What is the priority nursing diagnosis for a patient prescribed metoprolol (Lopressor)?

Deficient knowledge related to lack of information about the therapeutic regimen

Risk for injury related to possible adverse effects of the adrenergic blockers

Risk for decreased cardiac tissue perfusion related to effects of medication

Acute confusion related to adverse central nervous system effects of the drug

Answer and Explanation

The Correct Answer is C

Choice A reason: Deficient knowledge is relevant but not the priority. Metoprolol’s beta-blocker effects, which slow heart rate and lower blood pressure, pose a more immediate risk to cardiac perfusion. Education is secondary to ensuring physiological stability, making this choice less urgent.

Choice B reason: Risk for injury due to adverse effects like dizziness is a concern with metoprolol, but it is less critical than cardiac perfusion risks. Injuries from falls are secondary to the drug’s primary effect on heart function, making this choice lower priority.

Choice C reason: Metoprolol, a beta-blocker, reduces heart rate and contractility, potentially decreasing cardiac output and coronary perfusion. This poses a risk for decreased cardiac tissue perfusion, especially in patients with cardiovascular disease, making it the priority diagnosis due to its life-threatening potential.

Choice D reason: Acute confusion is a rare side effect of metoprolol and not a primary concern. Central nervous system effects are less common than cardiovascular impacts, which directly affect perfusion and are more critical, making this choice incorrect.

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Correct Answer is A

Explanation

Choice A reason: Chronic back pain from a gymnastics injury and anxiety are well-documented reasons for opioid use. Opioids alleviate physical pain by binding to mu-opioid receptors, reducing pain signals in the central nervous system. They also have anxiolytic effects, calming the amygdala and reducing anxiety, making this a likely reason for use.

Choice B reason: Witnessing parental drug or alcohol use may influence substance use behaviors through learned coping mechanisms or genetic predisposition. However, there is no evidence in the scenario confirming this history, making it less specific to the client’s situation compared to their documented pain and anxiety conditions.

Choice C reason: Opioids can induce sedation, promoting sleep, but the client’s diagnoses of chronic pain and anxiety are more directly linked to opioid use. Sleep issues are not mentioned in the scenario, making this a less likely primary reason compared to pain and anxiety management.

Choice D reason: Opioids are not used to treat hallucinations, which are unrelated to the client’s diagnoses. They also do not enhance work performance; instead, they impair cognitive function. This choice is incorrect, as it does not align with the client’s medical history or opioid use patterns.

A. I am just so sad. I cannot believe that my partner is gone B. I just cannot remember anything about the accident C. I don’t want to think or talk about what happened with anyone D. If I wasn’t such a bad person, this never would have happened

Correct Answer is C

Explanation

Choice A reason: Expressing sadness about the partner’s death reflects grief, not avoidance. Avoidance involves actively suppressing thoughts or discussions about the trauma. This statement indicates emotional processing, not avoidance, making it incorrect for identifying avoidance symptoms in this context.

Choice B reason: Inability to recall the accident may suggest dissociative amnesia, a potential trauma response, but it is not a clear avoidance symptom. Avoidance involves conscious efforts to avoid trauma-related stimuli, not memory loss, making this choice less precise than active refusal to discuss.

Choice C reason: Refusing to think or talk about the accident is a hallmark of avoidance symptoms in post-traumatic stress disorder (PTSD). This behavior reflects deliberate efforts to suppress trauma-related thoughts or conversations to reduce distress, aligning with the scenario, making this the correct choice.

Choice D reason: Blaming oneself for the accident reflects guilt or negative self-perception, common in PTSD, but is not an avoidance symptom. Avoidance involves dodging trauma-related stimuli, not internalizing blame, making this choice incorrect for identifying avoidance behaviors.

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What is the priority nursing diagnosis for a patient prescribed metoprolol (Lopressor)?

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is caring for a client who is recovering from a femur fracture sustained in a motor-vehicle crash. Their partner died in the collision. Which of the following client statements would indicate that the client is experiencing avoidance symptoms?

Correct Answer is C

Explanation

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