Based on a client’s serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement?

Administer potassium to stabilize the heart rate.

Begin cardioversion to stabilize heart rhythm.

Check acid-base and electrolyte values.

Give digoxin by another route to slow absorption.

Answer and Explanation

The Correct Answer is C

Choice A reason: Administering potassium is not the primary action for treating digoxin toxicity. While hypokalemia can exacerbate digoxin toxicity, the initial step is to assess and stabilize the patient’s overall condition, including acid-base and electrolyte balance. Potassium administration may be considered if hypokalemia is present, but it is not the first-line treatment.

Choice B reason: Cardioversion is not typically used to treat digoxin toxicity. Digoxin toxicity can cause various arrhythmias, but the treatment focuses on stabilizing the patient and addressing the toxicity itself2. Cardioversion may be considered in life-threatening arrhythmias, but it is not the primary intervention.

Choice C reason: Checking acid-base and electrolyte values is crucial in managing digoxin toxicity. Digoxin toxicity can lead to electrolyte imbalances, particularly hyperkalemia, which can be life-threatening. Assessing and correcting these imbalances is essential for stabilizing the patient and preventing further complications.

Choice D reason: Giving digoxin by another route to slow absorption is not an appropriate action. The primary treatment for digoxin toxicity involves stopping the medication and administering digoxin-specific antibody fragments (Fab) if necessary. These antibodies bind to digoxin, neutralizing its effects and allowing for its excretion.

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Correct Answer is A

Explanation

Choice A reason:

Decreased night vision is a significant concern for clients receiving miotics for open-angle glaucoma. Miotics, such as pilocarpine, work by constricting the pupil (miosis), which can reduce the amount of light entering the eye. This effect is particularly problematic in low-light conditions, leading to decreased night vision and increasing the risk of injury due to poor visibility

Choice B reason:

Increased sensitivity to light, also known as photophobia, can occur with the use of miotics, but it is not the primary concern related to the risk of injury. While photophobia can cause discomfort and avoidance of bright environments, it does not directly contribute to the risk of injury as significantly as decreased night vision.

Choice C reason:

Increased frequency of lacrimation (tearing) can be a side effect of miotics, but it is not a major factor in the risk of injury. Excessive tearing can cause discomfort and blurred vision temporarily, but it does not pose a significant risk for injury compared to decreased night vision.

Choice D reason:

Diminished color perception is not a common side effect of miotics. Miotics primarily affect the pupil size and accommodation, rather than color vision. Therefore, this choice is not relevant to the risk of injury associated with the use of miotics.

A. Teach the client about foods high in calcium. B. Begin tapering the drug dose per protocol. C. Notify the healthcare provider of the finding. D. Administer the medication with a glass of milk.

Correct Answer is C

Explanation

Choice A reason:

Teaching the client about foods high in calcium is important, but it is not the most immediate action required. A serum calcium level of 5.5 mg/dL is significantly below the normal range (8.5-10.2 mg/dL) and indicates severe hypocalcemia. While dietary education is beneficial for long-term management, the nurse must first address the acute issue by notifying the healthcare provider.

Choice B reason:

Beginning to taper the drug dose per protocol is not appropriate without consulting the healthcare provider. Methylprednisolone, a corticosteroid, can cause decreased calcium absorption and increased calcium excretion. However, any changes to the medication regimen should be directed by the healthcare provider, especially in the context of severe hypocalcemia.

Choice C reason:

Notifying the healthcare provider of the finding is the most critical action. Severe hypocalcemia can lead to serious complications such as cardiac arrhythmias, muscle spasms, and seizures. Immediate medical intervention is necessary to correct the calcium imbalance and prevent potential life-threatening conditions.

Choice D reason:

Administering the medication with a glass of milk is not sufficient to address the severe hypocalcemia. While milk contains calcium, the amount is not enough to correct a serum calcium level as low as 5.5 mg/dL. The nurse must prioritize notifying the healthcare provider to ensure appropriate treatment is initiated.

Word count: 500 words.

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Based on a client’s serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is receiving miotics for the treatment of open-angle glaucoma. The nurse determines that a priority nursing problem is the risk for injury. This nursing problem is based on which etiology?

Correct Answer is A

Explanation

Prior to administering an oral dose of methylprednisolone, the nurse determines the client’s serum total calcium level is 5.5 mg/dL (1.375 mmol/L). What action is most important for the nurse to take?

Correct Answer is C

Explanation

A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?

When administering zolpidem to an older client, which computer documentation indicates that the desired outcome has been achieved?

The nurse is planning discharge teaching for a client with type 2 diabetes mellitus who has a new prescription for insulin glargine. Which action should the nurse plan to include in the discharge teaching?

When administering zolpidem to an older client, which computer documentation indicates that the desired outcome has been achieved?

Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium?

A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client’s history requires follow-up by the nurse?

Administer a scheduled dose of labetalol PO to a client with hypertension. The client’s temperature is 99°F (37.2°C), a heart rate of 48 beats per minute, respirations of 16 breaths per minute, and a blood pressure of 150/90 mm Hg. Which action should the nurse take?

A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in the client’s plan of care?