Editing Fundamentals of Nursing – RN Practice Questions (section)

==Question 8==
The nurse is preparing to administer digoxin to an adult patient. The apical pulse is 54 beats per minute and irregular. What is the nurse's priority action?
# Administer the dose and recheck the pulse in one hour.
# Hold the dose, notify the provider, and document the finding.
# Administer half of the prescribed dose.
# Check the radial pulse in the opposite arm before deciding.

'''Answer:''' 2. Hold the dose, notify the provider, and document the finding.

''Rationale:'' The standard practice is to assess the apical pulse for one full minute before giving digoxin and to hold the dose in an adult if the rate is below 60 beats per minute, because digoxin slows conduction and further bradycardia may indicate toxicity. The nurse holds the medication, notifies the provider, and documents. Option 1 risks worsening bradycardia and heart block. Option 3 is outside nursing scope; a nurse may not alter a prescribed dose. Option 4 is not the deciding measurement, since the apical rate is the standard for digoxin and is the more accurate value in an irregular rhythm.