A nurse is assessing a client who has heart failure and is receiving metoprolol. Which of the following statements by the client indicates a therapeutic effect of the medication?
“I have less swelling in my ankles.”
“I can walk farther without getting tired.”
“I don’t have chest pain anymore.”
“I can breathe better at night.”.
The Correct Answer is B
The correct answer is choice B. “I can walk farther without getting tired.” This statement indicates a therapeutic effect of metoprolol, which is a beta-blocker that reduces the heart rate, blood pressure, and the workload of the heart. This helps to improve the blood flow and oxygen delivery to the heart and other organs, and reduces the symptoms of heart failure such as fatigue, dyspnea, and edema.
Choice A is wrong because “I have less swelling in my ankles.” This statement indicates a possible effect of a diuretic, which is a medication that reduces fluid retention and edema by increasing urine output. Metoprolol does not have a direct diuretic effect, although it may indirectly reduce fluid accumulation by improving cardiac function.
Choice C is wrong because “I don’t have chest pain anymore.” This statement indicates a possible effect of a nitrate, which is a medication that dilates the blood vessels and reduces the oxygen demand of the heart. Metoprolol may also help to prevent or treat angina by lowering the heart rate and blood pressure, but it is not the primary medication for chest pain relief.
Choice D is wrong because “I can breathe better at night.” This statement indicates a possible effect of an oxygen therapy, which is a treatment that delivers supplemental oxygen to the lungs and improves gas exchange. Metoprolol may also help to reduce dyspnea by improving cardiac function and reducing pulmonary congestion, but it is not the primary treatment for respiratory distress.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Mannitol is an osmotic diuretic that increases urine output and decreases intracranial pressure and intraocular pressure. The nurse should check the urine output before giving the medication to ensure adequate renal function and prevent fluid overload and electrolyte imbalance. The normal urine output is 0.5 to 1 mL/kg/hr.
Choice B is wrong because checking the blood pressure is not specific to mannitol administration. Mannitol can cause hypotension or hypertension depending on the fluid status of the client, but this is not the priority action before giving the medication.
Choice C is wrong because checking the blood glucose is not relevant to mannitol administration. Mannitol does not affect blood glucose levels.
Choice D is wrong because checking the oxygen saturation is not related to mannitol administration. Mannitol does not affect oxygen saturation levels.
Correct Answer is A
Explanation
The nurse should monitor the serum potassium level to determine the therapeutic effectiveness of carvedilol (Coreg), which is a beta-blocker that can lower the heart rate and blood pressure. Carvedilol can also cause hyperkalemia, which is a high level of potassium in the blood that can lead to cardiac arrhythmias and muscle weakness.Therefore, the nurse should monitor the serum potassium level and report any values above 5.0 mEq/L to the provider.
Choice B) Serum sodium level is wrong because carvedilol does not affect the sodium level significantly.Sodium level is more relevant for diuretics, which can cause hyponatremia (low sodium) or hypernatremia (high sodium) depending on the type and dose of the medication.
Choice C) Serum magnesium level is wrong because carvedilol does not affect the magnesium level significantly.
Magnesium level is more relevant for digoxin, which is another medication used for heart failure that can cause hypomagnesemia (low magnesium) or hypermagnesemia (high magnesium).Hypomagnesemia can increase the risk of digoxin toxicity, while hypermagnesemia can decrease the effectiveness of digoxin.
Choice D) Serum calcium level is wrong because carvedilol does not affect the calcium level significantly.
Calcium level is more relevant for calcium channel blockers, which are another class of medications used for heart failure that can lower the heart rate and blood pressure by blocking the entry of calcium into the cardiac and vascular smooth muscle cells.
Calcium channel blockers can cause hypocalcemia (low calcium) or hypercalcemia (high calcium), which can affect the cardiac contractility and conduction.
The normal ranges for serum electrolytes are:
• Potassium: 3.5 to 5.0 mEq/L
• Sodium: 135 to 145 mEq/L
• Magnesium: 1.5 to 2.5 mEq/L
• Calcium: 8.5 to 10.5 mg/dL
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