LATEST Exam 3 Guide
2023 WITH CORRECT
ANSWERS 100%
1. The nurse understandsthat which client is at greatest risk for digoxin toxicity? The client with
... [Show More] a:
a. digoxin level of 1.3 mg/mL.
b. creatinine level of 0.8 mg/dl.
c. potassium level of 5.2 mEq/L.
d. potassium level of 3.0 mEq/L.
A Incorrect: This is within defined limits for digoxin level.
B Incorrect: This is within defined limitsfor creatinine level.
C Incorrect: The risk of hyperkalemia in clients taking digoxin is highly unlikely.
D Correct: This potassium level indicates hypokalemia, a risk factor for digoxin toxicity.
2. The nurse caring for a client taking digoxin should monitor which of the following?
a. potassium level
b. digoxin level
c. blood glucose level
d. sodium level
A and B are correct. Both the potassium level and digoxin level should be monitored. Although blood glucose
and sodium are part of an electrolyte panel, these are not significant to digoxin use.
3. After receiving change-of-shift report on a heart failure unit, which patient should the nurse assess first?
a. Patient who is taking carvedilol (Coreg) and has a heart rate of 58
b. Patient who is taking digoxin and has a potassium level of 3.1 mEq/L
c. Patient who istaking isosorbide dinitrate/hydralazine (BiDil) and has a headache
d. Patient who istaking captopril (Capoten) and has a frequent nonproductive cough
The patient’slow potassium level increasesthe risk for digoxin toxicity and potentially fatal dysrhythmias. The
nurse should assess the patient for other signs of digoxin toxicity and then notify the health care provider
about the potassium level. The other patients also have side effects of their medications, but their symptoms
do not indicate potentially life-threatening complications.
4. The nurse isteaching a client about the newly prescribed medication digoxin (Lanoxin). Why should the
nurse instruct the client to report signs of yellow- or green-colored vision?
1. Color changes indicate an allergic response to digoxin.
2. The potassium level is in danger of being too high.
3. Vision color changesindicate digoxin toxicity.
4. The client is also taking antacids.
1. Symptoms of allergy usually take the form of rashes, or respiratory distress, in the extreme form.
2. Digoxin toxicity is accompanied by a decreased potassium level.
3. The client should be instructed to report vision color changes, as that is a symptom of digoxin toxicity.
4. Antacidstend to decrease the absorption of digoxin.
5. The nurse plans discharge teaching for a patient with chronic heart failure who has prescriptions for digoxin
(Lanoxin) and hydrochlorothiazide (HydroDIURIL). Appropriate instructions for the patient include
a. limit dietary sources of potassium.
LATEST Exam 3 Guide
2023 WITH CORRECT
ANSWERS 100%
b. take the hydrochlorothiazide before bedtime.
c. notify the health care provider if nausea develops.
d. skip the digoxin if the pulse is below 60 beats/minute.
Nausea is an indication of digoxin toxicity and should be reported so that the provider can assessthe patient
for toxicity and adjust the digoxin dose, if necessary. The patient will need to include potassium-containing
LATEST Exam 3 Guide
2023 WITH CORRECT
ANSWERS 100%
foods in the diet to avoid hypokalemia. Patients should be taught to check their pulse daily before taking the
digoxin and if the pulse is less than 60, to call their provider before taking the digoxin. Diuretics should be
taken early in the day to avoid sleep disruption.
6. A patient newly diagnosed with heart failure is prescribed 40 mg of furosemide (Lasix) to be given IV push.
Knowing that the patient is also prescribed digoxin (Lanoxin), the nurse should review which laboratory result?
1. sodium level
2. digoxin level
3. creatinine level
4. potassium level
Serum potassium level is measured in the patient receiving digoxin and furosemide. Heightened digoxin effect
can occur in the patient with hypokalemia. Hypokalemia also predisposes the patient to ventricular
dysrhythmias. There is no data indicating renal insufficiency; therefore creatinine level is not relevant.
Furosemide can cause hyponatremia, but the risk of hypokalemia has more severe consequences in this
situation.
7. Which instruction by the nurse will be included when teaching an adult patient about digoxin (Lanoxin) for
management of heart failure?
a. “Report nausea and vomiting to your health care provider.”
b. “Decrease the amount of high potassium foods you eat.”
c. “Omit your dose of digoxin if your pulse is 60 beats/min.”
d. “Visual disturbances are common adverse effects.”
Nausea and vomiting are serious adverse effectsindicative of toxicity. Low potassium levels can cause toxicity;
adequate intake of potassium is necessary. The dose is withheld if the pulse rate is less than 60 beats/min in
adults. Visual disturbances are not common adverse effects.
8. The nurse monitors a patient receiving digoxin closely for toxicity when which other medication is
prescribed?
a. Potassium supplements
b. Furosemide (Lasix)
c. Acetylsalicylic acid (aspirin)
d. Antibiotics
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.
9. A patient was admitted for heart failure, and over the past 3 days the patient’s brain natriuretic peptide has
decreased. What action by the nurse is best?
a. Prepare to administer extra diuretics.
b. Continue with the plan of care.
c. Prepare to intubate and ventilate the patient.
d. Discuss end-of-life care with the patient.
A decreasing BNP indicates less fluid volume in the heart, indicating that treatment measures for CHF are
working. The nurse continues with the plan of care. The other actions are not needed.
10. The respiratory therapist is asked to evaluate a patient with suspected congestive heart failure. Which of [Show Less]