A patient has an order for metoprolol. Prior to medication administration, what does the nurse need to assess?

Correct Answer: C

Rationale: Metoprolol, a beta-blocker, can cause bradycardia. The nurse must assess the patient’s heart rate before administration to ensure it is within a safe range (typically >60 beats/minute). Respirations (A), temperature (B), and oxygen saturation (D) are less critical for metoprolol administration.

Correct Answer: B

Rationale: The therapeutic range for digoxin levels is typically considered to be between 0.5 to 2.0 ng/mL for patients with heart failure. A digoxin level of 1.1 ng/mL falls within this range, indicating that the patient's digoxin level is appropriate for therapeutic effects. This level suggests that the patient is receiving an appropriate dose of digoxin to achieve the desired therapeutic response without reaching toxic levels.

Correct Answer: A

Rationale: Warfarin is an anticoagulant medication that works by inhibiting the production of certain clotting factors in the liver, specifically factors II, VII, IX, and X. By doing so, warfarin prevents the formation of new blood clots. It does not have the ability to dissolve existing blood clots, as that function is typically carried out by different types of medications known as thrombolytics. Warfarin is commonly prescribed to prevent and treat blood clots in conditions such as atrial fibrillation, deep vein thrombosis, and pulmonary embolism.

Correct Answer: A

Rationale: Mefloquine is an antimalarial drug that can cause hepatotoxicity, so liver enzyme tests are often ordered to monitor for liver damage. Blood glucose, sputum culture, and white blood cell count are not directly related to mefloquine use.

Correct Answer: B

Rationale: The first pass effect refers to the metabolism of a drug as it passes through the liver before reaching the systemic circulation. When a drug is absorbed from the gut lumen, it first enters the portal circulation where it is transported to the liver. In the liver, the drug may undergo metabolic processes that can reduce the amount of active drug reaching systemic circulation. This process can greatly affect the overall bioavailability and effectiveness of the drug. So, the metabolism of the drug en route from the gut lumen to the systemic circulation is primarily due to the first pass effect.