# Which teaching points should the nurse include? Select all that apply. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=556545&lang=en > language: en > subject: Adverse Effects/Contraindications/Interactions > category: PPT ## Question Which teaching points should the nurse include? Select all that apply. 1 If the pulse is below the prescriber's hold parameter or dizziness occurs, withhold the dose and contact the clinical team as directed. 2 Beta blockers can mask adrenergic warning symptoms; monitor glucose and remember that sweating can still occur. 3 When chest pain has been absent for a week, taper the medication over two days without a new prescription. 4 Ask a pharmacist or prescriber before using a decongestant that can increase heart rate or blood pressure. 5 Do not stop metoprolol abruptly because ischemia or angina can worsen; any taper should be clinician directed. 6 Take an extra dose before exercise whenever the heart rate is above the client's resting value. ## Explanation Metoprolol requires clinician-directed dosing and tapering. Clients with diabetes need careful glucose monitoring because some adrenergic hypoglycemia cues may be masked, and over-the-counter decongestants should be reviewed before use. ## In-depth explanation Correct Answer Choices 1, 2, 4, 5 Clinical Reasoning Metoprolol requires clinician-directed dosing and tapering. Clients with diabetes need careful glucose monitoring because some adrenergic hypoglycemia cues may be masked, and over-the-counter decongestants should be reviewed before use. Option Review - Correct — Hold parameters and symptoms require the prescribed plan; the item does not supply the client's actual parameter, so the nurse should not invent one. - Correct — Beta blockade can mask some hypoglycemia warnings, making glucose monitoring and alternate symptoms important. - Incorrect — The client should not create a taper or stop therapy based on short symptom-free periods. - Correct — Sympathomimetic decongestants may oppose cardiovascular goals and require review. - Correct — Abrupt withdrawal can exacerbate angina and ischemia. - Incorrect — Exercise-related heart-rate increase is not an indication for an unscheduled extra dose. Sources 12026 NCLEX-RN Test Plan 2DailyMed: Metoprolol tartrate ## Clinical scenario A client with stable angina and type 2 diabetes is prescribed metoprolol tartrate. The client also uses over-the-counter cold products during allergy season. ## Related questions - [A client is admitted to the emergency department after ingesting an unknown amount of acet…](https://mymerci.kr/pages/nclex_q.php?qn_id=362720&lang=en) - [A client with chronic heart failure is prescribed metoprolol 25 mg orally twice daily. Bef…](https://mymerci.kr/pages/nclex_q.php?qn_id=362756&lang=en) - [A 28-year-old client with type 1 diabetes receives regular insulin 6 units and NPH insulin…](https://mymerci.kr/pages/nclex_q.php?qn_id=362792&lang=en) - [A client receives IV vancomycin 1 g every 12 hours for MRSA bacteremia. Before the next do…](https://mymerci.kr/pages/nclex_q.php?qn_id=362833&lang=en) - [A client with bipolar disorder has been taking lithium carbonate 600 mg orally three times…](https://mymerci.kr/pages/nclex_q.php?qn_id=362894&lang=en) - [A nurse is monitoring a client receiving a continuous IV heparin infusion for pulmonary em…](https://mymerci.kr/pages/nclex_q.php?qn_id=363988&lang=en) - [A nurse is preparing to initiate a weight-based continuous IV unfractionated heparin infus…](https://mymerci.kr/pages/nclex_q.php?qn_id=364107&lang=en) - [A nurse is providing discharge teaching to a 65-year-old client newly prescribed warfarin …](https://mymerci.kr/pages/nclex_q.php?qn_id=364872&lang=en) ## Read in another language - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=556545&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=556545&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=556545&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=556545&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=556545&lang=vi) --- More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en) _For study reference only. Always follow current clinical guidelines and your institution’s protocols._