Deck 24: Heart Failure Drugs

Question 1

A patient about to receive a morning dose of digoxin has an apical pulse of 50 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.

Answer 1

Withhold the dose, and notify the prescriber.

Question 2

The nurse is reviewing discharge teaching for a patient who will be taking digoxin (Lanoxin) therapy. The nurse will teach the patient to avoid which foods when taking the digoxin?

A) Leafy green vegetables
B) Dairy products
C) Grapefruit juice
D) Bran muffins

Answer 2

Bran muffins

Question 3

Which drug classes are considered first-line treatment for heart failure?

A) Angiotensin-converting enzyme (ACE) inhibitors
B) Angiotensin II receptor blockers (ARBs)
C) Digoxin (cardiac glycoside)
D) Beta blockers
E) Nesiritide (Natrecor), the B-type natriuretic peptide

Answer 3

Angiotensin-converting enzyme (ACE) inhibitors
Angiotensin II receptor blockers (ARBs)
Beta blockers

Question 4

A patient has been placed on a milrinone (Primacor) infusion as part of the therapy for end-stage heart failure. What adverse effect of this drug will the nurse watch for when assessing this patient during the infusion?

A) Hypertension
B) Hyperkalemia
C) Nausea and vomiting
D) Cardiac dysrhythmias

Question 5

A patient is in the intensive care unit and receiving an infusion of milrinone (Primacor) for severe heart failure. The prescriber has written an order for an intravenous dose of furosemide (Lasix). How will the nurse give this drug?

A) Infuse the drug into the same intravenous line as the milrinone.
B) Stop the milrinone, flush the line, and then administer the furosemide.
C) Administer the furosemide in a separate intravenous line.
D) Notify the prescriber that the furosemide cannot be given at this time.

Question 6

When a patient is experiencing digoxin toxicity, which clinical situation would necessitate the use of digoxin immune Fab (Digifab)?

A) The patient reports seeing colorful halos around lights.
B) The patient's serum potassium level is above 5 mEq/L.
C) The patient is experiencing nausea and anorexia.
D) The patient is experiencing severe sinus bradycardia that does not respond to cardiac pacing.
E) The patient has received an overdose of greater than 10 mg of digoxin.
F) The patient reports fatigue and headaches.

Question 7

When administering digoxin immune Fab (Digibind) to a patient with severe digoxin toxicity, the nurse knows that each vial can bind with how much digoxin?

A) 0.5 mg
B) 5 mg
C) 5.5 mg
D) 15 mg

Question 8

The medication order for a 5-year-old child reads, "Give digoxin elixir, 15 mcg/kg, PO now." Convert the 15 micrograms to milligrams. _______

Question 9

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 causes your heart to beat at a slower rate."
D) "This drug is an antidote to digoxin and will help your heart to return to normal functioning.

Question 10

In assessing a patient before administration of a cardiac glycoside, the nurse knows that which lab result can increase the toxicity of the drug?

A) Potassium level 2.8 mEq/L
B) Potassium level 4.9 mEq/L
C) Sodium level 140 mEq/L
D) Calcium level 10 mg/dL

Question 11

The nurse administering the phosphodiesterase inhibitor milrinone (Primacor) recognizes that this drug will have a positive inotropic effect. Which result reflects this effect?

A) Increased heart rate
B) Increased blood vessel dilation
C) Increased force of cardiac contractions
D) Increased conduction of electrical impulses across the heart

Question 12

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.

Question 13

A patient has a digoxin level of 1.1 ng/mL. Which interpretation by the nurse is correct?

A) It is below the therapeutic level.
B) It is within the therapeutic range.
C) It is above the therapeutic level.
D) It is at a toxic level.

Question 14

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

Question 15

The nurse notes in a patient's medical record that nesiritide (Natrecor) has been ordered. Based on this order, the nurse interprets that the patient has which disorder?

A) Atrial fibrillation
B) Severe, life-threatening heart failure
C) Class II heart failure
D) Acute hypertensive crisis