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NCLEX Cardiovascular Drugs-Digoxin Questions - NCLEX Questions on Cardiovascular Drugs-Digoxin
Cardiovascular Drugs-Digoxin NCLEX Practice Questions
Question 1.
Mrs. Ranjan is a 65-year-old woman who has been experiencing atrial fibrillation. Her doctor has prescribed her digoxin to help manage her heart rate and rhythm. However, Mrs. Ranjan has also been experiencing some side effects such as vomiting, diarrhea, and blurred vision.
What is the most likely cause of Mrs. Ranjan's side effects?
(a) Hypokalemia
(b) Hypercalcemia
(c) Hypomagnesemia
(d) Renal impairment
Answer:
(a) Hypokalemia
Explanation:
It is important to remember that digoxin can cause electrolyte imbalance, particularly hypokalemia, which can lead to various symptoms such as vomiting, diarrhea, and blurred vision. It is also important to monitor digoxin levels in patients with renal impairment, electrolyte imbalance, and elderly patients, as they may be more prone to experiencing side effects.
In addition, digoxin can compete with other drugs for renal clearance, which may lead to increased side effects of those drugs. It is used to treat heart conditions with high impulse rates, such as atrial flutter and atrial fibrillation, by slowing down the heart rate, but if not monitored carefully, it can also cause bradycardia.
Rationale:
Option (a) Hypokalemia is the correct answer because digoxin can cause low levels of potassium in the blood, which can lead to the symptoms experienced by Mrs. Ranjan. Options (b) Hypercalcemia and (c) Hypomagnesemia may also be caused by digoxin, but they are less likely to cause the specific symptoms experienced by Mrs. Ranjan. Option (d) Renal impairment may also be caused by digoxin, but it is not specifically mentioned in the case study as a cause of Mrs. Ranjan's side effects.
Question 2.
A 65-year-old patient with atrial fibrillation is prescribed digoxin to manage their heart rate and rhythm. The patient is also taking an antibiotic for a respiratory infection. The patient begins experiencing blurted vision, diplopia, and photophobia.
What is the most likely cause of these symptoms?
(a) Hypokalemia
(b) Hypomagnesemia
(c) Hypercalcemia
(d) Drug interaction between the antibiotic and digoxin
Answer:
(d) Drug interaction between the antibiotic and digoxin
Explanation:
The patient's symptoms are most likely caused by a drug interaction between the antibiotic and digoxin. Digoxin can affect the renal clearance of other drugs and can cause electrolyte imbalances, which can lead to various side effects. In this case, the patient is experiencing visual changes, which could potentially be caused by the interaction between the antibiotic and digoxin. It is important to monitor digoxin levels and the potential for drug interactions in patients taking multiple medications, especially in elderly patients or those with renal impairment.
Rationale:
Option (a) (hypokalemia) is not the most likely cause of the patient's symptoms because while low potassium levels can cause digoxin toxicity, the question does not mention that the patient has low potassium levels. Option (b) (hypomagnesemia) is also not the most likely cause because while low magnesium levels can affect digoxin levels, the case study does not mention that the patient has low magnesium levels.
Option (c) (hypercalcemia) is also not the most likely cause because while high calcium levels can affect digoxin levels, the case study does not mention that the patient has high calcium levels. Option (d) (drug interaction between the antibiotic and digoxin) is the most likely cause because the patient is experiencing visual changes and digoxin can affect the renal clearance of other drugs, including antibiotics.
Question 3.
Mrs. Ranjan is a 65 year old woman with a history of atrial fibrillation. She has been prescribed digoxin to manage her heart rate and rhythm. However, after starting the medication, she experiences blurred vision, diplopia, photophobia, and weakness.
What is the most likely cause of Mrs. Ranjan's symptoms?
(a) Digoxin toxicity
(b) Hypokalemia
(c) Hypomagnesemia
(d) Hypercalcemia
Answer:
(a) Digoxin toxicity
Explanation:
Digoxin is a medication used to treat heart conditions such as atrial fibrillation, but it can also have side effects including visual changes and weakness. Mrs. Ranjan is an older patient, who may have impaired renal clearance and a higher risk of digoxin toxicity. The presence of these risk factors, along with the patient’s symptoms, strongly suggests that the cause of Mrs. Ranjan's symptoms is digoxin toxicity. It is important to monitor digoxin levels and watch for signs of toxicity in patients taking this medication, especially in older patients and those with impaired renal function.
Rationale:
Option (a) Digoxin toxicity is the correct answer because it fits the most with the patient's symptoms and risk factors. Option (b) Hypokalemia and Option (c) Hypomagnesemia can both cause electrolyte imbalances and may be related to digoxin toxicity, but they do not fully explain the patient's visual changes and w eakness. Option (d) Hypercalcemia is not related to the patient's symptoms and is not a risk factor for digoxin toxicity.