A nurse is preparing to administer metoprolol 25 mg PO to a client with a history of hypertension and heart failure. The client’s vital signs are: BP 132/78 mm Hg, HR 86 beats per minute, and respiratory rate 18 breaths per minute. Which action should the nurse take?
Give half of the prescribed dose
Give the full dose as ordered
Delay the dose until the pulse is below 60
Omit the dose and record the pulse rate as the reason
The Correct Answer is B
Choice A reason: Giving half the dose of metoprolol is inappropriate without a medical order, as it may reduce therapeutic efficacy. The client’s vital signs (BP 132/78, HR 86) are stable, indicating no need to alter the prescribed dose, which is intended to manage hypertension and heart failure.
Choice B reason: Metoprolol, a beta-blocker, reduces heart rate and blood pressure in hypertension and heart failure. The client’s vital signs (BP 132/78, HR 86) are within acceptable ranges, indicating the full 25 mg dose is safe and appropriate to maintain therapeutic control of their condition.
Choice C reason: Delaying the dose until the pulse is below 60 is unnecessary, as the client’s heart rate of 86 is not bradycardic. Metoprolol is indicated for heart rates above 60 in heart failure and hypertension, and withholding it could worsen blood pressure control.
Choice D reason: Omitting the dose due to a pulse of 86 is inappropriate, as this heart rate is not dangerously low. Metoprolol is prescribed to manage hypertension and heart failure, and withholding it without clinical justification could lead to uncontrolled symptoms or disease progression.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Anorexia nervosa involves severe food restriction, leading to malnutrition and weight loss. Ensuring the client eats well and maintains weight directly addresses the core physiological issue, promoting recovery by restoring nutritional balance and supporting organ function, which is critical for effective treatment and long-term health.
Choice B reason: Eating meals together may foster a supportive environment but does not ensure nutritional adequacy or weight maintenance. It may provide emotional support, but without specific focus on the client’s dietary intake and weight restoration, it is less effective in addressing the primary physiological needs of anorexia nervosa.
Choice C reason: Negotiating family conflicts can reduce stress, which may exacerbate anorexia nervosa symptoms. However, it does not directly address the client’s nutritional or weight restoration needs, which are the primary focus in anorexia treatment. Emotional health is secondary to physical recovery in effective education.
Choice D reason: Reducing discussion about troublesome family members may decrease emotional tension but does not address the core issue of anorexia nervosa, which is severe food restriction and weight loss. This approach lacks direct impact on the physiological aspects of recovery, making it less relevant to effective education.
Correct Answer is ["C","D","E"]
Explanation
Choice A reason: Buspirone is a non-benzodiazepine anxiolytic that takes weeks to achieve therapeutic effects, making it ineffective for acute panic attacks. It does not provide immediate relief, so administering it during a panic attack does not promote safety or address the client’s acute distress.
Choice B reason: Offering therapy during a panic attack may be overwhelming, as the client’s heightened anxiety impairs their ability to engage in therapeutic dialogue. Safety-focused interventions, like reducing stimuli or staying with the client, are more effective in managing acute panic and ensuring immediate safety.
Choice C reason: Turning off televisions or music reduces environmental stimuli, which can exacerbate a panic attack by overwhelming the client’s heightened sympathetic nervous system response. Minimizing sensory input helps de-escalate anxiety, creating a calmer environment and promoting safety during the acute episode.
Choice D reason: Remaining with the client during a panic attack provides reassurance and ensures safety by monitoring for escalating symptoms or self-harm risks. The nurse’s presence helps stabilize the client emotionally and physically, reducing feelings of isolation and supporting de-escalation of the panic state.
Choice E reason: A calm nursing approach prevents further escalation of the client’s panic by modeling stability and reducing perceived threats. A calm demeanor lowers the client’s sympathetic arousal, fostering a sense of safety and helping to de-escalate the acute anxiety episode effectively.
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