toxicity. Glyburide is an antidiabetic medication and does not interact directly with digoxin.
Choice B rationale:
A client who takes furosemide for hypertension is not at significant risk for developing digoxin toxicity. Furosemide is a diuretic and can lead to electrolyte imbalances, but the risk of digoxin toxicity is generally associated with interactions with medications that affect digoxin metabolism or clearance.
Choice C rationale:
A client who takes cimetidine to reduce gastric acid secretion is at risk for developing digoxin toxicity. Cimetidine is a medication that inhibits the cytochrome P450 enzyme system, which plays a role in metabolizing digoxin. Inhibition of this enzyme system can lead to increased levels of digoxin in the blood, potentially resulting in digoxin toxicity.
Choice D rationale:
A client who takes azelastine for allergic rhinitis is not at significant risk for developing digoxin toxicity. Azelastine is an antihistamine and does not interact directly with digoxin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
Choice A rationale:
Crackles in lung bases Crackles in the lung bases are often indicative of fluid accumulation in the lungs, which can occur in conditions like heart failure. These crackles are discontinuous and sound like "fine rales.”. They can be heard during inspiration and expiration.
Choice B rationale:
Periorbital edema Periorbital edema, or swelling around the eyes, can be a sign of fluid volume overload, especially in the context of an older adult receiving IV therapy. It suggests that excess fluid is accumulating in the body.
Choice D rationale:
Bounding radial pulse A bounding radial pulse is a sign of increased stroke volume and can occur when the heart is working harder to pump the increased blood volume associated with fluid overload.
Choice C rationale:
Swelling at the IV site Swelling at the IV site can be a local reaction and may not necessarily indicate fluid volume overload unless it is associated with other systemic signs.
Choice E rationale:
Flat neck veins when supine Flat neck veins when the client is supine are not typically associated with fluid volume overload. In fact, flat neck veins are more characteristic of hypovolemia. Now, let's address the final question.
Correct Answer is C
Explanation
Choice A rationale:
Administer IV morphine. Administering IV morphine may be necessary for pain management in a client with a pulmonary embolism. However, pain relief should not take precedence over ensuring the patient's oxygenation and cardiovascular stability. Oxygen therapy is the top priority to address hypoxia and prevent further deterioration. Once oxygenation is secured, pain management can be considered.
Choice B rationale:
Start an IV infusion of lactated Ringer's. Initiating an IV infusion of lactated Ringer's solution may be important for maintaining hydration and electrolyte balance in a patient with a pulmonary embolism. However, this is not the top priority when a client is at risk of or experiencing a pulmonary embolism. Ensuring oxygenation and cardiovascular stability takes precedence. Once the patient is stable, intravenous fluids can be administered if needed.
Choice D rationale:
Initiate cardiac monitoring. Initiating cardiac monitoring is important in assessing the patient's cardiac rhythm and identifying any dysrhythmias or changes that may occur due to the pulmonary embolism. While this is a vital step, it is not the highest priority when the client is in a state of hypoxia and respiratory distress. Oxygen therapy should be the first intervention to address the immediate threat to the patient's life.
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