A nurse is caring for a client who has a prescription for metoprolol. The nurse measures the client's vital signs and notes that the client's apical heart rate is 49/min. The nurse should prepare to administer which of the following medications?

Diltiazem

Atropine

Digoxin

Carvedilol

Answer and Explanation

The Correct Answer is B

A. Diltiazem: Diltiazem is a calcium channel blocker used to treat high blood pressure and heart rhythm disorders. However, it can further lower the heart rate, which is not desirable in this case as the client’s heart rate is already low.

B. Atropine: This is correct. Atropine is often used to treat bradycardia (low heart rate). It works by blocking the action of the vagus nerve on the heart, which increases the heart rate.

C. Digoxin: Digoxin is used to treat heart failure and atrial fibrillation1. However, one of its side effects is that it can lower the heart rate, so it would not be appropriate to give to a client who already has a low heart rate.

D. Carvedilol: Carvedilol is a beta-blocker used to treat high blood pressure and heart failure1. Like other beta-blockers, it can lower the heart rate, so it would not be appropriate to give to a client who already has a low heart rate.

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Correct Answer is D

Explanation

(A) Respiratory acidosis: Respiratory acidosis is characterized by a low pH (<7.35) and a high PaCO2 (>45 mm Hg). In this case, the client’s pH is high and PaCO2 is normal, which rules out respiratory acidosis.

(B) Respiratory alkalosis: Respiratory alkalosis is characterized by a high pH (>7.45) and a low PaCO2 (<35 mm Hg). Although the client’s pH is high, the PaCO2 is normal, which rules out respiratory alkalosis.

(C) Metabolic acidosis: Metabolic acidosis is characterized by a low pH (<7.35) and a low bicarbonate level (<22 mEq/L). The client’s pH and bicarbonate levels are both high, which rules out metabolic acidosis.

(D) Metabolic alkalosis: Metabolic alkalosis is characterized by a high pH (>7.45) and a high bicarbonate level (>26 mEq/L). The client’s pH is 7.6 and bicarbonate level is 32 mEq/L, both of which are higher than normal. This indicates metabolic alkalosis. Therefore, the nurse should identify that the client is experiencing metabolic alkalosis.

A. A 14-month-old toddler who is reportedly learning to walk and has several bruises on bony prominences of the lower legs and elbows. B. A9-month-old infant who sustained near drowning when he reportedly climbed into the tub and turned on the water C. A3-year-old toddler with scalding burns over the face and chest reportedly sustained when the child pulled on tablecloth, spilling a cup of tea on himself. D. A 6-year-old child who has a spiral fracture of the tibia and fibula, which reportedly occurred while riding a bicycle

Correct Answer is D

Explanation

A. A 14-month-old toddler with bruises on bony prominences:

Bruises on bony prominences are common in toddlers who are learning to walk and are prone to falls. While bruising can raise concerns, it is not necessarily indicative of physical abuse, especially in this age group.

B. A 9-month-old infant who sustained near drowning:

Near drowning in an infant who climbed into the tub and turned on the water suggests an accidental event rather than physical abuse. This scenario is consistent with lack of supervision or an unfortunate accident.

C. A 3-year-old toddler with scalding burns:

Scalding burns from spilling hot tea on oneself can occur accidentally, especially in young children who may not understand the dangers associated with hot liquids. While the circumstances may raise suspicion, it does not necessarily indicate physical abuse without further evidence.

D. A 6-year-old child with a spiral fracture:

A spiral fracture of the tibia and fibula is concerning for physical abuse, especially in a child who reportedly sustained the injury while riding a bicycle. Spiral fractures are often associated with twisting or pulling forces and are considered suspicious for non-accidental trauma, particularly when there is no plausible explanation for the injury.

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A nurse is caring for a client who has a prescription for metoprolol. The nurse measures the client's vital signs and notes that the client's apical heart rate is 49/min. The nurse should prepare to administer which of the following medications?

Nursing Test Bank

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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