A nurse is assessing a client who is receiving metoprolol. Which of the following indicates a therapeutic effect?

Choice A reason:

Stop taking the pills and switch to a different contraceptive method: This is not necessary for a single missed dose. Stopping the pills entirely and switching methods would be an overreaction and could lead to unnecessary complications. The standard recommendation for a missed dose is to take it as soon as remembered and continue with the regular schedule.

Choice B reason:

Take a home pregnancy test: Taking a home pregnancy test is not required immediately after missing a single dose of oral contraceptives, especially if it is the first week of the cycle. Pregnancy tests are typically recommended if there is a significant delay in the menstrual cycle or if multiple doses are missed.

Choice C reason:

Do not have vaginal intercourse until after your next period: This advice is overly cautious for a single missed dose. While it is important to use backup contraception if multiple doses are missed, abstaining from intercourse until the next period is not necessary for just one missed pill.

Choice D reason:

Take the missed dose now, then continue the medication as ordered: This is the correct course of action. According to guidelines, if a single hormonal pill is missed, it should be taken as soon as possible, and the next pill should be taken at the usual time. This may mean taking two pills in one day, but it ensures continuous contraceptive protection.

Choice A reason:

Place a pillow under the client’s head: During a tonic-clonic seizure, it is crucial to protect the client’s head from injury. Placing a pillow or any soft object under the head can help prevent head trauma caused by the convulsions. Ensuring the client’s safety by protecting their head is a primary concern during a seizure.

Choice B reason:

Insert a padded tongue blade into the client’s mouth: This action is incorrect and potentially dangerous. Inserting any object into the mouth during a seizure can cause injury to the teeth, gums, or jaw. It can also obstruct the airway. The myth that a person can swallow their tongue during a seizure is false, and no object should be placed in the mouth.

Choice C reason:

Apply a face mask for oxygen administration: While providing oxygen can be beneficial after the seizure has ended, during the seizure, the priority is to ensure the client’s safety and prevent injury. Applying a face mask during the active phase of a seizure is not practical and can interfere with managing the seizure safely.

Choice D reason:

Gently restrain the client’s extremities: Restraining the client’s extremities during a seizure is not recommended. Attempting to restrain the movements can cause injury to both the client and the nurse. The focus should be on protecting the client from harm without restricting their movements.