Answer to Question 1
ANS: D
With low potassium levels (ie, below 3.5 mEq/L), which can occur secondary to furosemide administration, the risk of digoxin-induced toxicity is greatly increased. The apical pulse must be monitored, and digoxin should not be administered to a patient with a pulse below 60/minutes.
Crackles and respirations of 22/minute would be indications for furosemide and digoxin therapy and therefore not a concern for the nurse related to administration.
A digoxin level of 0.5 mg/dL is considered therapeutic, therefore digoxin should be continued with no concern.
A blood pressure of 140/90 would not be affected by digoxin and may actually be helped by furosemide, which would reduce volume and thus help reduce blood pressure.
Answer to Question 2
ANS: B
Spironolactone (Aldactone) blocks the action of aldosterone in the distal nephron and benefits patients with severe heart failure. Aldosterone acts to promote sodium uptake in exchange for potassium secretion; it therefore increases the excretion of sodium, promoting diuresis.
Spironolactone increases, rather than decreases, the excretion of sodium.
Spironolactone does not redistribute edema; rather, it is used to help reduce edema.
Spironolactone spares potassium removal rather than increasing its excretion.
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