護理師正在為心衰竭病人投予地高辛（Digoxin）。下列哪項發現需要護理師停藥？
A nurse is administering a dose of digoxin to a client with heart failure. Which assessment finding requires the nurse to withhold the medication?
- ABlood pressure of 110/70 mmHg血壓 110/70 mmHg
- BSerum potassium level of 4.0 mEq/L血清鉀離子濃度 4.0 mEq/L
- CClient reports feeling energetic病人表示感覺精力充沛
- DApical pulse of 52 beats per minute✓ 正解心尖脈搏 52 次/分
地高辛（Digoxin）具有強心作用（正性肌力）與減慢房室結傳導（負性變時）的效果。在投藥前，護理師必須評估心尖脈（apical pulse）一整分鐘。若成人心率低於每分鐘 60 次，即顯示藥物可能過量或產生毒性，導致嚴重的竇性心搏過緩（sinus bradycardia）或心臟傳導阻滯，此時必須停藥並通知醫師，這是 NCLEX 的安全護理核心。
Digoxin has positive inotropic effects on the myocardium and slows AV nodal conduction (negative chronotropic effect). Before administration, the nurse must assess the apical pulse for a full minute. In adults, a heart rate below 60 bpm suggests potential drug accumulation or toxicity and risk of severe sinus bradycardia or AV block; the dose must be held and the provider notified. This is a core NCLEX safety concept.
在美國臨床，Digoxin 給藥前的評估標準極為嚴格，通常成人心率 < 60 bpm 需停藥並通知醫師；幼兒則標準更高（通常 < 90-100 bpm）。護理師應務必查閱醫院政策（Facility Policy）。