A patient is prescribed metoprolol in the treatment of stable angina.
What is the best outcome measure of decreased cardiac workload due to metoprolol for the nurse to evaluate?
Patient's heart rate is 62 and regular.
Patient is able to lie flat without reporting difficulty breathing.
Patient does not report dyspnea after climbing one flight of stairs.
Patient has weight loss of 3 lbs (1.4 kg) over 2 weeks.
The Correct Answer is A
Choice A rationale
Metoprolol decreases cardiac workload by reducing heart rate and myocardial oxygen demand. A heart rate of 62 is within normal limits, demonstrating effective beta-blocker action and improved cardiac efficiency.
Choice B rationale
Lying flat without difficulty breathing reflects improved respiratory status, which is more related to pulmonary management, not directly indicative of reduced cardiac workload or beta-blocker efficacy.
Choice C rationale
Absence of dyspnea after climbing stairs suggests improved physical fitness but does not directly measure the cardiac effects of metoprolol, which targets heart rate reduction and myocardial oxygen use.
Choice D rationale
Weight loss is related to overall health improvement or dietary changes rather than specific effects of metoprolol, which primarily impacts heart rate and cardiac oxygen consumption.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Cervical spinal cord injuries at or above C3 disrupt the phrenic nerve, impairing diaphragm control, leading to respiratory failure. Mechanical ventilation compensates for the loss of neural signals required for effective breathing.
Choice B rationale
Unconsciousness alone does not necessitate ventilation unless breathing is compromised. Here, respiratory failure stems from cervical nerve injury, not loss of consciousness, requiring mechanical support.
Choice C rationale
The lungs themselves are not damaged in cervical spinal cord injuries; the issue lies in disrupted nerve signals needed for diaphragm and respiratory muscle function, necessitating ventilatory assistance.
Choice D rationale
Smoking history does not explain the acute respiratory failure caused by cervical spinal cord injuries. The need for ventilation directly results from damage to the neural control of respiratory muscles.
Correct Answer is C
Explanation
Choice A rationale
IV fluid bolus may address hypotension but is not the first priority. Symptoms of dizziness and diaphoresis in a spinal cord injury patient suggest autonomic dysreflexia or orthostatic hypotension requiring positional changes first.
Choice B rationale
Rescheduling therapy does not address the acute symptoms the patient is experiencing. Immediate action to manage dizziness and diaphoresis, such as altering body position, is required to stabilize the patient.
Choice C rationale
Lowering the head of the bed counters orthostatic hypotension, a common issue in spinal cord injury patients. Obtaining vital signs identifies the underlying cause and guides further interventions.
Choice D rationale
Bladder distention can trigger autonomic dysreflexia, but without evidence of urinary retention, prioritizing positional adjustments is more urgent to alleviate symptoms of dizziness and stabilize hemodynamics.
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