Pharmacology exam 3

The nurse is providing education to a client who is being started on atenolol. Which statement by the client indicates that teaching has been effective? 1."I am taking this medication for hypertension." 2."It is to help manage my rheumatoid arthritis." 3."This medication will help my ulcerative colitis." 4."This medication will reverse my second-degree heart block."

1."I am taking this medication for hypertension." Atenolol is a beta-adrenergic blocker that is used as an antihypertensive, antianginal, and antidysrhythmic. It is used to treat conditions such as hypertension and angina pectoris. It is not used to treat the conditions noted in the other options. In addition, its use is contraindicated in the client with heart block greater than first degree.

The home care nurse has given instructions to a client who is beginning therapy with digoxin for atrial fibrillation. The nurse determines a need for further teaching if the client makes which statement? 1."If I miss a dose, I should just take 2 the next day." 2."I shouldn't change brands without asking the primary health care provider first." 3."I should call the primary health care provider if my daily pulse rate is under 60 or over 100." 4."The pills should be kept in their original container so they don't get mixed up with my other medicines."

1."If I miss a dose, I should just take 2 the next day." Client teaching should include taking the dose exactly as prescribed each day. If the client misses a dose and more than 12 hours goes by, that dose should be omitted, and only the next scheduled dose should be taken; the client should not double-dose. The primary health care provider (PHCP) should be consulted before changing brands because the bioavailability of another preparation of the medication may be different. A daily pulse check is necessary, and the client should know the parameters for which the PHCP should be called. Clients are advised not to mix digoxin in pill boxes with other medications.

The nurse is monitoring a client for adverse effects of medications. Which findings are characteristic of adverse effects of hydrochlorothiazide? Select all that apply. 1.Sulfa allergy 2.Osteoporosis 3.Hypokalemia 4.Hypouricemia 5.Hyperglycemia 6.Hypercalcemia

1.) Sulfa allergy 3.) Hypokalemia 5.) Hyperglycemia 6.) Hypercalcemia

The nurse is reviewing the record of a client who arrives at the health care clinic. The nurse notes that irbesartan has been prescribed for the client. The nurse should suspect that the client has which condition? 1.Hypertension 2.Hypothyroidism 3.Diabetes mellitus 4.Renal transplant rejection

1.Hypertension Irbesartan is an angiotensin II type 1 receptor antagonist. It is used to treat hypertension. This medication is not used to treat hypothyroidism, diabetes mellitus, or renal transplant rejection.

A client who is taking chlorothiazide comes to the clinic for periodic evaluation. In monitoring the client's laboratory test results for medication side effects, what is the clinic nurse most likely to note if a side or adverse effect is present? 1.Hypokalemia 2.Hypocalcemia 3.Hypernatremia 4.Hyperphosphatemia

1.Hypokalemia The client taking a potassium-losing diuretic such as chlorothiazide should be monitored for decreased potassium levels. Other possible fluid and electrolyte imbalances that occur with use of this medication include hypercalcemia, hyponatremia, hypophosphatemia, and hypomagnesemia.

A client has been prescribed pindolol for hypertension. The nurse provides anticipatory guidance, knowing that which common side effect of this medication may decrease client compliance? 1.Impotence 2.Mood swings 3.Increased appetite 4.Difficulty swallowing

1.Impotence A common side effect of beta-adrenergic blocking agents such as pindolol is impotence. Other common side effects include fatigue and weakness. Central nervous system side effects are rarer and include mental status changes, nervousness, depression, and insomnia. Mood swings, increased appetite, and difficulty swallowing are not side effects of this medication.

Atenolol has been prescribed for a client, and the client asks the nurse about the action of the medication. How should the nurse respond regarding the action of this medication? 1.Slows the heart rate 2.Increases cardiac output 3.Increases myocardial oxygen demand 4.Maintains the blood pressure at a level within the 140/90 mm Hg range

1.Slows the heart rate Atenolol is a beta-adrenergic blocker that is used as an antihypertensive, antianginal, and antidysrhythmic. It blocks beta-adrenergic receptors in cardiac tissue and produces the therapeutic effects of slowing the heart rate, decreasing cardiac output, decreasing myocardial oxygen demand, and decreasing blood pressure.

The nurse has given a client information about the use of nitroglycerin sublingual tablets. The client has a prescription for PRN (as needed) use if chest pain occurs. Which client statement indicates an understanding of this medication? 1."It's best to keep this medication in a shirt pocket close to the body." 2."I need to discard unused tablets 6 months after the bottle is opened." 3."I will avoid using the medication until the chest pain actually begins and gets worse." 4."I can take aspirin for any headache that occurs when I first start taking the nitroglycerin."

2."I need to discard unused tablets 6 months after the bottle is opened."

Atenolol has been prescribed for a client, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching? 1."I need to rise slowly from a lying to a sitting position." 2."If I feel that my heart rate is too low, I should stop the medication." 3."It will take 1 to 2 weeks before my blood pressure becomes controlled." 4."I should avoid tasks that require alertness until I know how the medication will affect my body."

2."If I feel that my heart rate is too low, I should stop the medication."

A client in the hospital emergency department who received nitroglycerin for chest pain has obtained relief but now complains of a headache. The nurse should interpret that this client is most likely experiencing which condition? 1.An allergic reaction to nitroglycerin 2.An expected medication side effect 3.An early sign of tolerance to the medication 4.A warning that the medication should not be used again

2.An expected medication side effect Headache is a frequent side effect of nitroglycerin, resulting from its vasodilator action. It often subsides as the client becomes accustomed to the medication and is effectively treated with acetaminophen. The other options are incorrect interpretations.

Atenolol has been prescribed for a hospitalized client. The nurse should check which item before administering this medication? 1.Pedal pulses 2.Apical heart rate 3.Most recent potassium level 4.Most recent electrolyte levels

2.Apical heart rate Atenolol is a beta-adrenergic blocker that is used as an antihypertensive, antianginal, and antidysrhythmic. It blocks beta-adrenergic receptors in cardiac tissue and produces the therapeutic effects of slowing the heart rate, decreasing cardiac output, decreasing blood pressure, and decreasing myocardial oxygen demand. The nurse should check the client's apical heart rate and blood pressure immediately before administering the medication. If the heart rate is 60 beats/min or lower or if the systolic blood pressure is less than 90 mm Hg, the medication is withheld and the primary health care provider is contacted. The remaining options are unrelated to the administration of this medication.

The primary health care provider (PHCP) writes a prescription for atenolol for a client who was admitted to the hospital. The nurse contacts the PHCP to verify the prescription if which finding is noted in the assessment data? 1.Temperature is 100.1º F (37.8º C). 2.Apical heart rate is 48 beats/min. 3.Blood pressure is 138/82 mm Hg. 4.Pedal pulses are bounding and strong.

2.Apical heart rate is 48 beats/min. Atenolol is a beta-adrenergic blocker that is used as an antihypertensive, antianginal, and antidysrhythmic. It blocks beta-adrenergic receptors in cardiac tissue and produces the therapeutic effects of slowing the heart rate, decreasing cardiac output, decreasing blood pressure, and decreasing myocardial oxygen demand. Contraindications to the medication include severe bradycardia, cardiac failure, cardiogenic shock, and heart block greater than first degree. The remaining options are not contraindications to this medication

The nurse is monitoring a client with hypertension who is taking propranolol. Which assessment finding indicates a potential adverse complication associated with this medication? 1.Report of infrequent insomnia 2.Development of expiratory wheezes 3.A baseline blood pressure of 150/80 mm Hg after 2 doses of the medication 4.A baseline resting heart rate of 88 beats per minute followed by a resting heart rate of 72 beats per minute after 2 doses of the medication

2.Development of expiratory wheezes Audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm. Beta blockers may induce this reaction, particularly in clients with chronic obstructive pulmonary disease or asthma. Normal decreases in blood pressure and heart rate are expected. Insomnia is a frequent mild side effect and should be monitored.

The nurse is monitoring a client with heart failure who is taking digoxin. Which findings are characteristic of digoxin toxicity? Select all that apply. 1.Tremors 2.Diarrhea 3.Irritability 4.Blurred vision 5.Nausea and vomiting

2.Diarrhea 4.Blurred vision 5.Nausea and vomiting

The nurse provides instructions to a client about newly prescribed furosemide. Which information should the nurse use to provide instructions in this teaching session? 1.The medication acts on the distal tubule of the nephron. 2.The medication acts on the loop of Henle in the nephron. 3.The collecting duct of the nephron will be affected by this medication. 4.The site of action for furosemide is the proximal tubule of the nephron.

2.The medication acts on the loop of Henle in the nephron. Furosemide works by acting to excrete sodium, potassium, and chloride in the ascending limb of the loop of Henle; therefore, options 1, 3, and 4 are incorrect.

A client being treated for heart failure is administered intravenous bumetanide. Which outcome indicates that the medication has achieved the expected effect? 1.Cough becomes productive of frothy pink sputum. 2.Urine output increases from 10 mL/hour to greater than 50 mL hourly. 3.The serum potassium level changes from 3.8 to 3.1 mEq/L (3.8 to 3.1 mmol/L). 4.B-type natriuretic peptide (BNP) factor increases from 200 to 262 pg/mL (200 to 262 ng/L).

2.Urine output increases from 10 mL/hour to greater than 50 mL hourly. Bumetanide is a diuretic and expected outcomes include increased urine output, decreased crackles, and decreased weight. Options 1, 3, and 4 are incorrect. A cough with productive frothy sputum is indicative of pulmonary edema, a complication of heart failure. A change in serum potassium is a side effect of the medication. An increase in the BNP level indicates worsening of the condition.

A client with heart failure is scheduled to be discharged to home with digoxin and furosemide as daily prescribed medications. The nurse tells the client to report which finding as an indication that the medications are not having the intended effect? 1.Sudden increase in appetite 2.Weight gain of 2 to 3 lb in a few days 3.Increased urine output during the day 4.Cough accompanied by other signs of respiratory infection

2.Weight gain of 2 to 3 lb in a few days Clients with heart failure should immediately report weight gain, loss of appetite, shortness of breath with activity, edema, persistent cough, and nocturia. An increase in urine output during the day is expected with diuretic therapy. A cough resulting from respiratory infection does not necessarily indicate that heart failure is worsening.

The clinic nurse is providing instructions to a client with hypertension who will be taking captopril. Which statement by the client indicates a need for further instruction? 1."I need to change positions slowly." 2."I need to avoid taking hot baths or showers." 3."I need to drink at least 4 quarts (4 liters) of water daily." 4."I need to sit down and rest if dizziness or lightheadedness occurs.

3."I need to drink at least 4 quarts (4 liters) of water daily." Captopril is an antihypertensive medication (angiotensin-converting enzyme [ACE] inhibitor). Orthostatic hypotension can occur in clients taking this medication. Adequate fluid is important, but 4 quarts (4 liters) of water daily could actually aggravate the hypertension. Clients are advised to avoid standing in one position for long periods, to change positions slowly, and to avoid extreme warmth such as with baths, showers, or heat from the sun in warm weather. The client should be instructed to monitor for signs of orthostatic hypotension, such as dizziness, lightheadedness, weakness, and syncope

The nurse is caring for a client with hypertension who is receiving torsemide orally daily. Which laboratory test result would indicate to the nurse that the client may be experiencing a side or adverse effect related to the medication? 1.A chloride level of 98 mEq/L (98 mmol/L) 2.A sodium level of 135 mEq/L (135 mmol/L) 3.A potassium level of 3.1 mEq/L (3.1 mmol/L) 4.A blood urea nitrogen (BUN) of 15 mg/dL (5.4 mmol/L)

3.A potassium level of 3.1 mEq/L (3.1 mmol/L)

The nurse has given a client the prescribed dose of intravenous hydralazine. The nurse evaluates the effectiveness of the medication by monitoring which client parameter? 1.Pulse rate 2.Urine output 3.Blood pressure 4.Potassium level

3.Blood pressure Hydralazine is an antihypertensive medication used in the management of moderate to severe hypertension. It is a vasodilator medication that decreases afterload. The blood pressure needs to be monitored. The remaining options are unrelated to the use of this medication.

A client is scheduled for a dose of ramipril. The nurse should check which measurement before administering the medication 1.Weight 2.Apical pulse 3.Blood pressure 4.Potassium level

3.Blood pressure Ramipril is an angiotensin-converting enzyme (ACE) inhibitor, and a serious adverse effect of this medication is profound hypotension. The client's blood pressure should be checked before administration of this medication. The medication does not cause weight gain or loss, bradycardia, or depletion of potassium

Atenolol has been prescribed for a client with hypertension, and the client asks the nurse about the side effects of the medication. What should the nurse tell the client is an occasional side effect of this medication? 1.Dry skin 2.Flushing 3.Decreased libido 4.Increased blood pressure

3.Decreased libido

The nurse is planning to administer hydrochlorothiazide to a client diagnosed with hypertension. The nurse should monitor for which adverse effects related to the administration of this medication? 1.Hypouricemia, hyperkalemia 2.Increased risk of osteoporosis 3.Hypokalemia, hyperglycemia, sulfa allergy 4.Hyperkalemia, hypoglycemia, penicillin allergy

3.Hypokalemia, hyperglycemia, sulfa allergy Thiazide diuretics such as hydrochlorothiazide are sulfa-based medications, and a client with a sulfa allergy is at risk for an allergic reaction. Also, clients are at risk for hypokalemia, hyperglycemia, hypercalcemia, hyperlipidemia, and hyperuricemia.

A client admitted to the hospital is taking atenolol. The nurse monitors the client for which sign or symptom of an adverse effect of the medication? 1.Nausea 2.Diaphoresis 3.Hypotension 4.Tachycardia

3.Hypotension

The nurse is planning discharge teaching for a client started on acetazolamide for a supratentorial lesion. Which information about the primary action of the medication should be included in the client's education? 1.It will prevent hypertension. 2.It will prevent hyperthermia. 3.It decreases cerebrospinal fluid production. 4.It maintains adequate blood pressure for cerebral perfusion.

3.It decreases cerebrospinal fluid production. Acetazolamide is a carbonic anhydrase inhibitor and a diuretic. It is used in the client with or at risk for increased intracranial pressure to decrease cerebrospinal fluid production. The remaining options are not actions of this medication.

The nurse is caring for a client who was prescribed furosemide. The nurse should monitor the client for damage of which kidney structure? 1.Pelvis 2.Calyx 3.Nephron 4.Renal artery

3.Nephron The nephron is the functional unit of the kidney that is responsible for clearance of excess fluid and waste products of metabolism. The renal pelvis and calices collect urine to send to the ureter. The renal artery brings blood to the kidney for filtering by the nephron.

A client with cardiac disease has begun taking propranolol, and the nurse provides information to the client about the medication. The nurse should tell the client to contact the primary health care provider (PHCP) if which symptoms develop? 1.Insomnia and headache 2.Nausea and constipation 3.Night cough and dyspnea 4.Drowsiness and nightmares

3.Night cough and dyspnea Propranolol is a beta-adrenergic blocker that is used as an antihypertensive, antianginal, antidysrhythmic, and antimigraine medication. It may precipitate heart failure or myocardial infarction in clients with cardiac disease. Signs of heart failure include dyspnea (particularly on exertion or lying down), night cough, peripheral edema, and distended neck veins.

The nurse has been given a medication prescription to administer intravenous (IV) hydralazine. The nurse obtains which priority piece of equipment needed for use during administration of this medication? 1.Pulse oximetry 2.Cardiac monitor 3.Noninvasive blood pressure cuff 4.Non-rebreather oxygen face mask

3.Noninvasive blood pressure cuff Hydralazine is an antihypertensive medication used for moderate to severe hypertension. Because the blood pressure and pulse should be monitored frequently after administration, a noninvasive blood pressure cuff should be obtained. The other options are not priority items specific to the use of this medication.

The nurse is performing an assessment on a client with a diagnosis of chronic angina pectoris. The client is receiving sotalol orally daily. Which assessment finding indicates to the nurse that the client is experiencing a side or adverse effect related to the medication? 1.Dry mouth 2.Diaphoresis 3.Palpitations 4.Difficulty swallowing

3.Palpitations Sotalol is a beta-adrenergic blocking agent. Side and adverse effects include bradycardia, palpitations, difficulty breathing, irregular heartbeat, signs of heart failure, and cold hands and feet. Gastrointestinal disturbances, anxiety and nervousness, and unusual tiredness and weakness also can occur.

A client receiving total parenteral nutrition (TPN) has a history of heart failure. The primary health care provider (PHCP) has prescribed furosemide 40 mg by mouth daily to prevent fluid overload. Which laboratory value should the nurse monitor to identify the presence of an adverse effect of this medication? 1.Sodium 2.Glucose 3.Potassium 4.Magnesium

3.Potassium Furosemide is a potassium-losing diuretic, and insufficient replacement of potassium may lead to hypokalemia. Although the sodium, glucose, and magnesium levels may be monitored, these laboratory values are not specific to administering furosemide

A client is due for a dose of bumetanide. The nurse should temporarily withhold the dose and notify the primary health care provider (PHCP) if which laboratory test result is noted? 1.Sodium level of 137 mEq/L (137 mmol/L) 2.Chloride level of 106 mEq/L (106 mmol/L) 3.Potassium level of 2.9 mEq/L (2.9 mmol/L) 4.Magnesium level of 2.1 mEq/L (1.05 mmol/L)

3.Potassium level of 2.9 mEq/L (2.9 mmol/L) Bumetanide is a loop diuretic that is not potassium retaining. The value given for potassium is below the therapeutic range of 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L) for this electrolyte.

Lisinopril has been prescribed for a client with hypertension. What should the nurse instruct the client about this medication? 1.Take the medication with food only. 2.Discontinue the medication if nausea occurs. 3.Rise slowly from a reclining to a sitting position. 4.Expect to note a full therapeutic effect immediately.

3.Rise slowly from a reclining to a sitting position. Lisinopril is an angiotensin-converting enzyme inhibitor used in the treatment of hypertension. The client should be instructed to rise slowly from a reclining to a sitting position and to dangle the legs from the bed for a few moments before standing to reduce the hypotensive effect.

A client is taking amiloride 10 mg orally daily for hypertension. What medication instruction should the nurse provide to the client? 1.Take the dose without food. 2.Eat foods with extra sodium. 3.Take the dose in the morning. 4.Withhold the dose if the blood pressure is high.

3.Take the dose in the morning Amiloride is a potassium-retaining diuretic used to treat edema or hypertension. The daily dose should be taken in the morning to avoid nocturia, and the medication should be taken with food to increase bioavailability. Sodium should be restricted or limited as prescribed. Increased blood pressure is not a reason to withhold the medication; rather, it may be an indication for its use.

The nurse is auscultating a 56-year-old adult client's apical heart rate before giving digoxin and notes that the heart rate is 48 beats/minute. Which action should the nurse take? 1.Withhold the digoxin, and reevaluate the heart rate in 4 hours. 2.Administer half of the prescribed dose to avoid a further decrease in heart rate. 3.Withhold the digoxin and assess for signs of decreased cardiac output and digoxin toxicity. 4.Administer the digoxin; the heart rate would be considered normal because of the client's age.

3.Withhold the digoxin, and assess for signs of decreased cardiac output and digoxin toxicity. The normal heart rate is 60 to 100 beats/minute in an adult. If the nurse notes a heart rate that is less than 60 beats/minute, the nurse would not administer the digoxin and would further evaluate the client for signs and symptoms of digoxin toxicity. When clients are bradycardic, they may have symptoms of decreased cardiac output, so this would also be assessed.

The nurse has completed giving medication instructions to a client receiving benazepril. Which client statement indicates to the nurse that the client needs further instruction? 1."I need to change positions slowly." 2."I will monitor my blood pressure every week." 3."I will report signs and symptoms of infection immediately." 4."I can use salt substitutes freely and eat foods high in potassium."

4."I can use salt substitutes freely and eat foods high in potassium."

A client with angina pectoris has been given a new prescription for nitroglycerin transdermal patches. The client indicates an understanding of how to use this medication administration system by making which statement? 1."I need to wait until the next day to apply a new patch if it falls off." 2."I need to alternate daily dosage times to prevent tolerance to the medication." 3."I need to place the patch in the area of a skin fold to promote better adherence." 4."I need to apply the patch in the morning and leave it in place for 12 to 14 hours as directed."

4."I need to apply the patch in the morning and leave it in place for 12 to 14 hours as directed.

The nurse is reviewing the assessment findings for a client who has been taking spironolactone for treatment of hypertension. Which, if noted in the client's record, would indicate that the client is experiencing an adverse effect related to the medication? 1.Client complaint of dry skin 2.Client complaint of constipation 3.A potassium level of 3.5 mEq/L (3.5 mmol/L) 4.A potassium level of 5.8 mEq/L (5.8 mmol/L)

4.A potassium level of 5.8 mEq/L (5.8 mmol/L) Spironolactone is a potassium-retaining diuretic. Side and adverse effects include hyperkalemia, dehydration, hyponatremia, and lethargy. Although the concern with most diuretics is hypokalemia, this medication is potassium sparing, which means that the concern with this medication is hyperkalemia. Additional side and adverse effects include nausea, vomiting, cramping, diarrhea, headache, ataxia, drowsiness, confusion, and fever.

Hydrochlorothiazide has been prescribed for a client with hypertension. The nurse contacts the primary health care provider (PHCP) to verify the prescription if which condition is noted in the assessment data? 1.Hypertension 2.Allergy to eggs 3.Nephrotic syndrome 4.Allergy to sulfonamides

4.Allergy to sulfonamides Hydrochlorothiazide is a diuretic and antihypertensive medication that is used to treat mild to moderate hypertension, edema associated with heart failure, and nephrotic syndrome. The medication is a sulfonamide derivative. A contraindication to the use of this medication is a history of hypersensitivity to sulfonamides. The conditions noted in the remaining options are not contraindications for the use of this medication.

The nurse notes a persistent, dry cough in an adult client being seen in the ambulatory clinic. When questioned, the client states that the cough began approximately 2 months ago. On further assessment, the nurse learns that the client began taking quinapril shortly before the time that the cough began. How should the nurse interpret the development of the cough? 1.An early indication of heart failure 2.Caused by neutropenia as a result of therapy 3.Caused by a concurrent upper respiratory infection 4.An expected although bothersome side effect of therapy

4.An expected although bothersome side effect of therapy A frequent side effect of therapy with any angiotensin-converting enzyme (ACE) inhibitor, including quinapril, is a persistent, dry cough. In general, the cough does not resolve during the course of medication therapy, so clients should be advised to notify the primary health care provider if the cough becomes very troublesome. The other options are incorrect.

The nurse is administering a dose of clonidine to a client. The nurse should ensure that which item is in place before injecting the medication? 1.Central line 2.Foley catheter 3.Pulse oximeter 4.Blood pressure cuff

4.Blood pressure cuff Clonidine is an antihypertensive medication used in the management of moderate to severe hypertension. The blood pressure and pulse should be monitored frequently after administration, so a blood pressure cuff is one item to have in place. The items in the remaining options are not necessary.

A client with hypertension has begun taking spironolactone. The nurse teaches the client to limit intake of which food? 1.Rice 2.Salad 3.Oatmeal 4.Citrus fruits

4.Citrus fruits Spironolactone is a potassium-retaining diuretic that causes hyperkalemia as the principal side or adverse effect. Clients are instructed to restrict their intake of potassium-rich foods, such as citrus fruits and bananas. The other foods listed are appropriate to include in the diet.

A client is seen in the clinic complaining of anorexia and nausea. The primary health care provider (PHCP) suspects that the client may be experiencing digoxin toxicity. While waiting for test results to become available, the nurse should assess the client for which sign or symptom that would support a diagnosis of digoxin toxicity? 1.Edema 2.Chest pain 3.Constipation 4.Photophobia

4.Photophobia The most common early manifestations of digoxin toxicity are gastrointestinal disturbances such as anorexia, nausea, and vomiting and neurological disturbances such as fatigue, headache, weakness, drowsiness, confusion, and nightmares. Visual disturbances such as photophobia, light flashes, halos around bright objects, and yellow or green color perception also may occur.

The nurse is reviewing the use of diltiazem for clients with Prinzmetal's variant angina. The nurse should provide information based on which action of the medication? 1.The medication works by increasing the heart rate. 2.The medication works by constricting peripheral arteries. 3.The medication works by increasing sinoatrial and atrioventricular conduction. 4.The medication works by inhibiting calcium movement across cell membranes of cardiac and smooth muscle.

4.The medication works by inhibiting calcium movement across cell membranes of cardiac and smooth muscle. Diltiazem is a calcium channel blocker that inhibits calcium movement across cell membranes of cardiac and smooth muscle. It dilates coronary arteries and peripheral arteries and arterioles. Diltiazem decreases the heart rate and slows sinoatrial and atrioventricular conduction

A client who is receiving digoxin daily has a serum potassium level of 3 mEq/L (3 mmol/L) and reports anorexia. The health care provider prescribes a serum digoxin level to be done. The nurse checks the results and should recognize which level that is outside of the therapeutic range? A.) 0.5 ng/mL (0.63 nmol/L) B.) 0.8 ng/mL (1.02 nmol/L) C.) 0.9 ng/mL (1.14 nmol/L) D.) 2.2 ng/mL (2.8 nmol/L)

C.) 0.9 ng/mL (1.14 nmol/L) The optimal therapeutic range for digoxin is 0.5 to 2.0 ng/mL (0.63 to 2.56 nmol/L). If the client is experiencing symptoms such as anorexia and is experiencing hypokalemia as evidenced by a low potassium level, digoxin toxicity is a concern. Therefore, option 4 is correct because it is outside of the therapeutic level and elevated.