Cardiac Glycosides Study Guide

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Sample questions from Cardiac Glycosides Study Guide

This material has 12 questions with answers and rationales. Here are the first 5.

1. 1.An adult client has a prescription for digoxin 0.125 mg orally daily with instructions to hold for an apical pulse below 60 beats/min. The nurse counts an apical pulse of 54 beats/min for one full minute. The client denies dizziness. What should the nurse do?

   • A.Withhold the dose and notify the prescriber according to policy.
   • B.Administer the dose because the client is asymptomatic.
   • C.Ask assistive personnel to obtain a radial pulse and administer if it is higher.
   • D.Give half of the prescribed dose and reassess in one hour.

   Rationale: B is correct because the measured apical pulse meets the explicit hold parameter. The nurse should withhold, assess further as indicated, and notify. A ignores the prescription; absence of symptoms does not cancel the parameter. C independently changes the prescribed dose. D substitutes a potentially less reliable peripheral count for the required assessment and does not address the abnormal finding.

2. 2.A client taking digoxin and furosemide reports new nausea and weakness. The potassium level is 2.8 mEq/L, and the digoxin concentration is 0.8 ng/mL. Which interpretation is most appropriate?

   • A.The symptoms indicate that the client needs a larger digoxin dose.
   • B.The digoxin concentration excludes medication toxicity.
   • C.Furosemide prevents digoxin toxicity by increasing urine output.
   • D.The low potassium increases susceptibility to digoxin toxicity despite the concentration.

   Rationale: C is correct because hypokalemia increases myocardial sensitivity to digoxin, and symptoms must be assessed even with a target-range concentration. A incorrectly treats a laboratory result as proof of safety. B could worsen toxicity and is unsupported by the findings. D is wrong because furosemide can promote potassium and magnesium loss, increasing risk rather than reliably preventing it.

3. 3.A stable client receives oral digoxin at 0800. Which scheduled blood collection time is most appropriate for a routine postdistribution digoxin concentration?

   • A.1100
   • B.1600
   • C.1000
   • D.0900

   Rationale: D is correct because 1600 is 8 hours after the dose, allowing the distribution phase to pass. A, B, and C are only 1, 2, and 3 hours after administration and can yield misleadingly high concentrations. Routine samples are generally obtained at least 6 to 8 hours after a dose or at an appropriate predose time according to policy.

4. 4.An older adult taking a stable daily dose of digoxin develops acute kidney injury. Which outcome is the nurse most concerned about?

   • A.Protection from toxicity because older adults have lower muscle mass
   • B.Rapid elimination of digoxin because serum creatinine has increased
   • C.Accumulation of digoxin because renal clearance is reduced
   • D.Loss of all digoxin effect because the kidneys activate the medication

   Answer and rationale are in the full material.

5. 5.A client with substantial acute digoxin poisoning develops ventricular dysrhythmias and hyperkalemia. Which prescribed medication directly binds digoxin and addresses the poisoning?

   • A.Naloxone
   • B.Protamine sulfate
   • C.Digoxin immune Fab
   • D.Vitamin K

   Answer and rationale are in the full material.