A nurse is preparing to administer a 5 mg IV bolus of metoprolol to a patient for heart rate control.

The available metoprolol injection is 1 mg/mL. How many mL should the nurse administer per dose?

(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A rationale

Swabbing an area of skin away from the wound to identify the usual flora is not the correct action. This would not provide a representative sample of the wound infection.

Choice B rationale

Irrigating the wound with an antiseptic prior to obtaining the specimen is not the correct action. This could potentially alter the results of the culture.

Choice C rationale

Cleansing the wound with 0.9% sodium chloride saline irrigation before obtaining the specimen is the correct action. This helps to remove surface bacteria and ensures a more accurate culture result.

Choice D rationale

Including intact skin at the wound edges in the culture is not the correct action. This could contaminate the specimen with bacteria that are not part of the wound infection.

Choice A rationale

Phenytoin is an antiepileptic medication used to control seizures. It’s important for the patient to understand that they should not switch brands of this medication without consulting their healthcare provider. Different brands of phenytoin can have different effects, and switching could potentially lead to changes in seizure control.

Choice B rationale

Regular dental appointments are important for patients taking phenytoin. This medication can cause gum overgrowth (gingival hyperplasia), so good oral hygiene and regular dental check- ups are essential.

Choice C rationale

It’s crucial for patients to notify their doctor before taking any other medications. Phenytoin can interact with many other drugs, altering their effectiveness or increasing side effects.

Therefore, the patient’s statement indicates an understanding of the need for caution when considering additional medications.

Choice D rationale

Phenytoin is a long-term medication for controlling seizures. It’s not something that patients can stop taking once they feel better. Abruptly stopping the medication can lead to withdrawal

seizures. Therefore, the patient’s statement, “I’ll be glad when I can stop taking this medicine,” indicates a need for further teaching about the importance of continuing the medication as prescribed.