Registered Nurse RN

Registered Nurse, Free Care Plans, Free NCLEX Review, Nurse Salary, and much more. Join the nursing revolution.

  • RN
    • Nursing Clinical Skills
  • Nursing Videos
  • Blog
  • Nursing School
  • Nursing Care Plans
  • Nursing Quizzes
  • Nursing
  • Nursing Jobs
  • NCLEX Review
  • Store

NCLEX Hotspot Practice Question

This is an NCLEX hotspot practice question. This question provides a scenario about administering the drug called Digoxin (Lanoxin), and the nurse must determine what area on the chest must be assessed before administering this drug.

This question is one of the many questions we will be practicing in our new series called “Weekly NCLEX Question”.

So, every week be sure to tune into our YouTube Channel for the NCLEX Question of the Week.

More NCLEX Weekly Practice Questions.

NCLEX Hotspot Question on Digoxin

A 55-year-old male patient is ordered by the physician to take Digoxin (Lanoxin) 0.25 mg by mouth daily. Prior to administering this medication, you will assess what area on the diagram?

nclex, hotspot, question, digoxin

First let’s ask ourselves, “What is Digoxin?”:

It is a cardiac medication that is part of the cardiac glycoside family.

How does it work? It is an interesting drug in that it has a POSITIVE inotropic effect and NEGATIVE chronotropic effect on the heart.

Positive inotropic effect = each heart contraction is stronger

Negative chronotropic effect = each heart beat is slower

End result = the heart pumps more efficiently at a slower rate…hence decreasing the workload on the heart.

Therefore, it is a great medication for patients with certain types of heart failure or for patients who are experiencing atrial fibrillation.

Nurse’s Role BEFORE administering Digoxin:  You must listen to the apical pulse with your stethoscope for 1 full minute to make sure the pulse is at least 60 bpm or greater in adults.

Where is the apical pulse?

First, let’s back track a little bit and think about assessing heart sounds because the apical pulse is located at the same location as the MITRAL VALVE assessment point, which is the apex of the heart. The apex of the heart is where the point of maximal impulse is located…hence the best area to determine the apical pulse.  

When assessing heart sounds the nurse is assessing the closure of the 4 heart valves in the heart, which are the Aortic, Pulmonic, Tricuspid, and Mitral valve. Therefore, the nurse will listen to 4 areas on the chest, and these areas can be found at certain landmark locations.

heart valves heart sounds, s2, s1

To help me remember the order of how I will assess the valves, I like to remember this mnemonic:

“All Patients Take Medicine”

All = Aorta

Patients = Pulmonic

Take = Tricuspid

Medicine = Mitral

heart sounds, aortic, pulmonic, mitral, tricuspid valvesLandmarks for assessing heart sounds:

Aortic: found right of the sternal border in the 2nd intercostal space REPRESENTS S2 “dub”

Pulmonic: found left of the sternal border in the 2nd intercostal space REPRESENTS S2 “dub”

Tricuspid: found left of the sternal border in the 4th intercostal space REPRESENTS S1 “lub”

Mitral: found midclavicular in the 5th intercostal space REPRESENTS S1 “lub” *Apical Pulse location

 

Answer to this question:

The nurse will assess the apical pulse, which will be found at the 5th intercostal space at the midclavicular line:

nclex practice questions, hotspot, heart sounds, apical pulse

More NCLEX Reviews

Please Share:

  • Click to print (Opens in new window)
  • Click to share on Facebook (Opens in new window)
  • Click to share on Twitter (Opens in new window)
  • Click to share on Pinterest (Opens in new window)
  • More
  • Click to share on Reddit (Opens in new window)
  • Click to share on LinkedIn (Opens in new window)
  • Click to share on WhatsApp (Opens in new window)
  • Click to share on Pocket (Opens in new window)
  • Click to share on Telegram (Opens in new window)
  • Click to share on Skype (Opens in new window)
Nursing Gear

RSS Latest YouTube Videos

  • IV Drip Flow Rates Drop Factor gtts/minute Dosage Calculations Nursing | NCLEX Review
  • Do Nurses Really Need to Know This?
  • This Vein is Going to Roll... Nurse IV Insertion Tips #shorts
  • Nursing Graduation Spring Class of 2022: Congratulations!!

Recent Posts

  • Sinus Tachycardia ECG/EKG Rhythm Nursing Review
  • Sinus Tachycardia ECG/EKG Rhythm Quiz
  • Crying in Nursing School
  • Desired over Have by Weight Examples Dosage Calculations
  • Tablets and Capsules Dosage Calculations (Desired over Have Method)

Disclosure and Privacy Policy

This website provides entertainment value only, not medical advice or nursing protocols. We strive for 100% accuracy, but nursing procedures and state laws are constantly changing. By accessing any content on this site or its related media channels, you agree never to hold us liable for damages, harm, loss, or misinformation. See our full disclosure and privacy policy. Copyright Notice: Do not copy this site, articles, images, or its contents without permission.

Important Links

  • Advertise
  • Contact Us

Follow Us on Social Media

  • Facebook Nursing
  • Instagram Nursing
  • TikTok Nurse
  • Twitter Nursing
  • YouTube Nursing

Get Free Email Updates:

Enter your email address below and hit "Submit" to receive free email updates and nursing tips.

Copyright © 2022 RegisteredNurseRN.com. All Rights Reserved.