The nurse is assessing a patient who is receiving metoprolol 2 days after an acute coronary syndrome (ACS), Which physiological action of metoprolol supports the desired or therapeutic response?

Increases contractility.

Increases preload.

Decreases afterload.

Decreases diastolic filing time.

Answer and Explanation

The Correct Answer is C

A) Increases contractility: Metoprolol, a beta-blocker, actually decreases contractility. It reduces the force of contraction of the heart muscle, which can help reduce myocardial oxygen demand and improve outcomes after ACS. Increasing contractility would counteract the therapeutic goals of metoprolol in managing ACS.
B) Increases preload: Preload refers to the volume of blood in the ventricles at the end of diastole. Metoprolol does not increase preload; rather, it reduces myocardial workload and oxygen demand, which does not directly affect preload but rather the heart's performance overall.
C) Decreases afterload: Metoprolol reduces afterload indirectly by lowering blood pressure and decreasing heart rate, which helps reduce the workload on the heart. This reduction in afterload supports the therapeutic goals of metoprolol in managing ACS by decreasing the heart's work and improving cardiac efficiency.
D) Decreases diastolic filling time: Metoprolol slows the heart rate, which can lead to increased diastolic filling time, not a decrease. Increased filling time can be beneficial as it allows the heart more time to fill with blood between beats, thereby improving cardiac output.

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Correct Answer is C

Explanation

A) Pull up 30 units from the 70/30 vial, but only administer one third: The 70/30 insulin vial contains a mixture of 70% isophane (NPH) insulin and 30% regular insulin. If 30 units of this mixture are drawn, the actual amount of regular insulin would be 30% of 30 units, which equals 9 units. This does not equate to the 10 units of regular insulin required, making this option inaccurate for precise dosing.
B) Withdraw ten units regular insulin from the 70/30 vial: The 70/30 vial provides a fixed ratio of regular to NPH insulin. Extracting 10 units from this vial would not yield exactly 10 units of regular insulin; instead, it would include both types in the specified ratio, leading to an incorrect dosage of regular insulin.
C) Withhold the dose until insulin regular is available on the unit: Since the 70/30 vial contains a mixture and not solely regular insulin, it is necessary to withhold the dose until a vial of regular insulin is available. This ensures that the precise amount of regular insulin needed is administered, avoiding the imprecision and potential errors that could arise from using a mixed insulin vial.
D) Obtain a new vial of regular insulin and withdraw ten units: While obtaining a new vial of regular insulin is the correct approach for ensuring accurate dosing, the option of withdrawing ten units directly from a vial of regular insulin is not feasible if the current medication available is a mixture. This option assumes that the correct type of insulin is already available for use.

A. Reduce caffeine and acidic intake. B. Double the dose if a dose is missed. C. Avoid taking on an empty stomach. D. Consume 2 liters of water daily.

Correct Answer is B

Explanation

A. Reduce caffeine and acidic intake: This is appropriate advice as caffeine and acidic foods can potentially affect uric acid levels and might exacerbate gout symptoms.
B. Double the dose if a dose is missed: This is incorrect and requires additional instruction. Allopurinol should not be doubled if a dose is missed. Instead, the missed dose should be taken as soon as possible unless it is almost time for the next dose. Doubling the dose could lead to increased risk of side effects or adverse reactions.
C. Avoid taking on an empty stomach: This is generally good advice, although allopurinol can be taken with or without food. Taking it with food might help reduce potential gastrointestinal discomfort.
D. Consume 2 liters of water daily: This is recommended to help prevent the formation of uric acid crystals and to ensure adequate hydration, which is beneficial while on allopurinol.

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The nurse is assessing a patient who is receiving metoprolol 2 days after an acute coronary syndrome (ACS), Which physiological action of metoprolol supports the desired or therapeutic response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Based on the capillary glucose measurement, a client is to receive 10 units of regular insulin. The client's medication drawer contains one vial of a 70/30 mixture of regular Insulin and Isophane insulin How should the nurse prepare the prescribed dose?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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