Question 1
A 68‐year‐old client with congestive heart failure is
receiving digoxin for systolic dysfunction. Which electrolyte
imbalance most increases the risk of digoxin toxicity?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: B. Hypokalemia
Rationale:
Digoxin binds at the same receptor site as potassium.
When serum potassium is low, digoxin binds more easily,
increasing the risk of toxicity (manifested by arrhythmias
and gastrointestinal distress). Although hypomagnesemia
(D) can also worsen toxicity, the most significant risk in
this scenario is hypokalemia. Hyperkalemia (A) typically is
seen when digoxin toxicity is already present, while
hypercalcemia (C) is a less direct factor.
Question 2
A client on warfarin therapy states that she consumes
leafy green vegetables daily. What is the best nursing
action?
A. Advise replacing leafy greens with low-potassium fruits.
B. Inform the client that the provider must be notified about
, her consistent diet.
C. Commend the healthy eating habits and encourage
continuation.
D. Tell the client that vitamin K intake increases warfarin’s
effectiveness.
Answer: B. Inform the client that the provider must be
notified about her consistent diet.
Rationale:
Warfarin’s anticoagulant effect is antagonized by vitamin
K. A consistent intake of vitamin K helps the provider
adjust the warfarin dose for steady anticoagulation. A
sudden change in dietary vitamin K can result in
unpredictable INR levels. Option A would alter her
nutritional balance unnecessarily, option C overlooks the
need for precise dose adjustments, and option D is
incorrect since vitamin K actually reduces warfarin’s effect.
Question 3
A 45‐year‐old client is prescribed a broad-spectrum
antibiotic for a severe infection. Which instruction is most
important regarding taking the medication?
A. Take the medication with food to minimize stomach
upset.
B. Complete the full course of therapy even if you feel
better.
C. Discontinue if a rash appears.
D. Split the dose evenly between meals.
A 68‐year‐old client with congestive heart failure is
receiving digoxin for systolic dysfunction. Which electrolyte
imbalance most increases the risk of digoxin toxicity?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: B. Hypokalemia
Rationale:
Digoxin binds at the same receptor site as potassium.
When serum potassium is low, digoxin binds more easily,
increasing the risk of toxicity (manifested by arrhythmias
and gastrointestinal distress). Although hypomagnesemia
(D) can also worsen toxicity, the most significant risk in
this scenario is hypokalemia. Hyperkalemia (A) typically is
seen when digoxin toxicity is already present, while
hypercalcemia (C) is a less direct factor.
Question 2
A client on warfarin therapy states that she consumes
leafy green vegetables daily. What is the best nursing
action?
A. Advise replacing leafy greens with low-potassium fruits.
B. Inform the client that the provider must be notified about
, her consistent diet.
C. Commend the healthy eating habits and encourage
continuation.
D. Tell the client that vitamin K intake increases warfarin’s
effectiveness.
Answer: B. Inform the client that the provider must be
notified about her consistent diet.
Rationale:
Warfarin’s anticoagulant effect is antagonized by vitamin
K. A consistent intake of vitamin K helps the provider
adjust the warfarin dose for steady anticoagulation. A
sudden change in dietary vitamin K can result in
unpredictable INR levels. Option A would alter her
nutritional balance unnecessarily, option C overlooks the
need for precise dose adjustments, and option D is
incorrect since vitamin K actually reduces warfarin’s effect.
Question 3
A 45‐year‐old client is prescribed a broad-spectrum
antibiotic for a severe infection. Which instruction is most
important regarding taking the medication?
A. Take the medication with food to minimize stomach
upset.
B. Complete the full course of therapy even if you feel
better.
C. Discontinue if a rash appears.
D. Split the dose evenly between meals.
