Nokea
What clinical manifestation is a common sign of digoxin toxicity?
- A. Seizures
- B. Vomiting
- C. Bradypnea
- D. Tachycardia
Correct Answer: B
Rationale: Vomiting, unrelated to feedings, is a common sign of digoxin toxicity due to its narrow therapeutic range. Seizures are not associated, bradycardia (not bradypnea or tachycardia) may occur, but vomiting is a key indicator.
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A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate?
- A. 60 beats/min
- B. 90 beats/min
- C. 100 beats/min
- D. 120 beats/min
Correct Answer: B
Rationale: For infants and young children, digoxin is withheld if the 1-minute apical pulse is below 90 beats/min to prevent toxicity. A rate of 60 is the adult threshold, and 100-120 beats/min are acceptable for administration.
What statement best identifies the cause of heart failure (HF)?
- A. Disease related to cardiac defects
- B. Consequence of an underlying cardiac defect
- C. Inherited disorder associated with a variety of defects
- D. Result of diminished workload imposed on an abnormal myocardium
Correct Answer: B
Rationale: Heart failure results from the heart?s inability to pump sufficient blood, often due to congenital defects causing increased volume or pressure. It?s not a primary disease, not typically inherited, and involves increased, not diminished, myocardial workload.
After returning from cardiac catheterization, the nurse monitors the childs vital signs. The heart rate should be counted for how many seconds?
- A. 15
- B. 30
- C. 60
- D. 120
Correct Answer: C
Rationale: Counting the heart rate for 60 seconds ensures accurate detection of arrhythmias or bradycardia. Shorter durations (15 or 30 seconds) are insufficient, and 120 seconds is unnecessarily long for routine assessment.
What drug is an angiotensin-converting enzyme (ACE) inhibitor?
- A. Furosemide (Lasix)
- B. Captopril (Capoten)
- C. Chlorothiazide (Diuril)
- D. Spironolactone (Aldactone)
Correct Answer: B
Rationale: Captopril is an ACE inhibitor used in heart failure management. Furosemide is a loop diuretic, chlorothiazide acts on distal tubules, and spironolactone is a potassium-sparing diuretic, none of which are ACE inhibitors.
After returning from cardiac catheterization, the nurse determines that the pulse distal to the catheter insertion site is weaker. How should the nurse respond?
- A. Elevate the affected extremity.
- B. Notify the practitioner of the observation.
- C. Record data on the assessment flow record.
- D. Apply warm compresses to the insertion site.
Correct Answer: C
Rationale: A weaker pulse post-catheterization is expected initially and should be documented as a baseline for monitoring. The pulse should strengthen over hours. Elevation, warm compresses, or immediate notification are unnecessary unless neurovascular changes occur.