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.

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Correct Answer is A

Explanation

Calcium gluconate is used to treat hypermagnesemia because it can help calm some symptoms such as impaired breathing, irregular heartbeat, and hypotension. Calcium also helps normalize the neuromuscular function that is affected by excess magnesium.

Choice B. Acetylcysteine is wrong because it is used to treat acetaminophen overdose and prevent kidney damage from contrast dye.

It has no role in treating hypermagnesemia.

Choice C. Flumazenil is wrong because it is used to reverse the effects of benzodiazepines, a class of sedative drugs.

It has no role in treating hypermagnesemia.

Choice D. Protamine sulfate is wrong because it is used to reverse the effects of heparin, an anticoagulant drug.

It has no role in treating hypermagnesemia.

Normal ranges for magnesium are 1.7 to 2.3 mg/dL or 0.7 to 1.1 mmol/L. Hypermagnesemia is defined as a magnesium level above 2.6 mg/dL or 1.5 mmol/L.

A. Decreased blood pressure. B. Decreased nausea. C. Increased respiratory rate. D. Increased pain relief.

Correct Answer is C

Explanation

A therapeutic effect of naloxone is the reversal of opioid-induced respiratory depression, which is one of the most dangerous complications of opioid overdose. Naloxone works by binding to opioid receptors, displacing opioids, and restoring normal respiratory drive. An increase in respiratory rate after administration indicates that naloxone is effective.

Choice A is wrong because decreased blood pressure is not a therapeutic effect of naloxone.

In fact, naloxone can cause hypertension (high blood pressure) as a side effect due to opioid withdrawal.

Choice B is wrong because decreased nausea is not a therapeutic effect of naloxone. Nausea is a common side effect of morphine, but naloxone does not affect it directly.

Naloxone can actually cause nausea and vomiting as a side effect due to opioid withdrawal.

Choice D is wrong because increased pain relief is not a therapeutic effect of naloxone.

Pain relief is a desired effect of morphine, but naloxone antagonizes it by blocking the opioid receptors.

Naloxone can cause pain and discomfort as a side effect due to opioid withdrawal.

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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

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Correct Answer is A

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Correct Answer is C

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