Karch’s Focus on Nursing
Pharmacology
9th Edition
Author(s)Rebecca G. Tucker
TEST BANK
Question 1
A nurse is preparing to administer a scheduled dose of digoxin
to a patient with heart failure. The patient's apical pulse is 52
beats per minute, and the patient reports seeing "yellow halos"
around the lights in the room. Which action should the nurse
take first?
A. Administer the digoxin as ordered, as the pulse is within an
acceptable range for this medication.
,B. Withhold the digoxin, assess the patient further, and notify
the healthcare provider.
C. Administer the digoxin and then recheck the pulse in 30
minutes.
D. Give the digoxin with a full glass of water to enhance
absorption.
Correct Answer: B. Withhold the digoxin, assess the patient
further, and notify the healthcare provider.
Rationale: The patient is exhibiting signs of digoxin toxicity,
which include bradycardia (apical pulse < 60 bpm) and visual
disturbances like yellow or green halos. The nurse's priority is to
withhold the medication to prevent further toxicity, assess the
patient (e.g., for other symptoms, lab values like serum digoxin
and potassium levels), and notify the provider for further
orders .
Why the Other Options Are Incorrect
A. The pulse is below the typical parameter of 60 bpm for
holding digoxin, making administration unsafe.
C. Administering the medication when toxicity is suspected is
unsafe. Rechecking the pulse does not address the visual
disturbance.
D. While taking digoxin with food can affect absorption, this
does not address the critical issue of potential toxicity.
,Learning Objective: Apply the nursing process to monitor for
and respond to adverse effects and toxicity of cardiac
glycosides.
Bloom's Taxonomy: Apply
Difficulty: Easy
NCLEX Client Needs Category: Pharmacological and Parenteral
Therapies
NCJMM Clinical Judgment Skill: Recognize Cues
Question 2
A patient with type 2 diabetes is prescribed metformin. The
nurse is providing patient education. Which statement by the
patient indicates a correct understanding of the medication?
A. "I should take this medication with my meals to prevent an
upset stomach."
B. "I can stop taking this medication once my blood sugar levels
are normal."
C. "This medication increases the amount of insulin my
pancreas makes."
D. "I should check my blood sugar only once a week while on
this medication."
, Correct Answer: A. "I should take this medication with my
meals to prevent an upset stomach."
Rationale: Metformin is a biguanide that decreases hepatic
glucose production and increases insulin sensitivity. A common
side effect is gastrointestinal distress, which can be minimized
by taking the medication with food .
Why the Other Options Are Incorrect
B. Metformin is a chronic medication for managing diabetes; it
should not be stopped without a provider's order, even if
glucose levels are normal.
C. This describes the action of sulfonylureas, not metformin.
D. Patients on metformin need to monitor their blood glucose
regularly, as directed by their provider, to manage their
condition and adjust therapy.
Learning Objective: Develop a teaching plan for a patient
prescribed metformin, including administration, side effects,
and monitoring.
Bloom's Taxonomy: Evaluate
Difficulty: Easy
NCLEX Client Needs Category: Pharmacological and Parenteral
Therapies
NCJMM Clinical Judgment Skill: Evaluate Outcomes
Pharmacology
9th Edition
Author(s)Rebecca G. Tucker
TEST BANK
Question 1
A nurse is preparing to administer a scheduled dose of digoxin
to a patient with heart failure. The patient's apical pulse is 52
beats per minute, and the patient reports seeing "yellow halos"
around the lights in the room. Which action should the nurse
take first?
A. Administer the digoxin as ordered, as the pulse is within an
acceptable range for this medication.
,B. Withhold the digoxin, assess the patient further, and notify
the healthcare provider.
C. Administer the digoxin and then recheck the pulse in 30
minutes.
D. Give the digoxin with a full glass of water to enhance
absorption.
Correct Answer: B. Withhold the digoxin, assess the patient
further, and notify the healthcare provider.
Rationale: The patient is exhibiting signs of digoxin toxicity,
which include bradycardia (apical pulse < 60 bpm) and visual
disturbances like yellow or green halos. The nurse's priority is to
withhold the medication to prevent further toxicity, assess the
patient (e.g., for other symptoms, lab values like serum digoxin
and potassium levels), and notify the provider for further
orders .
Why the Other Options Are Incorrect
A. The pulse is below the typical parameter of 60 bpm for
holding digoxin, making administration unsafe.
C. Administering the medication when toxicity is suspected is
unsafe. Rechecking the pulse does not address the visual
disturbance.
D. While taking digoxin with food can affect absorption, this
does not address the critical issue of potential toxicity.
,Learning Objective: Apply the nursing process to monitor for
and respond to adverse effects and toxicity of cardiac
glycosides.
Bloom's Taxonomy: Apply
Difficulty: Easy
NCLEX Client Needs Category: Pharmacological and Parenteral
Therapies
NCJMM Clinical Judgment Skill: Recognize Cues
Question 2
A patient with type 2 diabetes is prescribed metformin. The
nurse is providing patient education. Which statement by the
patient indicates a correct understanding of the medication?
A. "I should take this medication with my meals to prevent an
upset stomach."
B. "I can stop taking this medication once my blood sugar levels
are normal."
C. "This medication increases the amount of insulin my
pancreas makes."
D. "I should check my blood sugar only once a week while on
this medication."
, Correct Answer: A. "I should take this medication with my
meals to prevent an upset stomach."
Rationale: Metformin is a biguanide that decreases hepatic
glucose production and increases insulin sensitivity. A common
side effect is gastrointestinal distress, which can be minimized
by taking the medication with food .
Why the Other Options Are Incorrect
B. Metformin is a chronic medication for managing diabetes; it
should not be stopped without a provider's order, even if
glucose levels are normal.
C. This describes the action of sulfonylureas, not metformin.
D. Patients on metformin need to monitor their blood glucose
regularly, as directed by their provider, to manage their
condition and adjust therapy.
Learning Objective: Develop a teaching plan for a patient
prescribed metformin, including administration, side effects,
and monitoring.
Bloom's Taxonomy: Evaluate
Difficulty: Easy
NCLEX Client Needs Category: Pharmacological and Parenteral
Therapies
NCJMM Clinical Judgment Skill: Evaluate Outcomes
