A nurse is caring for a client who has a prescription for metoprolol. The nurse measures the client's vital signs and notes that the client's apical heart rate is 49/min. The nurse should prepare to administer which of the following medications?
Diltiazem
Atropine
Digoxin
Carvedilol
The Correct Answer is B
A. Diltiazem: Diltiazem is a calcium channel blocker used to treat high blood pressure and heart rhythm disorders. However, it can further lower the heart rate, which is not desirable in this case as the client’s heart rate is already low.
B. Atropine: This is correct. Atropine is often used to treat bradycardia (low heart rate). It works by blocking the action of the vagus nerve on the heart, which increases the heart rate.
C. Digoxin: Digoxin is used to treat heart failure and atrial fibrillation1. However, one of its side effects is that it can lower the heart rate, so it would not be appropriate to give to a client who already has a low heart rate.
D. Carvedilol: Carvedilol is a beta-blocker used to treat high blood pressure and heart failure1. Like other beta-blockers, it can lower the heart rate, so it would not be appropriate to give to a client who already has a low heart rate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
(A) Respiratory acidosis: Respiratory acidosis is characterized by a low pH (<7.35) and a high PaCO2 (>45 mm Hg). In this case, the client’s pH is high and PaCO2 is normal, which rules out respiratory acidosis.
(B) Respiratory alkalosis: Respiratory alkalosis is characterized by a high pH (>7.45) and a low PaCO2 (<35 mm Hg). Although the client’s pH is high, the PaCO2 is normal, which rules out respiratory alkalosis.
(C) Metabolic acidosis: Metabolic acidosis is characterized by a low pH (<7.35) and a low bicarbonate level (<22 mEq/L). The client’s pH and bicarbonate levels are both high, which rules out metabolic acidosis.
(D) Metabolic alkalosis: Metabolic alkalosis is characterized by a high pH (>7.45) and a high bicarbonate level (>26 mEq/L). The client’s pH is 7.6 and bicarbonate level is 32 mEq/L, both of which are higher than normal. This indicates metabolic alkalosis. Therefore, the nurse should identify that the client is experiencing metabolic alkalosis.
Correct Answer is D
Explanation
A. Insert the IV catheter:
Inserting an IV catheter is necessary to administer IV fluids and medications. However, it is not the most immediate need. The priority is to address the client's oxygenation status first to stabilize them before proceeding with other interventions.
B. Obtain a blood sample:
Obtaining a blood sample for cardiac enzyme levels is important to diagnose a myocardial infarction. Nevertheless, this step should be taken after ensuring the client is receiving adequate oxygen, as hypoxia needs to be addressed immediately.
C. Attach the leads for a 12-lead ECG:
Attaching the leads for a 12-lead ECG is crucial for diagnosing the client's cardiac condition. However, it should be done after initiating oxygen therapy, as improving the client's oxygenation status is more urgent and can help stabilize the client for further diagnostic procedures.
D. Initiate oxygen therapy:
Initiating oxygen therapy is the most critical first action. The client is experiencing severe chest pain, shortness of breath, and signs of cyanosis, indicating that their oxygen levels are insufficient. Providing oxygen at 4 L/min via nasal cannula will help alleviate hypoxia, improve the client's condition, and provide time for further diagnostic and therapeutic interventions.
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