The nurse is assessing a patient who is receiving metoprolol 2 days after an acute coronary syndrome (ACS), Which physiological action of metoprolol supports the desired or therapeutic response?

Increases contractility.

Increases preload.

Decreases afterload.

Decreases diastolic filing time.

Answer and Explanation

The Correct Answer is C

A) Increases contractility: Metoprolol, a beta-blocker, actually decreases contractility. It reduces the force of contraction of the heart muscle, which can help reduce myocardial oxygen demand and improve outcomes after ACS. Increasing contractility would counteract the therapeutic goals of metoprolol in managing ACS.
B) Increases preload: Preload refers to the volume of blood in the ventricles at the end of diastole. Metoprolol does not increase preload; rather, it reduces myocardial workload and oxygen demand, which does not directly affect preload but rather the heart's performance overall.
C) Decreases afterload: Metoprolol reduces afterload indirectly by lowering blood pressure and decreasing heart rate, which helps reduce the workload on the heart. This reduction in afterload supports the therapeutic goals of metoprolol in managing ACS by decreasing the heart's work and improving cardiac efficiency.
D) Decreases diastolic filling time: Metoprolol slows the heart rate, which can lead to increased diastolic filling time, not a decrease. Increased filling time can be beneficial as it allows the heart more time to fill with blood between beats, thereby improving cardiac output.

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Correct Answer is A

Explanation

A) Takes metformin hydrochloride for type 2 diabetes mellitus: Metformin can interact with the contrast dye used in CT scans, particularly in patients with impaired renal function. The contrast dye can affect kidney function, potentially leading to lactic acidosis in patients taking metformin. It is important to follow up on this history and possibly temporarily discontinue metformin and monitor kidney function before and after the procedure.

B) Metal hip prosthesis was placed twenty years ago: A metal hip prosthesis does not typically affect the CT scan with contrast, though it may affect the imaging technique or quality. This history usually does not require follow-up related to the contrast use.
C) Report of client's sobriety for the last five years: Sobriety does not directly impact the use of contrast dye in a CT scan. This information is relevant for overall health but not specifically for the use of contrast.
D) CT scan that was performed six months earlier: The timing of a previous CT scan is not a contraindication for a new scan with contrast. Follow-up on the history of a prior scan may be relevant for comparison but does not specifically impact the use of contrast dye.

A. Ensure that the client eats breakfast. B. Provide a mid-afternoon snack for the client. C. Assess the client for hypoglycemia around 1500. D. Perform a glucometer reading at 1000.

Correct Answer is A

Explanation

A. Ensure that the client eats breakfast: Regular insulin is a fast-acting insulin that typically begins to work within 30 minutes to an hour after administration, peaks around 2-3 hours, and can last for up to 6 hours. Therefore, it is crucial that the client eats a meal, such as breakfast, shortly after the insulin is administered to prevent hypoglycemia.
B. Provide a mid-afternoon snack for the client: While snacks may be necessary depending on the client's overall meal and insulin schedule, it is more critical to ensure the client eats the meal immediately following insulin administration to manage blood glucose levels.
C. Assess the client for hypoglycemia around 1500: While monitoring for hypoglycemia is important, it is more critical to ensure the client eats their meal soon after insulin administration to prevent hypoglycemia in the first place.
D. Perform a glucometer reading at 1000: A glucometer reading at 1000 might be useful for monitoring blood glucose levels but ensuring that the client eats a meal promptly is a more immediate and critical action following insulin administration.

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The nurse is assessing a patient who is receiving metoprolol 2 days after an acute coronary syndrome (ACS), Which physiological action of metoprolol supports the desired or therapeutic response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Explanation

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