A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following factors predisposes this client to developing digoxin toxicity?

Taking an HMG CoA reductase inhibitor.

Having a 10-year history of COPD.

Taking a high-ceiling diuretic.

Having a prolapsed mitral valve.

Answer and Explanation

The Correct Answer is C

Taking a high-ceiling diuretic predisposes this client to developing digoxin toxicity because it can cause hypokalemia (low blood potassium level), which increases the sensitivity of the heart to digoxin. Digoxin is a medicine that is used to treat heart failure or arrhythmias (abnormal heart rhythms) by increasing cardiac contractility and controlling the heart rate. Digoxin toxicity happens when there is too much digoxin in the body and it becomes harmful, causing symptoms such as nausea, vomiting, headache, confusion, vision disturbance, and irregular heartbeat.

Choice A is wrong because taking an HMG CoA reductase inhibitor (also called a statin) does not increase the risk of digoxin toxicity.

Statins are lipid-lowering medications used to prevent coronary heart disease by blocking an enzyme involved in cholesterol synthesis.

Statins do not affect the blood potassium level or the sensitivity of the heart to digoxin.

Choice B is wrong because having a 10-year history of COPD (chronic obstructive pulmonary disease) does not increase the risk of digoxin toxicity. COPD is a lung condition that causes breathing difficulties and chronic inflammation.

COPD does not affect the blood potassium level or the sensitivity of the heart to digoxin.

Choice D is wrong because having a prolapsed mitral valve does not increase the risk of digoxin toxicity.

A prolapsed mitral valve is a condition where the valve between the left atrium and left ventricle of the heart does not close properly, allowing some blood to leak back into the atrium.

A prolapsed mitral valve does not affect the blood potassium level or the sensitivity of the heart to digoxin.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

Drowsiness is a very common adverse effect of paroxetine, a selective serotonin reuptake inhibitor (SSRI) used to treat depression and anxiety. Paroxetine can cause somnolence (sleepiness) in up to 22% of patients who take it. The nurse should instruct the client to monitor for this effect and avoid driving or operating machinery until they know how the medication affects them.

Choice A is wrong because tinnitus (ringing in the ears) is not a common adverse effect of paroxetine.

It may occur rarely in some patients, but it is not a typical symptom of SSRI use.

Choice B is wrong because alopecia (hair loss) is not a common adverse effect of paroxetine.

It may occur rarely in some patients, but it is not a typical symptom of SSRI use.

Choice C is wrong because peripheral edema (swelling of the limbs) is not a common adverse effect of paroxetine.

It may occur rarely in some patients, but it is not a typical symptom of SSRI use.

A. Store the remaining half of the pill in the automated medication dispensing system. B. Dispose of the remaining medication while another nurse observes. C. Return the remaining medication to the facility’s pharmacy. D. Place the remaining half of the pill in the unit-dose package.

Correct Answer is B

Explanation

This is because hydromorphone is a controlled substance and any unused portion should be discarded in the presence of a witness. Some possible explanations for the other choices are:

Choice A is wrong because storing the remaining half of the pill in the automated medication dispensing system could lead to errors in dosage or diversion of the drug.

Choice C is wrong because returning the remaining medication to the facility’s pharmacy is not a recommended practice for controlled substances and could also result in errors or diversion.

Choice D is wrong because placing the remaining half of the pill in the unit-dose package could compromise the integrity and stability of the medication and expose it to environmental factors.

Normal ranges for hydromorphone are not applicable as it is a synthetic opioid analgesic that does not have a therapeutic level.

However, some factors that may affect its pharmacokinetics and pharmacodynamics are age, weight, renal function, liver function, genetic polymorphisms, and drug interactions.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following factors predisposes this client to developing digoxin toxicity?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has a new prescription for paroxetine. The nurse should instruct the client to monitor for which of the following adverse effects?

Correct Answer is D

Explanation

A nurse is administering 4 mg of hydromorphone to a client by mouth every 4 hr. The medication is provided as hydromorphone 8 mg per tablet. Which of the following actions is appropriate for the nurse to take?

Correct Answer is B

Explanation

A home health nurse is visiting a client who has heart failure and a prescription for furosemide. The nurse identifies that the client has gained 2.5 kg (5 Ib) since the last visit 2 days ago. Which of the following actions should the nurse take first?

A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin. Which of the following information should the nurse include in the teaching?

A nurse is caring for a client who is taking tamoxifen to treat breast cancer. The nurse should identify which of the following manifestations as an adverse effect of this medication?

A nurse is reviewing the medical record of an adult client who has a fever and a prescription for acetaminophen. Which of the following findings should the nurse identify as a contraindication for receiving this medication?

A nurse is teaching a client who has a prescription for ferrous gluconate. Which of the following statements by the client indicates an understanding of the teaching?

A nurse is teaching a client who has a new prescription for a nitroglycerin transdermal patch. Which of the following instructions should the nurse include?

A nurse is caring for a client who has diabetes mellitus and is taking pioglitazone. The nurse should plan to monitor the client for which of the following adverse effects?

A client who has Graves’ disease is prescribed methimazole. Which of the following effects should the nurse expect to see after the client has taken the medication for 2 months?