Chapter 25: Heart Failure Drugs
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice
MULTIPLE CHOICE
1. A patient about to receive his morning dose of digoxin (Lanoxin®) has an apical pulse of 70 beats per
minute. What should the nurse do?
a. Administer the dose
b. Withhold the dose and notify the physician
c. Notify the physician and monitor the patient’s vital signs d. Recheck the pulse, making sure to count
for 1 full minute
ANS: A
Administer the dose if the apical pulse is 70 beats per minute; the dose should be held and the physician
notified if the apical pulse is 60 beats per minute or less or higher than 120 beats per minute.
DIF: Cognitive Level: Application
2. The nurse is assessing the patient before administration of a cardiac glycoside. Which condition can
predispose a patient to digitalis toxicity?
a. Hypokalemia
b. Hyperkalemia c. Hypocalcemia d. Heart failure
ANS: A
Hypokalemia and hypercalcemia are two conditions that predispose a patient to digitalis toxicity. Heart
failure is a therapeutic use for digitalis.
DIF: Cognitive Level: Comprehension
, 3. The nurse who is assessing a patient who is receiving intravenous (IV) digitalis recognizes that the drug
has a negative chronotropic effect. How is a negative chronotropic effect evident in a patient?
a. By an increased heart rate b. By a decreased heart rate c. By decreased conduction
d. By increased ectopic beats
ANS: B
A negative chronotropic effect results in a reduced heart rate, which is one effect of cardiac glycosides.
DIF: Cognitive Level: Application
4. A patient has been taking digoxin (Lanoxin) at home but has developed toxicity. The physician has
ordered digoxin immune Fab.
The patient asks the nurse why the medication has been changed. Which is the nurse’s best response?
a. “It works faster than digoxin.”
b. “It is safer than digoxin and can be taken orally.”
c. “It helps to convert the fibrillating atria to a more normal rhythm.”
d. “This new drug is an antidote to digoxin and will help to lower the blood levels.”
ANS: D
Digoxin immune Fab, which is available as an IV dose only, is the antidote for a severe digoxin overdose.
DIF: Cognitive Level: Analysis
5. A patient has been placed on a milrinone infusion as part of the therapy for end-stage heart failure.
What risk should the nurse keep in mind while assessing this patient during the infusion?
a. Hypotension
b. Hyperkalemia
c. Hypertension
d. Decreased urine output
ANS: A
Milrinone may cause significant hypotension. DIF: Cognitive Level: Application
6. A patient with atrial fibrillation has been started on digoxin (Lanoxin), and 1 week later a digoxin level
is drawn. Which result is within the normal therapeutic levels for digoxin?
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice
MULTIPLE CHOICE
1. A patient about to receive his morning dose of digoxin (Lanoxin®) has an apical pulse of 70 beats per
minute. What should the nurse do?
a. Administer the dose
b. Withhold the dose and notify the physician
c. Notify the physician and monitor the patient’s vital signs d. Recheck the pulse, making sure to count
for 1 full minute
ANS: A
Administer the dose if the apical pulse is 70 beats per minute; the dose should be held and the physician
notified if the apical pulse is 60 beats per minute or less or higher than 120 beats per minute.
DIF: Cognitive Level: Application
2. The nurse is assessing the patient before administration of a cardiac glycoside. Which condition can
predispose a patient to digitalis toxicity?
a. Hypokalemia
b. Hyperkalemia c. Hypocalcemia d. Heart failure
ANS: A
Hypokalemia and hypercalcemia are two conditions that predispose a patient to digitalis toxicity. Heart
failure is a therapeutic use for digitalis.
DIF: Cognitive Level: Comprehension
, 3. The nurse who is assessing a patient who is receiving intravenous (IV) digitalis recognizes that the drug
has a negative chronotropic effect. How is a negative chronotropic effect evident in a patient?
a. By an increased heart rate b. By a decreased heart rate c. By decreased conduction
d. By increased ectopic beats
ANS: B
A negative chronotropic effect results in a reduced heart rate, which is one effect of cardiac glycosides.
DIF: Cognitive Level: Application
4. A patient has been taking digoxin (Lanoxin) at home but has developed toxicity. The physician has
ordered digoxin immune Fab.
The patient asks the nurse why the medication has been changed. Which is the nurse’s best response?
a. “It works faster than digoxin.”
b. “It is safer than digoxin and can be taken orally.”
c. “It helps to convert the fibrillating atria to a more normal rhythm.”
d. “This new drug is an antidote to digoxin and will help to lower the blood levels.”
ANS: D
Digoxin immune Fab, which is available as an IV dose only, is the antidote for a severe digoxin overdose.
DIF: Cognitive Level: Analysis
5. A patient has been placed on a milrinone infusion as part of the therapy for end-stage heart failure.
What risk should the nurse keep in mind while assessing this patient during the infusion?
a. Hypotension
b. Hyperkalemia
c. Hypertension
d. Decreased urine output
ANS: A
Milrinone may cause significant hypotension. DIF: Cognitive Level: Application
6. A patient with atrial fibrillation has been started on digoxin (Lanoxin), and 1 week later a digoxin level
is drawn. Which result is within the normal therapeutic levels for digoxin?
