Abrams' Clinical Drug Therapy
Rationales for Nursing Practice
13th Edition
• Author(s)Geralyn Frandsen;
Sandra Pennington
TEST BANK
,Question 1
A nurse is preparing to administer an initial dose of a newly
prescribed beta-blocker to a client with hypertension. Which
assessment finding requires the nurse to withhold the
medication and immediately notify the healthcare provider?
A. Blood pressure of 142/88 mmHg B. Heart rate of 54 beats per
minute C. Respiratory rate of 18 breaths per minute D. Serum
potassium level of 4.2 mEq/L
Correct Answer: B
Rationale: Beta-blockers (beta-adrenergic antagonists) decrease
heart rate, myocardial contractility, and conduction velocity
through the AV node. A heart rate below 60 beats per minute
constitutes bradycardia. Administering a beta-blocker to a client
who is already bradycardic could lead to severe hypotension,
heart block, or cardiac arrest. A blood pressure of 142/88
mmHg is an expected indication for the drug. The respiratory
rate and potassium levels are within normal limits and do not
contraindicate beta-blocker administration.
Question 2
A client diagnosed with chronic open-angle glaucoma is
prescribed timolol ophthalmic drops. The nurse teaches the
client how to administer the drops to minimize systemic
,absorption. Which action should the nurse instruct the client to
perform?
A. Blink rapidly for 30 seconds immediately after instilling the
drops. B. Apply gentle pressure to the lacrimal sac for 1 to 2
minutes after instillation. C. Keep the eyes tightly closed for 5
minutes following administration. D. Wipe the excess
medication from the outer canthus inward toward the nose.
Correct Answer: B
Rationale: Applying digital pressure to the lacrimal sac
(nasolacrimal occlusion) for 1 to 2 minutes after instilling eye
drops prevents the medication from running into the
nasolacrimal duct, where it could be absorbed systemically
through the nasal mucosa. Systemic absorption of a beta-
blocker like timolol can cause adverse cardiovascular and
respiratory effects. Blinking rapidly increases drug clearance via
the tear duct. Tightly closing the eyes or wiping inward can
express the medication or introduce contaminants.
Question 3
A client with a history of severe asthma is admitted for
management of cardiac dysrhythmias. The healthcare provider
prescribes a nonselective beta-adrenergic blocker. The nurse
should monitor the client closely for which priority adverse
effect?
, A. Hypoglycemia B. Bronchospasm C. Peripheral edema D.
Hyperthermia
Correct Answer: B
Rationale: Nonselective beta-blockers block both beta1
receptors (located primarily in the heart) and beta2 receptors
(located primarily in the lungs). Blocking beta2 receptors
induces bronchoconstriction and can precipitate life-
threatening bronchospasm or status asthmaticus in clients with
a history of asthma or chronic obstructive pulmonary disease
(COPD). While nonselective beta-blockers can mask symptoms
of hypoglycemia, bronchospasm represents an acute, life-
threatening respiratory emergency that takes priority.
Question 4
A nurse is providing discharge education to a client who has
been prescribed metoprolol for the management of angina
pectoris. Which instruction is most critical for the nurse to
include to ensure client safety?
A. "Take this medication with a high-protein meal to enhance
absorption." B. "Stop taking this medication immediately if you
experience dizziness." C. "Do not abruptly discontinue this
medication; always taper it off under your doctor's guidance."
D. "Monitor your weight daily and report any gain of more than
1 pound in a week."
Rationales for Nursing Practice
13th Edition
• Author(s)Geralyn Frandsen;
Sandra Pennington
TEST BANK
,Question 1
A nurse is preparing to administer an initial dose of a newly
prescribed beta-blocker to a client with hypertension. Which
assessment finding requires the nurse to withhold the
medication and immediately notify the healthcare provider?
A. Blood pressure of 142/88 mmHg B. Heart rate of 54 beats per
minute C. Respiratory rate of 18 breaths per minute D. Serum
potassium level of 4.2 mEq/L
Correct Answer: B
Rationale: Beta-blockers (beta-adrenergic antagonists) decrease
heart rate, myocardial contractility, and conduction velocity
through the AV node. A heart rate below 60 beats per minute
constitutes bradycardia. Administering a beta-blocker to a client
who is already bradycardic could lead to severe hypotension,
heart block, or cardiac arrest. A blood pressure of 142/88
mmHg is an expected indication for the drug. The respiratory
rate and potassium levels are within normal limits and do not
contraindicate beta-blocker administration.
Question 2
A client diagnosed with chronic open-angle glaucoma is
prescribed timolol ophthalmic drops. The nurse teaches the
client how to administer the drops to minimize systemic
,absorption. Which action should the nurse instruct the client to
perform?
A. Blink rapidly for 30 seconds immediately after instilling the
drops. B. Apply gentle pressure to the lacrimal sac for 1 to 2
minutes after instillation. C. Keep the eyes tightly closed for 5
minutes following administration. D. Wipe the excess
medication from the outer canthus inward toward the nose.
Correct Answer: B
Rationale: Applying digital pressure to the lacrimal sac
(nasolacrimal occlusion) for 1 to 2 minutes after instilling eye
drops prevents the medication from running into the
nasolacrimal duct, where it could be absorbed systemically
through the nasal mucosa. Systemic absorption of a beta-
blocker like timolol can cause adverse cardiovascular and
respiratory effects. Blinking rapidly increases drug clearance via
the tear duct. Tightly closing the eyes or wiping inward can
express the medication or introduce contaminants.
Question 3
A client with a history of severe asthma is admitted for
management of cardiac dysrhythmias. The healthcare provider
prescribes a nonselective beta-adrenergic blocker. The nurse
should monitor the client closely for which priority adverse
effect?
, A. Hypoglycemia B. Bronchospasm C. Peripheral edema D.
Hyperthermia
Correct Answer: B
Rationale: Nonselective beta-blockers block both beta1
receptors (located primarily in the heart) and beta2 receptors
(located primarily in the lungs). Blocking beta2 receptors
induces bronchoconstriction and can precipitate life-
threatening bronchospasm or status asthmaticus in clients with
a history of asthma or chronic obstructive pulmonary disease
(COPD). While nonselective beta-blockers can mask symptoms
of hypoglycemia, bronchospasm represents an acute, life-
threatening respiratory emergency that takes priority.
Question 4
A nurse is providing discharge education to a client who has
been prescribed metoprolol for the management of angina
pectoris. Which instruction is most critical for the nurse to
include to ensure client safety?
A. "Take this medication with a high-protein meal to enhance
absorption." B. "Stop taking this medication immediately if you
experience dizziness." C. "Do not abruptly discontinue this
medication; always taper it off under your doctor's guidance."
D. "Monitor your weight daily and report any gain of more than
1 pound in a week."
