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 nurse should instruct the client to discontinue the dose of acetylsalicylic acid (aspirin) 2 weeks before surgery. Aspirin is an antiplatelet medication that can increase the risk of bleeding during and after surgery. Discontinuing it before surgery helps reduce the risk of excessive bleeding during the procedure. The recommended time frame for discontinuation may vary based on the patient's surgical procedure and the surgeon's preferences. However, 2 weeks is a common guideline to ensure that the antiplatelet effects of aspirin have diminished.

Choice B rationale:

Decreasing the dose by half 2 weeks before surgery may not be sufficient to minimize the risk of bleeding associated with aspirin. It is generally recommended to discontinue the medication completely to ensure that the antiplatelet effect has worn off.

Choice C rationale:

Taking the originally prescribed dose of aspirin the week of surgery is not advisable because it can increase the risk of bleeding during the surgical procedure. It is important to discontinue aspirin well before the surgery.

Choice D rationale:

Doubling the dose of aspirin the week of surgery is contraindicated as it can significantly increase the risk of bleeding. This choice is not recommended in the context of preoperative management.

A. Pitting edema of the lower legs. B. Jugular venous distention. C. Shortness of breath while lying down. D. Right upper quadrant pain.

Correct Answer is C

Explanation

Choice A rationale:

"Pitting edema of the lower legs.”. Pitting edema is a common sign of congestive heart failure (CHF), and it often occurs bilaterally in the lower extremities. While this is a potential finding in left-sided heart failure, it is not specific to it.

Choice B rationale:

"Jugular venous distention.”. Jugular venous distention (JVD) is more indicative of right-sided heart failure or elevated central venous pressure. It is not a typical finding in left-sided heart failure.

Choice C rationale:

"Shortness of breath while lying down.”. This is a classic symptom of left-sided heart failure, known as orthopnea. When the patient lies flat, fluid that has accumulated in the lungs can lead to difficulty breathing. Patients with left-sided heart failure often find relief by sleeping with their upper body elevated.

Choice D rationale:

"Right upper quadrant pain.”. Right upper quadrant pain is not a typical finding in left-sided heart failure. It may be associated with issues related to the liver or gallbladder but is not directly related to heart failure.

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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

A nurse is conducting a preoperative interview with a client who is scheduled for surgery.The client states that he takes acetylsalicylic acid 81 mg. by mouth daily.Prior to the client's upcoming surgery, the nurse should instruct the client to do which of the following?

Correct Answer is A

Explanation

A nurse is collecting data from a client who has left-sided heart failure. Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

A nurse is caring for a client who has heart failure. The client states she has recently been bothered by a non-productive cough. Which of the following medications should the nurse associate with the non-productive cough?

A nurse is collecting data from a client who has heart failure, prior to the administration of furosemide. For which of the following findings should the nurse withhold the medication?

A nurse is reinforcing teaching with a client who is taking hydrochlorothiazide.Which of the following information should the nurse include in the teaching?

A nurse is caring for a client who is postoperative following vascular surgery. Which of the following manifestations should indicate to the nurse that the client has developed a thrombus?

A nurse is preparing to review discharge instructions with a client who has pulmonary tuberculosis.Which of the following information should the nurse include?

A nurse is reinforcing discharge teaching with a client about dietary sources of potassium. Which of the following statements by the client indicates an understanding of the teaching?

A nurse is preparing to administer digoxin to a client who has left-sided heart failure.Which of the following clinical manifestations should the nurse expect to see in this client? (Select all that apply.).

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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?