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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Platelet count of 100,000/mm³ (100 x 10^9/L): Enoxaparin is a low molecular weight heparin used to prevent deep vein thrombosis (DVT), and a low platelet count (thrombocytopenia) can be a serious adverse effect of anticoagulant therapy. A platelet count of 100,000/mm³ is below the normal range (150,000 to 400,000/mm³) and indicates potential thrombocytopenia, which could increase the risk of bleeding and may warrant immediate action.
B. Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L): This BUN level is at the upper limit of normal but does not typically require immediate action unless there are other symptoms or significant changes in kidney function.
C. Serum creatinine 1.0 mg/dL (88.4 μmol/L): This value is within the normal range for serum creatinine and does not indicate an immediate concern related to enoxaparin.
D. Hematocrit 45% (0.45 volume fraction): This hematocrit level is within the normal range and does not typically require immediate action.
Correct Answer is B
Explanation
A. Obtain a platelet count weekly: Regular monitoring of platelet counts is important for clients on methotrexate due to the risk of bone marrow suppression and potential thrombocytopenia. This instruction is appropriate and necessary.
B. Take the medication during pregnancy: Methotrexate is contraindicated during pregnancy due to its teratogenic effects and potential to cause fetal harm. It is crucial for clients to avoid using methotrexate while pregnant or planning to become pregnant.
C. Use folic acid to protect the liver: While folic acid is often used to help reduce the side effects of methotrexate, particularly its gastrointestinal effects and potential for liver toxicity, it is not used to "protect the liver" per se. The correct approach is to use folic acid as directed by a healthcare provider, often to mitigate some of the side effects of methotrexate.
D. Store the medication at room temperature: Methotrexate should be stored according to the manufacturer's instructions, which usually involve keeping it at room temperature. This information is correct and does not require additional instruction.
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