Deck 25: Agents Used in the Treatment of Heart Failure

Question 1

The nurse understands that which of the following statements applies to digoxin-immune Fab (Digibind)?

A) The onset of action is 30 to 45 minutes
B) It is useful in digitalizing clients
C) It is a short-acting type of digoxin
D) It is used as an antidote to digoxin

Answer 1

It is used as an antidote to digoxin

Question 2

The family of a client in atrial fibrillation asks the nurse what the purpose of digoxin (Lanoxin)is.The nurse should consider in a response that this drug is helpful to

A) convert the fibrillating atria.
B) convert the fibrillating ventricles.
C) slow the ventricular rate.
D) increase the ventricular rate.

Answer 2

slow the ventricular rate.

Question 3

Before administering digoxin,the nurse makes certain to assess which of the following items of client data?

A) Urinary output
B) Peripheral pulses
C) Apical pulse
D) Blood pressure

Answer 3

Apical pulse

Question 4

The nurse would question an order for digoxin (Lanoxin)after learning that the client has a history of which of the following cardiac rhythm abnormalities?

A) Atrial tachycardia
B) Atrioventricular block
C) Sinus tachycardia
D) Atrial fibrillation

Question 5

Which of the following statements accurately describes heart failure?

A) It occurs more often in women than in men
B) The 5-year mortality rate is 2%
C) Estimated annual expenditures for treatment are in excess of $20 billion
D) The prevalence decreases in each decade of life until approximately 1% of the population older than 80 years is affected

Question 6

The nurse concludes that the client receiving digoxin (Lanoxin)has therapeutic serum levels after noting which of the following digoxin levels drawn earlier that day?

A) 0.2 ng/mL
B) 1.8 ng/mL
C) 3.7 ng/mL
D) 5.5 ng/mL

Question 7

The nurse understands that a client receiving inamrinone (Inocor)has reduced preload and afterload because of which of the following drug effects?

A) Relaxation of vascular smooth muscle
B) Increased force of cardiac contraction
C) Overall reduction in cardiac rate
D) Increased speed of cardiac conduction

Question 8

The nurse is concerned that which of the following medications would result in a drug interaction if given to a client who is taking digoxin?

A) Aspirin
B) Steroids
C) Tylenol
D) Vitamin K

Question 9

The nurse would expect to see which of the following when reviewing the electrocardiogram of a client with digoxin toxicity?

A) Shortened P-R intervals
B) Lengthened T waves
C) Ectopic pacemakers
D) Normal sinus rhythm

Question 10

The nurse understands that the cardiac effects of digoxin improve symptoms of heart failure by

A) increasing the heart rate.
B) lengthening the sarcomere.
C) emptying the ventricle more completely.
D) decreasing coronary blood flow.

Question 11

Which of the following client statements may indicate that the client has an early sign of digoxin toxicity?

A) "I've gained three fourths of a pound in 2 days."
B) "I've had awful diarrhea all day."
C) "I still get a little short of breath."
D) "My head has hurt most of the day."

Question 12

The nurse interprets that a client with which of the following health problems is most at risk for developing digoxin toxicity?

A) Cerebrovascular accident
B) Pneumonia
C) Urinary calculi
D) Renal insufficiency

Question 13

Intracellular sodium accumulates with the use of digoxin,stimulating the release of large quantities of which electrolyte?

A) Potassium
B) Sodium
C) Magnesium
D) Calcium

Question 14

The home care nurse advises a client with chronic heart failure that which of the following items being taken by the client is satisfactory because of its low sodium content?

A) Carbenicillin (Geopen)
B) Alka-Seltzer cold and flu preparation
C) Ensure nutritional supplement
D) Calcium (Os-Cal)

Question 15

An older adult client taking digoxin telephones the clinic nurse to say she has no more digoxin pills and cannot get to the pharmacy.She asks if she can take one of her friend's pills because she also takes digoxin.The nurse should tell the client "no" for which of the following reasons?

A) "It will cause confusion for dosing later in the week."
B) "You are more likely to forget again in the future if you borrow pills now."
C) "Using another brand could precipitate drug hypersensitivity."
D) "The effect of your friend's drug on your heart could be different."

Question 16

The nurse reviewing the electrocardiograms of assigned clients realizes that which rhythm would not be amenable to treatment with digoxin (Lanoxin)?

A) Premature ventricular contractions
B) Paroxysmal atrial tachycardia
C) Atrial fibrillation
D) Atrial flutter

Question 17

A client reports beginning to "see green lights." The nurse could consider that this symptom represents which of the following?

A) An adverse effect of being in an intensive care unit
B) A possible adverse effect of the digoxin the client is receiving
C) An overreaction to the narcotic analgesic morphine
D) Vasodilation from the cardiac glycoside

Question 18

The nurse overhears a physician stating that a client will be starting drug therapy with inamrinone (Inocor).The nurse prepares to gather the supplies needed to give this drug by which of the following routes?

A) Oral
B) Subcutaneous
C) Intramuscular
D) Intravenous

Question 19

Cardiac glycosides are the "cornerstone" of the pharmacologic management of heart failure because they are

A) positive inotropics.
B) negative dromotropics.
C) positive chronotropics.
D) negative somatotropics.

Question 20

The nurse determines that administering a prescribed dose of digoxin (Lanoxin)to an assigned client is safe after noting that the client's potassium level drawn earlier that day was

A) 1.9 mEq/L.
B) 2.8 mEq/L.
C) 3.9 mEq/L.
D) 5.4 mEq/L.

Question 21

A client is receiving milrinone (Primacor).Because of concern about possible adverse drug reactions,the nurse places highest priority on noting which of the following client laboratory test results?

A) Sodium level
B) Platelet count
C) White blood cell count
D) Blood urea nitrogen

Question 22

The nurse places highest priority on attending to which of the following adverse effects experienced by a client receiving nesiritide (Natrecor)?

A) Dizziness
B) Nausea
C) Ventricular dysrhythmias
D) Back pain