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 B
Explanation
A. Expresses that they cannot get enough air to breathe: While this is concerning, it is less specific than a respiratory rate finding for opioid overdose.
B. Respiratory rate of 7 breaths/minute: This indicates severe respiratory depression, a critical sign of opioid overdose, which necessitates immediate administration of naloxone.
C. Intercostal retractions and bilateral wheezing on auscultation: These signs suggest respiratory distress but do not directly indicate an opioid overdose.
D. Pulse oximeter reading of 89% on room air: While low, this reading does not specifically indicate opioid overdose unless accompanied by respiratory depression.
Correct Answer is D
Explanation
A. Affirm the decision to use the medication when the symptoms start to worsen: Waiting to start rivastigmine until symptoms worsen may not be the best approach, as early intervention can be more beneficial in managing symptoms and slowing disease progression.
B. Assess the client’s current mental status before deciding to support the decision: While assessing the client's mental status is important, the immediate concern is to educate on the timing of medication use rather than evaluating the current state of the client.
C. Confirm that the daughter is aware of the progressive nature of the disease: It is important for the daughter to understand the progressive nature of Alzheimer's disease, but this does not directly address the timing for starting rivastigmine.
D. Explain that the drug should be used early in the course of the disease process: Rivastigmine, a cholinesterase inhibitor, is most effective when started early in the course of Alzheimer's disease. Early use can help manage symptoms more effectively and potentially delay progression.
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