Editing Medical-Surgical Nursing – LPN Practice Questions (section)

==Question 8==
The licensed practical nurse is preparing to give a scheduled dose of digoxin. The apical pulse, counted for a full minute, is 54 beats per minute. What should the nurse do?
# Give the dose, since the pulse is only slightly low.
# Hold the dose and notify the registered nurse.
# Give half of the prescribed dose.
# Recheck the radial pulse and give the dose if it is above 60.

'''Answer:''' Option 2, hold the dose and notify the registered nurse.

''Rationale:'' Digoxin is withheld in an adult when the apical pulse is below 60 beats per minute, because the drug slows conduction further and may cause dangerous bradycardia. The nurse holds the dose, reports, and documents. Option 1 ignores the parameter. Option 3 is outside the nurse's scope, because a nurse never alters a prescribed dose. Option 4 is incorrect, because the apical pulse counted for a full minute is the required measurement and a radial pulse may be lower than the apical rate.