A nurse is medicating her patient and sees Metoprolol (Toprol XL) (Beta Blocker) on her patient's MAR. The nurse assesses her patient's heart rate and it is 56 beats per minute. What action should the nurse take?

Call the physician to get a hold order for the Metoprolol

Skip the dose and re-assess the patient's heart rate in 4 hours

Administer the medication as ordered

Call the physician to get an order for Lasix

Answer and Explanation

The Correct Answer is A

A. Call the physician to get a hold order for the Metoprolol: A heart rate of 56 bpm may indicate bradycardia, which is a common contraindication to administering beta blockers like Metoprolol. The nurse should notify the physician before giving the medication.

B. Skip the dose and re-assess the patient's heart rate in 4 hours: Skipping medication without provider approval is unsafe. Re-assessment alone does not address the potential risk of bradycardia.

C. Administer the medication as ordered: Administering Metoprolol with a low heart rate risks worsening bradycardia and causing adverse effects such as dizziness or syncope. This can compromise cardiac output and patient safety.

D. Call the physician to get an order for Lasix: Lasix is a diuretic unrelated to heart rate management and is not appropriate in this situation. It does not address the bradycardia or the effects of Metoprolol on heart rate.

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Correct Answer is A

Explanation

A. State, "This is not something I or any of the nurses can do.": Nurses have an ethical and legal duty to avoid participating in any form of euthanasia. A therapeutic response should acknowledge the client’s suffering while reinforcing the nurse’s role in providing compassionate, appropriate care.

B. Ignore the client's statement, and limit any contact with the client: Ignoring such a statement dismisses the client’s distress and emotional pain, and it undermines trust and therapeutic communication at a critical time.

C. Obtain additional medication from the automated medication system that would hasten the client's death: This action would be both illegal and unethical, constituting active euthanasia and a serious violation of professional standards.

D. Contact the health care provider to request additional intravenous medication to honor the client's request: While providers may adjust pain management, honoring a request to hasten death is not permissible and would breach ethical and legal boundaries.

A. "Crushing the medication is a good idea, and I can mix it in some ice cream for you." B. "Crushing the medication might cause you to have a stomachache or indigestion." C. "Crushing is unsafe, as it destroys the ingredients in the medication." D. "Crushing the medication would release all the medication at once, rather than over time."

Correct Answer is B

Explanation

A. "Crushing the medication is a good idea, and I can mix it in some ice cream for you.": Enteric-coated medications should not be crushed because the coating protects the stomach lining and controls where the medication dissolves. Crushing removes this protection.

B. "Crushing the medication might cause you to have a stomachache or indigestion.": Enteric coatings prevent irritation of the stomach lining. Crushing the tablet can lead to direct stomach irritation, increasing the risk of discomfort or gastrointestinal side effects.

C. "Crushing is unsafe, as it destroys the ingredients in the medication.": Crushing does not destroy the medication’s ingredients but alters its intended release and absorption, potentially causing side effects.

D. "Crushing the medication would release all the medication at once, rather than over time.": This applies to extended-release medications, not enteric-coated aspirin, which is designed to dissolve in the intestines to protect the stomach.

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A nurse is medicating her patient and sees Metoprolol (Toprol XL) (Beta Blocker) on her patient's MAR. The nurse assesses her patient's heart rate and it is 56 beats per minute. What action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client who is terminally ill has unrelieved and intractable pain. The nurse is administering hydromorphone intravenously. The client states, "I want you to give me additional medication so I will die. I cannot go on any longer!” What action would the nurse take?

Correct Answer is A

Explanation

A nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide?

Correct Answer is B

Explanation

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