護理師準備給藥，下列哪項藥物在給藥前需要測量心尖脈整整一分鐘？
A nurse is preparing to administer several medications to a client. Which medication requires checking the client's apical heart rate for one full minute before administration?
- ALisinoprilLisinopril（賴諾普利）
- BAmlodipineAmlodipine（氨氯地平）
- CDigoxin✓ 正解Digoxin（地高辛）
- DMetoprololMetoprolol（美托洛爾）
毛地黃類藥物（Digoxin）具有正性肌力與負性頻率作用，治療指數窄，極易發生中毒。給藥前檢查心尖脈（apical pulse）是因為這能提供最準確的心臟收縮評估，且心跳過慢（通常標準為小於 60 次/分）是毛地黃中毒的第一警訊。選項 A（Lisinopril）是 ACEI，注意血壓與高血鉀；選項 D（Metoprolol）是 beta-blocker，同樣會影響心跳，但在臨床常規中，Digoxin 對心率的敏感性要求更為嚴格，屬於必須測量一分鐘的標準程序。選項 B（Amlodipine）為鈣離子阻斷劑，主要監測血壓。護理師必須熟記各類心血管藥物的給藥前監測指標，這是臨床藥物安全考試的核心。
Digitalis-class medications (digoxin) have a positive inotropic and negative chronotropic effect with a narrow therapeutic index, making toxicity easy to develop. The apical pulse is checked before administration because it provides the most accurate evaluation of cardiac contractility, and bradycardia (typically a heart rate below 60/min) is the first warning sign of digoxin toxicity. Option A (lisinopril) is an ACE inhibitor; monitoring focuses on blood pressure and hyperkalemia. Option D (metoprolol) is a beta blocker that also affects heart rate, but in routine practice digoxin requires more stringent heart rate evaluation, making a full one-minute apical pulse measurement a standard procedure. Option B (amlodipine) is a calcium channel blocker, for which blood pressure is the principal monitoring parameter. The nurse must be familiar with pre-administration monitoring parameters for each class of cardiovascular medication; this is a core focus of clinical medication safety examinations.
美國護理教育中，對於 Digoxin 的心尖脈測量強調『整整一分鐘』的細節是標準考點；台灣醫院對於病房測量心尖脈的實作要求，有時會因自動化血壓計普及而簡化為測橈動脈，但護理師執行給藥責任時仍應遵守標準規範。