Chapter 24: Heart Failure Drugs

Chapter 24: Heart Failure Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient about to receive a morning dose of digoxin has an apical pulse of 53 beats/min. What will the nurse do next?

a.	Administer the dose.
b.	Administer the dose, and notify the prescriber.
c.	Check the radial pulse for 1 full minute.
d.	Withhold the dose, and notify the prescriber.

 

 

ANS:  D

Digoxin doses are held and the prescriber notified if the apical pulse is 60 beats/min or lower or is higher than 100 beats/min. The other options are incorrect.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 385

TOP:   NURSING PROCESS: Implementation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. A patient is taking digoxin (Lanoxin) and a loop diuretic daily. When the nurse enters the room with the morning medications, the patient states, “I am seeing a funny yellow color around the lights.” What is the nurse’s next action?

a.	Assess the patient for symptoms of digoxin toxicity.
b.	Withhold the next dose of the diuretic.
c.	Administer the digoxin and diuretic together as ordered.
d.	Document this finding, and reassess in 1 hour.

 

 

ANS:  A

Seeing colors around lights is one potential indication of developing digoxin toxicity. If a patient complains of this, the nurse needs to assess for other signs and symptoms of digoxin toxicity including bradycardia, headache, dizziness, confusion, nausea, and blurred vision, and then notify the prescriber. Administering the drug or withholding the diuretic are incorrect options.

 

DIF:    COGNITIVE LEVEL: Analyzing (Analysis)                     REF:   p. 382

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Reduction of Risk Potential

 

3. While assessing a patient who is receiving intravenous digitalis, the nurse recognizes that the drug has a negative chronotropic effect. How would this drug effect be evident in the patient?

a.	Decreased blood pressure
b.	Decreased heart rate
c.	Decreased conduction
d.	Decreased ectopic beats

 

 

ANS:  B

A negative chronotropic effect results in a decreased heart rate; this is one effect of cardiac glycosides. The other options are incorrect.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 381

TOP:   NURSING PROCESS: Evaluation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A patient has been taking digoxin at home but took an accidental overdose and has developed toxicity. The patient has been admitted to the telemetry unit, where the physician has ordered digoxin immune Fab (Digifab). The patient asks the nurse why the medication is ordered. What is the nurse’s best response?

a.	“It will increase your heart rate.”
b.	“This drug helps to lower your potassium levels.”
c.	“It helps to convert the irregular heart rhythm to a more normal rhythm.”
d.	“This drug is an antidote to digoxin and will help to lower the blood levels.”

 

 

ANS:  D

Digoxin immune Fab (Digifab) is the antidote for a severe digoxin overdose. It is given intravenously. The other options are incorrect.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 383

TOP:   NURSING PROCESS: Implementation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies