Page 1809 - Saunders Comprehensive Review For NCLEX-RN

disturbances can occur.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Pharmacology: Cardiovascular Medications: Cardiac Glycosides
Health Problem: Adult Health: Cardiovascular: Heart Failure
Priority Concepts: Clinical Judgment; Safety
References: Hodgson, Kizior (2015), p. 363; Burchum, Rosenthal (2016), pp. 532-
533.

635. Answer: 4

Rationale: An increased risk of toxicity exists in clients with hypercalcemia,
hypokalemia, hypomagnesemia, hypothyroidism, and impaired renal function. The
calcium, creatinine, and potassium levels are all within normal limits. The normal
range for magnesium is 1.8–2.6 mEq/L (0.74–1.07 mmol/L), and the results in the
correct option are reflective of hypomagnesemia.
Test-Taking Strategy: Focus on the subject, the laboratory result that places the
client at risk for digoxin toxicity. Recalling the normal laboratory values for each
electrolyte identified in the options will assist in answering correctly.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Pharmacology: Cardiovascular Medications: Cardiac Glycosides
Health Problem: Adult Health: Cardiovascular: Heart Failure
Priority Concepts: Perfusion; Safety
Reference: Hodgson, Kizior (2015), p. 363.

636. Answer: 2

Rationale: Bumetanide is a diuretic and expected outcomes include increased
urine output, decreased crackles, and decreased weight. Potassium loss is a side
effect rather than an expected effect of the diuretic. Frothy pink sputum indicates
progression to pulmonary edema. A BNP greater than 100 pg/mL (100 ng/L) is
indicative of heart failure; thus, a rise from a previous level indicates worsening of
the condition.
Test-Taking Strategy: Focus on the subject, assessment findings indicative of the
expected effect of bumetanide. Keep in mind when answering this question that an
expected effect of a medication refers to a positive outcome versus a side or adverse
effect. This will help you eliminate the option that refers to the potassium loss.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Evaluation
Content Area: Pharmacology: Cardiovascular Medications: Diuretics
Health Problem: Adult Health: Cardiovascular: Heart Failure
Priority Concepts: Evidence; Perfusion
Reference: Gahart, Nazareno (2015), pp. 191-192.

1809