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.

Answer and Explanation

The Correct Answer is B

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: Furosemide, a loop diuretic, can cause electrolyte imbalances such as hypokalemia (normal potassium levels: 3.5 to 5.0 mEq/L) and hypomagnesemia (normal magnesium levels: 1.7 to 2.2 mg/dL). These imbalances increase the sensitivity to digoxin and the risk of toxicity. Digoxin toxicity is associated with symptoms like nausea, vomiting, and arrhythmias. Furosemide's impact on electrolytes makes it a significant risk factor for digoxin toxicity.

Choice C rationale: Cimetidine, a histamine H2 receptor antagonist, can inhibit the metabolism of certain drugs by affecting liver enzymes. However, it does not significantly alter digoxin levels or increase the risk of toxicity. Normal liver enzyme levels include ALT (7 to 56 U/L) and AST (10 to 40 U/L). While cimetidine may interact with other medications, its effect on digoxin is minimal.

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.

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Correct Answer is A

Explanation

Choice A rationale:

The client's arterial blood gas (ABG) results indicate a low pH (acidemia) and high PaCO2, which is characteristic of respiratory acidosis. Respiratory acidosis occurs when there is inadequate removal of carbon dioxide (CO2) from the body, leading to an accumulation of CO2 and a decrease in pH. In this case, the high PaCO2 (50 mm Hg) indicates that the client is retaining carbon dioxide, likely due to impaired ventilation. The normal pH range is 7.35 to 7.45, and the normal PaCO2 range is 35 to 45 mm Hg. These ABG values reflect an acid-base imbalance in the respiratory system, specifically, respiratory acidosis.

Choice B rationale:

Metabolic alkalosis is characterized by an elevated pH and an increase in bicarbonate (HCO3) levels. This is not the condition described in the client's ABG results, as the pH is low (acidemic) and HCO3 levels are within the normal range (24 mEq/L).

Choice C rationale:

Metabolic acidosis is characterized by a low pH and a decreased HCO3 level. The client's ABG results do not align with metabolic acidosis since the pH is low (acidemic) and the HCO3 level is within the normal range (24 mEq/L).

Choice D rationale:

Respiratory alkalosis is characterized by a high pH and low PaCO2. The client's ABG results do not match this condition as the pH is low (acidemic) and the PaCO2 is high (50 mm Hg), indicating respiratory acidosis. Therefore, choice A, respiratory acidosis, is the correct interpretation of the ABG results.

A. Hypertension. B. Diaphoresis. C. Muscle tetany. D. Increased thirst.

Correct Answer is C

Explanation

Choice A rationale:

Hypertension is not typically associated with low calcium levels. Hypertension is more commonly linked to issues with blood pressure regulation and not calcium levels.

Choice B rationale:

Diaphoresis (excessive sweating) is not a direct symptom of low calcium levels. Low calcium can lead to muscle cramps and tetany, but not sweating.

Choice C rationale:

Muscle tetany is a common manifestation of low calcium levels (hypocalcemia). It results from increased neuromuscular excitability, causing muscle spasms and contractions. A calcium level of 7 mg/dL is below the normal range, and this client is at risk for muscle tetany.

Choice D rationale:

Increased thirst is not a typical symptom of low calcium levels. Symptoms of hypocalcemia are primarily related to neuromuscular and cardiovascular changes, such as muscle tetany and cardiac arrhythmias.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Explanation

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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?