The nurse takes a patient's vital signs prior to giving metoprolol tartrate and obtains the following results: T 98 degrees F, P 48, R 16 bpm, BP 100/50 and a pulse oximeter of 98%. What action will the nurse take?

Continue to administer the metoprolol tartrate as ordered.

Ask the patient if her pulse is within the normal range

Hold the medication and call the provider

Ask the patient to eat salty foods

Answer and Explanation

The Correct Answer is C

A. Continue to administer the metoprolol tartrate as ordered:
Metoprolol is a beta-blocker commonly used to treat hypertension, angina, and heart failure. One of its main effects is to decrease heart rate and blood pressure. In this scenario, the patient's vital signs reveal a low heart rate (48 bpm) and relatively low blood pressure (100/50 mmHg). Given that metoprolol can further reduce heart rate and blood pressure, it would be prudent for the nurse to withhold the medication until further assessment is conducted.

B. Ask the patient if her pulse is within the normal range:
While it's essential to assess the patient's understanding of her condition, asking if her pulse is within the normal range is not sufficient. The nurse should perform a more thorough assessment and consider the clinical significance of the vital signs obtained. In this case, a heart rate of 48 bpm is lower than the typical normal range for adults (60-100 bpm), indicating bradycardia, which may be symptomatic or concerning in the context of administering a beta-blocker like metoprolol.

C. Hold the medication and call the provider:
Given the patient's low heart rate (bradycardia) and relatively low blood pressure, holding the metoprolol tartrate and contacting the healthcare provider is the most appropriate action. Bradycardia and hypotension can be signs of excessive beta-blockade, especially with medications like metoprolol, which can further lower heart rate and blood pressure. The nurse should notify the provider promptly to discuss the patient's condition and determine the appropriate course of action.

D. Ask the patient to eat salty foods:
Encouraging the patient to eat salty foods would not address the underlying issue of bradycardia and hypotension. While increasing salt intake may help raise blood pressure in some cases, it is not a standard intervention for managing symptomatic bradycardia or low blood pressure caused by medication effects.

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Correct Answer is C

Explanation

A. Administer post-exposure prophylaxis medication: While post-exposure prophylaxis (PEP) medication may be necessary in certain cases of needlestick injuries involving potential exposure to HIV, it is not the first step to perform. The initial priority is to ensure the safety of the healthcare provider and prevent potential transmission of the virus.

B. Determine the HIV status of the patient: Determining the HIV status of the patient is essential for risk assessment and guiding subsequent management. However, this step may take some time, and immediate action to protect the healthcare provider should not be delayed while waiting for the patient's HIV status to be confirmed.

C. Advise exposed healthcare providers to use precautions: This is the first step to perform after a needlestick injury. Healthcare providers should be immediately advised to use standard precautions, including hand hygiene and the use of personal protective equipment, to minimize the risk of transmission of bloodborne pathogens.

D. Undergo early reevaluation after exposure: Early reevaluation after exposure is important to assess the risk of transmission and determine the need for further interventions, including PEP medication. However, advising exposed healthcare providers to use precautions should take precedence as an immediate response to the injury.

A. A renal ultrasound B. A cardiac stress test C. A manual blood pressure cuff D. Ambulatory blood pressure measurement

Correct Answer is D

Explanation

Answer: D

Rationale:

A) A renal ultrasound: A renal ultrasound is not typically used to confirm a diagnosis of hypertension. While renal artery stenosis can contribute to hypertension in some cases, it is not the primary diagnostic test for hypertension.

B) A cardiac stress test: A cardiac stress test is not used to confirm a diagnosis of hypertension. It is primarily used to assess cardiovascular function and detect coronary artery disease or cardiac arrhythmias.

C) A manual blood pressure cuff: While manual blood pressure measurements can provide accurate readings, they are subject to potential inaccuracies due to factors such as observer bias and white coat syndrome. Therefore, they may not be the most reliable method for confirming a diagnosis of hypertension.

D) Ambulatory blood pressure measurement: Ambulatory blood pressure measurement involves obtaining multiple blood pressure readings over a 24-hour period using a portable monitor. It is considered the gold standard for diagnosing hypertension, as it provides a more comprehensive assessment of blood pressure variability and reduces the impact of white coat syndrome. Therefore, it is the preferred diagnostic test in this scenario to confirm whether the patient has hypertension outside of the clinical setting.

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The nurse takes a patient's vital signs prior to giving metoprolol tartrate and obtains the following results: T 98 degrees F, P 48, R 16 bpm, BP 100/50 and a pulse oximeter of 98%. What action will the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A nurse is caring for a patient who is returning for a repeat blood pressure to determine if white coat syndrome occurred during the first clinical visit. Which diagnostic test will be used to confirm a diagnosis of hypertension?

Correct Answer is D

Explanation

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The nurse takes a patient's vital signs prior to giving metoprolol tartrate and obtains the following results: T 98 degrees F, P 48, R 16 bpm, BP 100/50 and a pulse oximeter of 98%. What action will the nurse take?