Nclex Cardiovascular Medications 105 Nursing Practice Questions Review.

1. The nurse is giving the client digoxin for heart failure and recognizes that the drug has what type of effect on the heart? a. Negative inotropic, negative chronotropic effect b. Positive inotropic, negative chronotropic effect c. Negative inotropic, positive inotropic effect d. Positive inotropic, positive chronotropic effect. Answer: b. Digoxin strengthens the heart muscle, providing and inotropic effect and decreases the heart rate, having a negative chronotropic effect on the heart. The end result is an improvement in heart failure symptoms. 2. The nurse is caring for a heart client on digoxin and notes a potassium level of 2.5. What is the appropriate priority nursing intervention? a. Do nothing as this is a normal potassium level. b. The potassium level is low so the nurse asks for an order for potassium. c. The nurse asks to check the digoxin level as low potassium can increase digoxin toxicity d. The nurse stops the digoxin. Answer: c. The potassium is low and this can cause digoxin toxicity so a digoxin level should be checked as a priority. A secondary priority item is to ask for an order for potassium replacement. The digoxin shouldn’t be stopped unless the digoxin level is toxic. 3. The client asks about side effects of taking digoxin. How does the nurse respond? a. Anorexia can be a side effect of digoxin. b. Tachycardia can be a side effect of digoxin. c. Constipation can be a side effect of digoxin. d. Urinary retention can be a side effect of digoxin. Answer: a. Anorexia, nausea, vomiting and diarrhea are side effects of digoxin. It can cause bradycardia but does not cause urinary retention or constipation. 4. The client is on hydrochlorothiazide and digoxin. What effect can the nurse expect? a. Hydrochlorothiazide increases digoxin levels. b. Hydrochlorothiazide decreases digoxin levels. c. Hydrochlorothiazide decreases potassium, increasing the risk of digoxin toxicity. d. Digoxin can increase the effectiveness of hydrochlorothiazide. Answer: c. Hydrochlorothiazide decreases potassium and can increase the risk of digoxin toxicity. It does not directly affect the digoxin level and digoxin does not increase the effectiveness of hydrochlorothiazide. 5. Which order should the nurse question? a. The addition of a loop diuretic with digoxin. b. The addition of a beta blocker with digoxin. c. A digoxin dose of 0.125 mg per day. d. The addition of an ACE inhibitor with digoxin. Answer: b. Adding a beta blocker to digoxin can potentiate the bradycardic effect of the digoxin so the two should be used cautiously together. The normal dosage of digoxin is 0.125-0.25 mg per day. It does not interact with an ACE inhibitor or a loop diuretic.