A patient is prescribed metoprolol in the treatment of stable angina.
What is the best outcome measure of decreased cardiac workload due to metoprolol for the nurse to evaluate?

Patient's heart rate is 62 and regular.

Patient is able to lie flat without reporting difficulty breathing.

Patient does not report dyspnea after climbing one flight of stairs.

Patient has weight loss of 3 lbs (1.4 kg) over 2 weeks.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Metoprolol decreases cardiac workload by reducing heart rate and myocardial oxygen demand. A heart rate of 62 is within normal limits, demonstrating effective beta-blocker action and improved cardiac efficiency.

Choice B rationale

Lying flat without difficulty breathing reflects improved respiratory status, which is more related to pulmonary management, not directly indicative of reduced cardiac workload or beta-blocker efficacy.

Choice C rationale

Absence of dyspnea after climbing stairs suggests improved physical fitness but does not directly measure the cardiac effects of metoprolol, which targets heart rate reduction and myocardial oxygen use.

Choice D rationale

Weight loss is related to overall health improvement or dietary changes rather than specific effects of metoprolol, which primarily impacts heart rate and cardiac oxygen consumption.

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Correct Answer is C

Explanation

Choice A rationale

Monitoring frequency of urination indicates bladder involvement, often related to cystitis. However, it does not indicate ascending progression to the kidneys, which is more severe and requires additional symptoms.

Choice B rationale

Dysuria, or painful urination, typically signifies lower urinary tract infection rather than progression to upper urinary tract infection, such as pyelonephritis. It is not specific to kidney involvement.

Choice C rationale

Flank pain and fever are hallmark symptoms of pyelonephritis, indicating ascending progression of infection from the bladder to the kidneys. These symptoms signal systemic involvement and require immediate medical attention.

Choice D rationale

Pyuria and hematuria are signs of bladder infection but do not indicate progression to kidney infection. These are specific to inflammation or infection in the lower urinary tract.

A. T98.7 F (36.4 C), BP 220/46, HR 30, RR 6, O2 Sat 98% Room Air. B. T92.5 F (33.6 C), BP 90/64, HR 80, RR 14, O2 Sat 97% Room Air. C. T103.1 F (39.5 C), BP 82/50, HR 132, RR 30, O2 Sat 99% Room Air. D. T98.6 F (37 C), BP 200/94, HR 90, RR 18, O2 Sat 100% Room Air.

Correct Answer is A

Explanation

Choice A rationale

Extremely high systolic BP (220 mmHg), bradycardia (HR 30), and altered respirations (RR 6) suggest Cushing's triad, a hallmark of increased ICP due to severe brain injury.

Choice B rationale

Hypothermia (T92.5°F) and hypotension (BP 90/64) do not indicate increased ICP but may result from shock or hypothermic conditions affecting autonomic responses.

Choice C rationale

Hyperthermia (T103.1°F) and tachycardia (HR 132) are commonly seen in infection or hypermetabolic states, not directly pointing to raised ICP.

Choice D rationale

Mild hypertension (BP 200/94) with normal HR (90) and RR (18) does not fit the classic signs of increased ICP like Cushing's triad.

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A patient is prescribed metoprolol in the treatment of stable angina.What is the best outcome measure of decreased cardiac workload due to metoprolol for the nurse to evaluate?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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A patient is prescribed metoprolol in the treatment of stable angina.
What is the best outcome measure of decreased cardiac workload due to metoprolol for the nurse to evaluate?