NSG 318 Final Exam Study Guide | Complete
Exam Prep with Actual Questions and
Verified Correct Answers | Latest Updated
Edition 2026/2027
Question 1
Which medication is in the cardiac glycoside drug class?
A. Coumadin
B. Plavix
C. Digoxin
D. Nitroglycerin
Answer: C
Rationale: Digoxin is a cardiac glycoside used to treat heart failure and atrial
fibrillation. Nitroglycerin (D) is an antianginal. Coumadin (A) is an anticoagulant.
Plavix (B) is an antiplatelet agent.
Question 2
What are the uses of Digoxin?
A. Used to prevent blood clots
B. Used to treat heart failure and atrial fibrillation
C. Used to treat hypertension and angina
D. Used to lower cholesterol
Answer: B
Rationale: Digoxin is used to treat heart failure by increasing the force of
myocardial contraction and to treat atrial fibrillation by slowing the heart rate.
Question 3
A patient's serum digoxin level is 1.1 ng/mL. What action should the nurse take?
A. Retake the lab test
B. Split the dose in half
C. Inform the HCP
D. Give the next dose
pg. 1
,Answer: C
Rationale: The therapeutic serum digoxin level is 0.5-1.0 ng/mL. A level of 1.1
ng/mL indicates toxicity. The nurse should inform the healthcare provider and hold
the next dose.
Question 4
What is the therapeutic serum level of digoxin?
A. 1.0 - 2.0 ng/mL
B. 2.0 - 3.0 ng/mL
C. 3.0 - 4.0 ng/mL
D. 0.5 - 1.0 ng/mL
Answer: D
Rationale: The therapeutic serum level of digoxin is 0.5-1.0 ng/mL. Levels above
1.0 ng/mL indicate toxicity.
Question 5
The nurse is caring for a patient on digoxin therapy. The student nurse asks the
nurse what are signs of digoxin toxicity. What should the nurse teach the student
nurse?
A. Depression
B. Green or yellow halos
C. Circulatory collapse
D. Tachycardia
Answer: B
Rationale: Signs of digoxin toxicity include green or yellow halos (visual
disturbances), cardiac dysrhythmias, bradycardia, vomiting, anorexia, and diarrhea.
Tachycardia (D) is not a sign—bradycardia is.
Question 6
A patient on digoxin therapy reports having blurred vision and yellow halos and
respirations are 5 per minute. What action should the nurse take next?
A. Administer vitamin K
B. Nothing, these are normal side effects
C. Administer digoxin immune fab
D. Administer protamine
pg. 2
,Answer: C
Rationale: Digoxin immune fab (Digibind) reverses digoxin toxicity by binding to
digoxin and preventing its effects. This is especially important when the patient has
bradycardia or respiratory depression. Protamine (D) reverses heparin. Vitamin K
(A) reverses warfarin.
Question 7
Which CAMs increase the risk of digitalis toxicity? (Select all that apply)
A. Cinnamon
B. Green tea
C. Gingko
D. Ginseng
E. Licorice
F. Parsley
G. Aloe
H. Ephedra
Answer: D, E, G, H
Rationale: Ginseng, licorice, aloe, and ephedra can increase the risk of digitalis
toxicity. Gingko (C), cinnamon (A), parsley (F), and green tea (B) do not have
significant interactions with digoxin.
Question 8
A patient on digoxin therapy frequently takes CAMs. Which CAMs should the
nurse educate the patient to avoid?
A. Gingko, Cinnamon, Green tea, and Parsley
B. Ginseng, St. John's Wort, Psyllium, Hawthorn, Licorice, Aloe, and Ephedra
C. Garlic, Ginger, and Chamomile
D. Valerian, Kava, and Echinacea
Answer: B
Rationale: Ginseng, St. John's Wort, psyllium, hawthorn, licorice, aloe, and
ephedra should be avoided due to interactions with digoxin. These CAMs can
increase toxicity or alter digoxin levels.
pg. 3
, Question 9
What are 3 important things a nurse needs to watch for during digoxin therapy?
A. Apical pulse > 60, Toxicity: 0.5-1.0 ng/mL, Potassium: increases risk of
digitalis toxicity
B. Radial pulse > 60, Toxicity: 0.5-1.0 ng/mL, Calcium: increases risk
C. Apical pulse < 60, Toxicity: 1.0-2.0 ng/mL, Sodium: increases risk
D. Apical pulse > 60, Toxicity: 2.0-3.0 ng/mL, Magnesium: increases risk
Answer: A
Rationale: The nurse should monitor the apical pulse for > 60 bpm before
administering digoxin, check digoxin levels (0.5-1.0 ng/mL therapeutic), and
monitor potassium levels because hypokalemia increases the risk of digitalis
toxicity.
Question 10
Which medication is in the antianginal drug class?
A. Coumadin
B. Digoxin
C. Plavix
D. Nitroglycerin
Answer: D
Rationale: Nitroglycerin is an antianginal medication used to treat angina pectoris.
Digoxin (B) is a cardiac glycoside. Coumadin (A) is an anticoagulant. Plavix (C) is
an antiplatelet agent.
Question 11
How should a nurse instruct a patient to take nitroglycerin?
A. Take 1 dose before activity to prevent chest pain
B. Take 1 dose when chest pain begins; if still in pain in 10 minutes, call 911 and
take a 2nd dose
C. Take 1 dose daily at bedtime
D. Take 1 dose when chest pain begins; if still in pain in 5 minutes, call 911 and
take a 2nd dose; if still in pain in 5 more minutes and EMT has not arrived, take a
3rd and final dose
Answer: D
Rationale: The most common route is sublingual. Patients should take 1 dose
pg. 4
Exam Prep with Actual Questions and
Verified Correct Answers | Latest Updated
Edition 2026/2027
Question 1
Which medication is in the cardiac glycoside drug class?
A. Coumadin
B. Plavix
C. Digoxin
D. Nitroglycerin
Answer: C
Rationale: Digoxin is a cardiac glycoside used to treat heart failure and atrial
fibrillation. Nitroglycerin (D) is an antianginal. Coumadin (A) is an anticoagulant.
Plavix (B) is an antiplatelet agent.
Question 2
What are the uses of Digoxin?
A. Used to prevent blood clots
B. Used to treat heart failure and atrial fibrillation
C. Used to treat hypertension and angina
D. Used to lower cholesterol
Answer: B
Rationale: Digoxin is used to treat heart failure by increasing the force of
myocardial contraction and to treat atrial fibrillation by slowing the heart rate.
Question 3
A patient's serum digoxin level is 1.1 ng/mL. What action should the nurse take?
A. Retake the lab test
B. Split the dose in half
C. Inform the HCP
D. Give the next dose
pg. 1
,Answer: C
Rationale: The therapeutic serum digoxin level is 0.5-1.0 ng/mL. A level of 1.1
ng/mL indicates toxicity. The nurse should inform the healthcare provider and hold
the next dose.
Question 4
What is the therapeutic serum level of digoxin?
A. 1.0 - 2.0 ng/mL
B. 2.0 - 3.0 ng/mL
C. 3.0 - 4.0 ng/mL
D. 0.5 - 1.0 ng/mL
Answer: D
Rationale: The therapeutic serum level of digoxin is 0.5-1.0 ng/mL. Levels above
1.0 ng/mL indicate toxicity.
Question 5
The nurse is caring for a patient on digoxin therapy. The student nurse asks the
nurse what are signs of digoxin toxicity. What should the nurse teach the student
nurse?
A. Depression
B. Green or yellow halos
C. Circulatory collapse
D. Tachycardia
Answer: B
Rationale: Signs of digoxin toxicity include green or yellow halos (visual
disturbances), cardiac dysrhythmias, bradycardia, vomiting, anorexia, and diarrhea.
Tachycardia (D) is not a sign—bradycardia is.
Question 6
A patient on digoxin therapy reports having blurred vision and yellow halos and
respirations are 5 per minute. What action should the nurse take next?
A. Administer vitamin K
B. Nothing, these are normal side effects
C. Administer digoxin immune fab
D. Administer protamine
pg. 2
,Answer: C
Rationale: Digoxin immune fab (Digibind) reverses digoxin toxicity by binding to
digoxin and preventing its effects. This is especially important when the patient has
bradycardia or respiratory depression. Protamine (D) reverses heparin. Vitamin K
(A) reverses warfarin.
Question 7
Which CAMs increase the risk of digitalis toxicity? (Select all that apply)
A. Cinnamon
B. Green tea
C. Gingko
D. Ginseng
E. Licorice
F. Parsley
G. Aloe
H. Ephedra
Answer: D, E, G, H
Rationale: Ginseng, licorice, aloe, and ephedra can increase the risk of digitalis
toxicity. Gingko (C), cinnamon (A), parsley (F), and green tea (B) do not have
significant interactions with digoxin.
Question 8
A patient on digoxin therapy frequently takes CAMs. Which CAMs should the
nurse educate the patient to avoid?
A. Gingko, Cinnamon, Green tea, and Parsley
B. Ginseng, St. John's Wort, Psyllium, Hawthorn, Licorice, Aloe, and Ephedra
C. Garlic, Ginger, and Chamomile
D. Valerian, Kava, and Echinacea
Answer: B
Rationale: Ginseng, St. John's Wort, psyllium, hawthorn, licorice, aloe, and
ephedra should be avoided due to interactions with digoxin. These CAMs can
increase toxicity or alter digoxin levels.
pg. 3
, Question 9
What are 3 important things a nurse needs to watch for during digoxin therapy?
A. Apical pulse > 60, Toxicity: 0.5-1.0 ng/mL, Potassium: increases risk of
digitalis toxicity
B. Radial pulse > 60, Toxicity: 0.5-1.0 ng/mL, Calcium: increases risk
C. Apical pulse < 60, Toxicity: 1.0-2.0 ng/mL, Sodium: increases risk
D. Apical pulse > 60, Toxicity: 2.0-3.0 ng/mL, Magnesium: increases risk
Answer: A
Rationale: The nurse should monitor the apical pulse for > 60 bpm before
administering digoxin, check digoxin levels (0.5-1.0 ng/mL therapeutic), and
monitor potassium levels because hypokalemia increases the risk of digitalis
toxicity.
Question 10
Which medication is in the antianginal drug class?
A. Coumadin
B. Digoxin
C. Plavix
D. Nitroglycerin
Answer: D
Rationale: Nitroglycerin is an antianginal medication used to treat angina pectoris.
Digoxin (B) is a cardiac glycoside. Coumadin (A) is an anticoagulant. Plavix (C) is
an antiplatelet agent.
Question 11
How should a nurse instruct a patient to take nitroglycerin?
A. Take 1 dose before activity to prevent chest pain
B. Take 1 dose when chest pain begins; if still in pain in 10 minutes, call 911 and
take a 2nd dose
C. Take 1 dose daily at bedtime
D. Take 1 dose when chest pain begins; if still in pain in 5 minutes, call 911 and
take a 2nd dose; if still in pain in 5 more minutes and EMT has not arrived, take a
3rd and final dose
Answer: D
Rationale: The most common route is sublingual. Patients should take 1 dose
pg. 4
