A nurse is discussing with a client who knows someone taking metoprolol for blood pressure management. The client inquires whether metoprolol would be suitable for her as well. Based on the client's medical record, which of the following should the nurse recognize as a contraindication to metoprolol?

Recently treated bilateral pneumonia

A concurrent prescription for tadalafil

Diet-controlled diabetes mellitus Type 2

A history of sinus bradycardia

Answer and Explanation

The Correct Answer is D

Choice A reason : Recently treated bilateral pneumonia is not a contraindication to metoprolol. Metoprolol is a beta-blocker used primarily for the management of hypertension and is not affected by a history of pneumonia.

Choice B reason : While tadalafil is known to interact with medications that lower blood pressure, it is not a direct contraindication to metoprolol. However, caution is advised when they are used concurrently due to the potential for additive blood pressure-lowering effects.

Choice C reason : Diabetes mellitus Type 2, especially when diet-controlled, is not a contraindication to metoprolol. Beta-blockers like metoprolol can mask hypoglycemic symptoms, so patients with diabetes should be monitored closely, but it does not preclude the use of the medication.

Choice D reason : A history of sinus bradycardia is a contraindication to metoprolol. Metoprolol can exacerbate bradycardia, leading to hemodynamic instability and is therefore contraindicated in patients with a history of significant bradycardia.

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Correct Answer is C

Explanation

Choice A reason : A low sodium diet is often prescribed for patients with heart conditions to help manage blood pressure and fluid retention. It is not typically something that would need to be questioned in the context of recent pacemaker surgery.

Choice B reason : Checking serum cardiac enzyme levels is a common practice after heart surgery to monitor for any signs of damage to the heart muscle. This would not typically be questioned unless there were specific contraindications for the patient.

Choice C reason : An MRI of the chest should be questioned because MRI machines use strong magnetic fields that can interfere with the functioning of a pacemaker. Unless the pacemaker is specifically labeled as MRI-safe, this type of imaging could be dangerous for the patient.

Choice D reason : Physical therapy is a standard part of recovery after many types of surgery, including pacemaker insertion, to help the patient regain strength and mobility. It would not typically be questioned unless the patient had specific restrictions.

A. Your cholesterol levels should be monitored monthly while taking this medication. B. Notify your doctor immediately if you become pregnant. C. Make sure your diet contains a lot of potassium-rich foods. D. Report the development of a persistent dry cough. E. Monitor blood pressure.

Correct Answer is ["B","D","E"]

Explanation

Choice A reason: Monitoring cholesterol levels is essential while taking lisinopril. This medication is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure, heart failure, and heart attack. Regular monitoring helps assess the impact of lisinopril on lipid levels and overall cardiovascular health. Elevated cholesterol can contribute to heart disease, so monitoring allows for timely interventions and adjustments in treatment.

Choice C reason: Potassium-rich foods are relevant because lisinopril can affect potassium levels. ACE inhibitors may lead to hyperkalemia (high potassium levels), especially in patients with impaired kidney function. Encouraging potassium-rich foods helps maintain a balance and prevent complications.

Choice D reason: Reporting a persistent dry cough is crucial. Lisinopril is associated with a common side effect: a dry, persistent cough. This occurs due to increased levels of bradykinin, a substance affected by ACE inhibitors. If the client experiences this cough, it's essential to notify the doctor for potential medication adjustments.

Choice E reason: Monitoring blood pressure aligns with the purpose of lisinopril. Regular blood pressure checks help assess the effectiveness of the medication in controlling hypertension. Consistent monitoring ensures timely adjustments and prevents complications related to high blood pressure.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who recently had surgery for the insertion of a permanent pacemaker. Which of the following prescriptions should the nurse question?

Correct Answer is C

Explanation

A nurse is reinforcing teaching with a young adult female client who has been prescribed lisinopril. Which of the following instructions should the nurse plan to include? (Select all that apply)

Correct Answer is ["B","D","E"]

Explanation

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