Chapter 28: Drugs Used to Treat Heart Failure

Chapter 28: Drugs Used to Treat Heart Failure

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Which drug will be administered to a patient being admitted with severe digoxin intoxication?

ANS:  C

The antidote for digoxin intoxication is digoxin immune Fab (Digibind). Amiodarone is an antidysrhythmic and would not treat digoxin intoxication. Spironolactone is a diuretic and does not treat digoxin intoxication. Giving more of the same type of drug does not treat drug intoxication.

DIF:    Cognitive Level: Comprehension     REF:   p. 453             OBJ:   4

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

2. The nurse is caring for a 3-year-old girl who has a congenital heart anomaly. The patient’s current medications include digoxin and furosemide (Lasix). The apical pulse rate is 100 beats/min. Which action will the nurse take?

ANS:  A

A pulse rate of 100 beats/min in a child who is 3 years old is considered acceptable. Administration of the medication is appropriate. There is no indication for contacting the cardiologist, holding the dose, or requesting further assessment because this is within the expected range.

DIF:    Cognitive Level: Application           REF:   p. 452             OBJ:   6

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity

3. An older adult male patient with long term heart failure has presented for an office visit. The nurse obtains information that he has recently begun taking St. John’s wort. What results with the use of this herbal supplement?

ANS:  C

St. John’s wort is a drug that may reduce therapeutic benefits of digoxin. St. John’s wort has the opposite effect on digoxin and does not affect electrolytes.

DIF:    Cognitive Level: Application           REF:   p. 453             OBJ:   6

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity

4. The nurse is to administer digoxin to an 18 month old patient who weighs 16.5 lb. Guidelines for administration read as follows: 0.0075-0.010 mg/kg/day. Which is a safe medication dosage?

ANS:  C

16.5 lb converts to 7.5 kg; 7.5 kg ´ 0.0075 mg = 0.05625; 7.5 kg ´ 0.010 mg = 0.075 mg; 0.074 mg is the only answer within the safe dosage range. Values of 0.05 mg, 0.12 mg, and 0.75 mg are too large.

DIF:    Cognitive Level: Application           REF:   pp. 451-453    OBJ:   3

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Safe, Effective Care Environment

5. The nurse monitors a patient receiving digoxin closely for toxicity when which other medication is prescribed?

ANS:  B

Furosemide is a potassium depleting diuretic. Low potassium levels potentiate digoxin toxicity. Taking potassium supplements with a diuretic prevents digoxin toxicity. Aspirin and antibiotics do not affect digoxin levels.

DIF:    Cognitive Level: Knowledge            REF:   p. 453             OBJ:   4

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity