A nurse is planning to administer digoxin to a client who has heart failure. Which of the following laboratory results is the priority for the nurse to review prior to administering the medication?

Hemoglobin

Creatinine

Blood urea nitrogen

Potassium

Answer and Explanation

The Correct Answer is A

A.   Hemoglobin levels are important for assessing oxygen-carrying capacity of the blood. While anemia can affect tissue oxygenation and exacerbate symptoms in heart failure, it is not directly related to the risk of digoxin toxicity.
B.   Creatinine levels are used to assess kidney function. Impaired kidney function can affect the clearance of digoxin from the body, potentially increasing the risk of toxicity. However, potassium levels have a more direct impact on the risk of digoxin toxicity.
C.   BUN levels are also used to assess kidney function. Similar to creatinine, impaired kidney function can affect digoxin clearance, but potassium levels are more directly related to the risk of digoxin toxicity.
D.   Potassium levels are critical because hypokalemia (low potassium) can predispose the client to digoxin toxicity. Digoxin competes with potassium for binding sites on the sodium-potassium ATPase pump in cardiac cells. When potassium levels are low, digoxin can bind more readily to these pumps, leading to increased toxicity and potentially life-threatening arrhythmias such as ventricular tachycardia or ventricular fibrillation.

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 C

Explanation

A. Metabolic acidosis is characterized by a decrease in bicarbonate or an increase in acids, which can be caused by conditions like kidney failure or diabetic ketoacidosis, but it is not typically associated with numbness and tingling.
B. Respiratory alkalosis is characterized by a high pH (>7.45) and a decreased PaCO2 (<35 mm Hg). It typically results from hyperventilation, which leads to excessive elimination of CO2 and subsequent alkalosis. This condition is less likely to occur in gastroenteritis unless there are other complicating factors such as anxiety or pain causing increased respiratory rate.
C. In the context of gastroenteritis, where there may be a loss of stomach acids through vomiting or diarrhea, the most likely acid-base imbalance would be metabolic alkalosis.
D. Respiratory acidosis is characterized by a low pH and an elevated PaCO2 (>45 mm Hg). It results from hypoventilation, leading to retention of CO2 and subsequent acidosis. Respiratory acidosis would not typically present with numbness and tingling in the extremities in the context of gastroenteritis.

A. A client who has diarrhea B. A client who has salicylate intoxication C. A client who is vomiting D. A client who is taking a thiazide diuretic

Correct Answer is A

Explanation

A. Diarrhea can lead to loss of bicarbonate from the body, resulting in metabolic acidosis. The loss of bicarbonate through gastrointestinal fluids causes an imbalance between acids and bases in the body.
B. Salicylates (such as aspirin) can cause metabolic acidosis by several mechanisms, including direct stimulation of the respiratory center in the brainstem (leading to hyperventilation and respiratory alkalosis initially) and later causing metabolic acidosis due to increased production of acids like lactic acid and ketoacids.
C. Vomiting can lead to loss of gastric acid (hydrochloric acid), which could initially lead to metabolic alkalosis due to loss of acid.
D. Thiazide diuretics can cause metabolic alkalosis rather than metabolic acidosis. They promote the loss of potassium and hydrogen ions (acid), leading to increased blood pH (alkalosis).

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 planning to administer digoxin to a client who has heart failure. Which of the following laboratory results is the priority for the nurse to review prior to administering the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is admitting a client who has gastroenteritis and is reporting numbness and tingling of the toes and fingers. The nurse should recognize the client is experiencing which of the following acid-base imbalances?

Correct Answer is C

Explanation

A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?

Correct Answer is A

Explanation

The nurse recognizes the need for client education when the client scheduled for a computed tomography (CT) states:

A nurse has been assigned to care for a client diagnosed with a small bowel obstruction. The client has a nasogastric tube attached to suction for 2 days. Which arterial blood gas result will the nurse expect to see for this client?

A nurse is caring for a client who had IV fluids initiated at 0330. The IV fluids are infusing at 120 mL/hr. The nurse should record how many mL of IV fluids on the intake record at 0600?

A nurse is caring for a client 8 hr postoperative following a total knee replacement. Which of the following actions should the nurse take?

A nurse is teaching a client scheduled for an activated partial thromboplastin time (aPTT). Which of the following statements by the client indicates an understanding of the teaching?

The nurse is caring for a client with a heart rate of 48. His blood pressure is 120/80. Which finding will help the nurse determine the cause of the client's bradycardia?

A nurse is reviewing the laboratory results for a client who has a history of atherosclerosis and notes elevated cholesterol levels. Which of the following statements by the client indicates the nurse should plan follow-up teaching on a low-cholesterol diet?