A nurse is reviewing the morning laboratory results of electrolytes for four clients who are receiving digoxin. Which of the following clients should the nurse identify as being at risk for developing digoxin toxicity?

A client taking furosemide for chronic hypertension.

A client taking a potassium supplement twice a day.

A client taking aluminum hydroxide for gastric upset.

A client taking chlorpropamide for type 2 diabetes mellitus.

Answer and Explanation

The Correct Answer is A

a. A client taking furosemide for chronic hypertension: Furosemide is a loop diuretic that can

lead to hypokalemia, which increases the risk of digoxin toxicity, as hypokalemia potentiates the effects of digoxin on the heart.

b. A client taking a potassium supplement twice a day: Potassium supplementation reduces the risk of digoxin toxicity, as hypokalemia is a risk factor for toxicity.

c. A client taking aluminum hydroxide for gastric upset: Aluminum hydroxide is an antacid and does not significantly affect digoxin levels.

d. A client taking chlorpropamide for type 2 diabetes mellitus: Chlorpropamide is an oral hypoglycemic agent and does not significantly affect digoxin levels.

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Correct Answer is C

Explanation

a. Serum chloride 99 mEq/L: Serum chloride within the reference range is not an adverse effect of spironolactone.

b. Serum calcium 10.5 mg/dL: Serum calcium within the reference range is not an adverse effect of spironolactone.

c. Serum potassium 5.2: Spironolactone is a potassium-sparing diuretic, and an elevated serum potassium level is an adverse effect that requires monitoring. The nurse should assess for

hyperkalemia.

d. Serum sodium 140 mEq/L: Serum sodium within the reference range is not an adverse effect of spironolactone.

A. Complete heart block B. Atrial fibrillation C. Sinus tachycardia D. First-degree AV block.

Correct Answer is B

Explanation

a. Complete heart block: Complete heart block would typically present with a regular ventricular rate, but with no association between P waves and QRS complexes.

b. Atrial fibrillation: Atrial fibrillation is characterized by the absence of identifiable P waves and an irregular ventricular rate. The atria fibrillate, leading to chaotic electrical activity and an irregular ventricular response.

c. Sinus tachycardia: Sinus tachycardia is characterized by a regular ventricular rate and identifiable P waves. It is not associated with the absence of P waves.

d. First-degree AV block: First-degree AV block is characterized by a prolonged PR interval, but it does not result in the absence of P waves. The relationship between P waves and QRS

complexes is maintained.

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A nurse is reviewing the morning laboratory results of electrolytes for four clients who are receiving digoxin. Which of the following clients should the nurse identify as being at risk for developing digoxin toxicity?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory findings of a client who has liver failure with ascites. The client takes spironolactone. Which of the following findings is an adverse effect of themedication?

Correct Answer is C

Explanation

A nurse is assisting with collecting data on a client who is on a continuous ECG monitor. The client's ECG tracing shows no identifiable P waves and an irregular ventricular rate. The nurseshould recognize the client is experiencing which of the following cardiac dysrhythmias?

Correct Answer is B

Explanation

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