護理師正為一位心衰竭病人投予地高辛（Digoxin）。投藥前護理師應優先評估下列何項發現？
A nurse is administering digoxin to a patient with heart failure. Which assessment finding should the nurse prioritize before drug administration?
- ABlood pressure血壓
- BSerum potassium level血清鉀濃度
- CRespiratory rate呼吸頻率
- DApical pulse rate✓ 正解心尖脈搏速率
Digoxin 具有負性變時作用（減緩心跳）。投藥前必須測量心尖脈至少一分鐘，若成人心跳低於 60 次/分則需暫停投藥，防止嚴重心動過緩或傳導阻滯。鉀離子雖重要但非投藥前「立即」動作，心跳數據是給藥的直接安全門檻。
Digoxin has a negative chronotropic effect (slows the heart rate). Prior to administration, the apical pulse must be measured for a full minute; if the heart rate in an adult is below 60 beats per minute, the dose must be held to prevent severe bradycardia or conduction block. Although serum potassium is also important, it is not the immediate pre-administration action; heart rate is the direct safety threshold for giving the medication.
台美臨床給藥皆強制執行給藥前心跳評估，美國護理師依 protocol 決策權較大，台灣則常見由護理師通知醫師確認是否給藥。