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1. A client takes digoxin 0.25 mg daily. Which finding
suggests digoxin toxicity?
A. Heart rate 72 bpm
B. Yellow-tinged vision
C. Blood pressure 130/80
D. Urine output 50 mL/hr
Answer: B
Rationale: Yellow or halos around vision (xanthopsia) is
classic for digoxin toxicity. Bradycardia, nausea, and
arrhythmias are also signs.
2. A nurse administers furosemide IV. Which lab requires
priority follow-up?
A. Sodium 135 mEq/L
B. Potassium 2.9 mEq/L
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,C. Glucose 110 mg/dL
D. Creatinine 0.9 mg/dL
Answer: B
Rationale: Hypokalemia (K+ <3.5) increases risk of
arrhythmias and digoxin toxicity. Furosemide is a loop
diuretic causing potassium loss.
3. A client on metoprolol reports dizziness and HR 52
bpm. What is the nurse’s priority?
A. Give the medication as ordered
B. Hold dose and notify provider
C. Increase fluids
D. Administer atropine
Answer: B
Rationale: Beta-blockers should be held if HR <60
(depending on order) and provider notified. Bradycardia
is a common adverse effect.
4. Which instruction is correct for sublingual nitroglycerin?
A. Swallow with full glass of water
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,B. Take up to 3 doses 5 minutes apart for chest pain
C. Store bottle in refrigerator
D. Discard 6 months after opening
Answer: B
Rationale: Standard: 1 tablet q5min x3 doses for chest
pain. Call 911 if no relief after first dose. Store in
original dark bottle, not refrigerated.
5. A client on amiodarone develops cough and dyspnea.
What does the nurse suspect?
A. Heart failure exacerbation
B. Pulmonary toxicity
C. Beta-blocker effect
D. Allergic reaction
Answer: B
Rationale: Amiodarone causes pulmonary fibrosis. New
cough/dyspnea needs chest X-ray and possibly stopping
the drug.
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, 6. A client takes lisinopril. Which adverse effect requires
immediate teaching?
A. Dry cough
B. Swelling of tongue and lips
C. Headache
D. Fatigue
Answer: B
Rationale: Angioedema (airway compromise) is a medical
emergency. Dry cough is common but not emergent.
7. A client on warfarin has INR 4.5. No bleeding. What
action is correct?
A. Administer vitamin K immediately
B. Hold next dose and notify provider
C. Give protamine sulfate
D. Increase warfarin dose
Answer: B
Rationale: INR 4.5 is above typical therapeutic range (2-
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